NEW TREATMENT FOR ONYCHOMYCOSIS WITH A FRACTIONAL CARBON-DIOXIDE LASER
Onychomycosis is a common fungal infection of the nails and it affects approximately 2.8% of the population.
More than just a cosmetic concern, onychomycosis can lead to infections of the toes and become particularly disturbing.
Traditionally, the treatment of onychomycosis is conducted using systemic and topical antifungal medication, which usually have low to moderate efficacy. It may also be related to adverse events and drug interactions, which limit its use for many patients
Even when pharmacotherapy initially results in a mycological cure, the relapse and/or re-infection rate ranges from 16 to 25%.
Many individuals have sustained infections persisting for months or even years and, hence, they may not be motivated to initiate or complete therapy due to a perception that their condition cannot be treated.
Successful treatment for onychomycosis requires antifungal drugs to penetrate the nail plate and nail bed, but incomplete dissemination to the lesion is a problem for both oral and topical agents.
New treatment with the use of fractional CO2 Laser
Onychomycosis is a common problem and it seems to affect significantly patients’ quality of life. Therefore, it is of utmost importance to specify the best treatment regimen for its management. Patients in many occasions cannot find a solution in traditional systemic treatments that are available, they do not tolerate pharmacological treatment and/or develop adverse events due to medication intake.
Lasers have become a popular option in the treatment of onychomycosis. One of the most important characteristics of Laser treatment is its ability for selective administration of energy on the target tissue, making it extremely effective. Apart from this, it prevents the development of adverse events as well as the possibility of drug-drug interactions
Fractional carbon dioxide Laser (CO2) is one of the most effective Laser systems. It has been developed in such a way so that to use fractional laser technology aiming at maximising its effectiveness and minimising side effects.
More specifically, this laser creates multiple columns of destruction in the tissues, called “microscopic treatment zones”. The creation of these therapeutic zones in the dermis enhances the penetration of topically applied anti-fungal agents from the nail plate in the nail bed and matrix, thus enhancing treatment effectiveness.
In a very recent research study that was conducted in USA both the effectiveness and the safety of fractional CO2 Laser were demonstrated. In particular, the combination of this Laser device and a topically applied anti-fungal agent may be used in patients for whom systemic antifungal agents are contraindicated or in cases where the use of systemic antifungal agents is ineffective.
In addition to this, the use of fractional CO2 Laser is quite easy as treatment method for patients with onychomycosis and it is well tolerated, especially if some anaesthetic cream is topically applied before treatment initiation.
The duration of fractional CO2 Laser treatment and topically applied anti-fungal agent is examined on a case-by-case basis. Usually 3 treatment sessions should be conducted every 4 weeks. Moreover, topical application of amorolfin is also used once a day immediately after Laser treatment.
In a few words…
Treatment of onychomycosis is a challenge and in many cases it is particularly difficult and it is associated with high rates of disease persistence and relapse.
Treatment using the fractional CO2 Laser in combination with topically applied anti-fungal cream is a promising treatment choice for the management of onychomycosis:
Selective administration of energy on target tissue
Shorter treatment duration
- Safe and well tolerated by the patients:
Avoidance of side effects and interactions between orally administered medication