Toenail fungus and laser treatments

Toenail fungus is one of the most common types of fungal infections out there, affecting millions of people from all over the world. It represents a particularly difficult infection to treat, especially since it has a high rate of reoccurrence. Unfortunately, the oral anti-fungal medication can lead to discomforting side-effects, while topical agents are not effective in all cases. In such situations, it makes sense for medical specialists to turn towards other types of treatments. The laser treatment seems to be a promising alternative to oral anti-fungal medication and topical agents. Let us find out more information on the subject.

Laser treatments, innovative solution for toenail fungus

Laser therapies have only recently started to be considered as suitable for the treatment of toenail fungus. Today, they are used for fungal infections, which have failed to respond to other types of treatments (oral, topical etc.). Regardless of the type of laser being used, the principle is the same, meaning that the laser will emit a high dose of light energy. This is automatically transported into heat, which will target the infected nail(s).

At the moment, there are a number of lasers approved for the treatment of such infections, meaning the Nd: YAG laser, diode laser and the Ti: Sapphire mode-locked laser. Studies have also been realized, in order to determine how efficient laser treatments actually are on toenail fungus. It was revealed that the laser treatment can either lead to an improvement in the appearance of the nail or even cure the condition altogether. In general, a couple of sessions are required, in order for the toenail fungal infection to be properly addressed.

What do studies have to say about the usage of lasers in the treatment of toenail fungal infections?

According to a study[1] undertaken in 2014 and published in the Journal of Foot and Ankle Research, laser technology has started to be recently considered for the treatment of such infections. This was because medical specialists needed an alternative to systemic and topical medication, given the disadvantages associated with such types of treatment. The laser treatment was perceived as a rapid and highly-efficient solution, especially for stubborn or reoccurring toenail fungal infections.

The study also drew attention to the fact that many of the oral antifungal drugs are actually contraindicated in patients who suffer from chronic liver disease. Moreover, the topical treatments rarely manage to eliminate the fungal infection altogether, which renders them as ineffective. In such situations, the laser treatment appears as a solution, which is both safe and effective.

In another study[2], undertaken in 2012 and published in the Skin Therapy Letter, it was revealed that there are a number of lasers approved for the treatment of onychomycosis. According to the authors of the study, the laser treatment for fungal infections is based on the selective photothermolysis principle. This means that the light energy emitted by the laser is absorbed by the fungi; these are sensitive to the heat, being eventually destroyed. So, it is safe to assume that the laser has fungicidal effects.

Nd: YAG laser, a common choice for the treatment of toenail fungus

The Nd: YAG laser is one of the approved types of lasers for the treatment of toenail fungus. The treatment concerns not only the affected nail but also the nail folds (infected tissue). You will be happy to know that the laser treatment is virtually painless, in many situations being accompanied by a cooling system, for the added comfort of the patient.

The main idea behind the usage of lasers for the treatment of toenail infections is that the cell structure of the fungi is weakened. The treatment has the advantage of being fast and easy, without any long-term side-effects. Moreover, as opposed to oral medication, it does not have contraindications for those who suffer from chronic liver disease. In the situation that the nails are too thick for the laser treatment, the doctor will pre-treat these. In this way, the penetration of the laser light is achieved and the success of the treatment guaranteed.

The laser treatment, a three-step process

If you are considering such kinds of treatment, you should know that the process involves three main steps. First, the doctor will file down the nail; this is because the nails affected by fungal infections become thick, with the passing of time. Once the infected nail is filed down, the laser light will be able to better penetrate the respective tissues.

For the next step, the laser will be applied at the level of the affected nail, following a circular pattern. As it was already mentioned above, it will cover not only the nail but also the nail folds. At this point, you might experience a heating sensation and minimal discomfort (if the laser is accompanied by a cooling system, these are not going to be present). The third step involves the targeted application of the laser, in the part of the nail which is more severely affected by the fungal infection. In general, there are between one and four sessions required, at intervals of one week.

Things to remember about the laser treatment

It is important to understand that all infected nails require treatment, especially since the fungus can be easily transmitted from one another. The laser treatment can be efficient on infected skin folds as well.

Before signing up for such kinds of treatment, you might want to check your insurance coverage. Unfortunately, these types of treatments are rarely covered by insurance and they tend to be pricey.

While the laser treatment can be highly efficient in treating the toenail fungus, you will still have to wait for the nail to grow out. Moreover, you might have to repeat the treatment, in case of a stubborn infection. And, as with other treatments, the risk of reoccurrence is present at all points.

Final word

The laser therapy is an excellent choice for the treatment of toenail fungus, especially in people who cannot take oral anti-fungal medication or in those who suffer from stubborn infections, with the topical agents failing to serve their purpose. It does not have contraindications, it can treat both the nail and the skin folds and it is definitely a minimally-invasive procedure.


[1] The effectiveness of lasers in the treatment of onychomycosis: a systematic review, 2014, Journal of Foot and Ankle Research. Link:
[2] Device-based therapies for onychomycosis treatment, 2012, Skin Therapy Letter. Link:

About the Author Amanda Powell

Amanda has struggled with plantar fasciitis for many years until she gathered enough knowledge to manage the symptoms and rid herself of all the problems. As there are too few sources for foot health issues, she has decided to help others with her knowledge about this and other foot conditions.

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