About Laser Toenail Fungus Treatments

Dr. María del Pilar Martín Santiago.Canary Islands. Tenerife.
Spain
European Master Degree in Laser Applications
About Laser Toenail Fungus Treatments
We use state of the art laser equipment to provide laser fingernail and toenail
fungus treatment, cure athlete's foot, calluses, warts, foot neurinome, foot
fascitis, metacarpe disorders with pain and ingrown toenails in our clinic in
Canary Islands, Tenerife, Dra. María del Pilar Martín Santiago. We use Er,Cr:
YSGG laser and Diodes laser from Biolase company for fungus treatment.
Podiatrists and doctors have been performing laser toenail fungus treatment
with different equipment for years. Some podiatrists have been claiming to see
results anecdotaly using CO2 lasers since the 1980s. However a number of
companies have been doing studies with lasers in specific spectrums. These
studies on laser toenail fungus treatment include using spectrums in infrared
light, red visible light and near infrared Light.
The target is toenail fungus — an infection in an estimated 10 percent of

American adults, or 23 million people — that causes toenails to become thick,
yellow and fetid. In all the World the infection is estimated in 10-15%.
Onychomycosis and tinea unguium, nail fungal infections are the most common
diseases of the nails, making up about 50% of nail abnormalities More frequent
in foot for humidity, a good condition for fungus. Also is frequent in hand when
the people have onychophagia . Is more frequents in baths of gym, saunas..etc
where we have a lot of humidity and many peoples with differents conditions. “
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Dr. María del Pilar Martín Santiago.Canary Islands. Tenerife. Spain
In the clinical Studies, the results with convencional treatment about topical
agents are about 8% of positive results, and with laser we have more that 75%
Who gets nail fungus infections?
Nail fungus infections are more common in men than women and in the elderly
than the young. Additional traits or factors that raise one's risk of nail fungal
infection include the following:
-Diminished blood circulation
-Slow growing nails
-A family history of fungal infection (genetics)
-Heavy perspiration
-Humid or moist work environment
-Heat
-Wearing socks and shoes that prevent ventilation
-Walking barefoot in damp public places (swimming pools, gyms and shower
rooms)
-Previous injury or infection to the skin or nail
-Diabetes, AIDS circulation problems, a weakened immune system
-Tight footwear with crowding of toes
-Exercise that causes repeated minor trauma to the hyponychium (where the
finger tip attaches to the nail)
Why to do a fungal infection treatment?
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-It is a chronic contagious infectious disease

-It steadily destroys nails and can be passed on to other members of the
family
-It is a breeding ground for various other infectious diseases and inflammations
-Fungus discharges toxic poisons into the body, and may lead to allergies which
may cause bronchial asthma as well as various skin rashes
-Neglected, or not fully treated fungal infections, may cause immune deficiency
-Toenail fungal infections can penetrate into internal organs through the blood
and the lymphatic systems and may lead to oncology disorders
Types of infections:
1.-onychomycosis and tinea unguium
2.- cure athlete's foot
3.- callus
4.- warts, spots, nevus
5.- foot neurinome
6.-foot fascitis
7.- metacarpe disorders with pain
8.- ingrown toenails
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In the onychomycosis we can have:
DSO - Distal subungual onychomycosis : infection in the distal nail bed and
progressing from distal to proximal.
PSO - Proximal subungual onychomycosis : infection in the proximal nail bed.
Rare in people with intact immune systems.
WSO - White superficial onychomycosis : white discoloration on the surface of
the nail which can be scraped away.
The Causes of infections are dermatophyte fungi (tinea unguium.

Nail fungal infections are caused by microscopic organisms called fungi that do
not require sunlight to survive. Most commonly, a group of fungi called
dermatophytes (such as Candida) is responsible for nail fungal infections.
However, some yeasts and molds also cause these infections.
Though Trichophyton rubrum is the most common dermatophyte that causes

nail fungal infections, Trichophyton interdigitale, Epidermophyton floccosum,
Trichophyton violaceum, Microsporum gypseum, Trichophyton tonsurans, and
Trichophyton soudanense may also cause the infections. Common mold causes
include Neoscytalidium, Scopulariopsis, and Aspergillus.
Pathogens that cause nail fungus infection usually enter the skin through tiny
cuts or small separations between the nail and nail bed. The fungi grow when
the nail provides a suitably warm and moist environment.
What are the symptoms of nail fungus infections?
Nails that are infected with fungus typically are thickened, brittle, crumbly,
ragged, distorted, dull, and darker or yellowish in color. Sometimes, nail fungal
infections result in pain in the toes or fingertips, and they may even emit a
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slight foul odor.
In the meantime, people who have nail fungus medically known as
onychomycosis can spread it by shedding invisible spores when they walk
barefoot in locker rooms or across carpets, and even as they remove shoes and
socks.
Another symptom associated with nail fungus infections are fungus-free skin
lesions called dermatophytids. These may be rashes or itchiness in an area of
the body that is not infected with the fungus - much like an allergic reaction.
Although for the majority of people, nail infection is primarily a cosmetic issue
— one of the great unsolved American lifestyle problems, up there with balding
and cellulite — it can lead to serious health problems among people with
diabetes and immune disorders.
How are nail fungus infections diagnosed?
In order to diagnose nail fungus infectionswe can examine debris that is

scraped from underneath the nail. The nail scrapings will be used in tests such
as a potassium hydroxide (KOH) smear or a fungal culture. The KOH test can be
quickly performed.
The fungal culture is other option and can take weeks.
Physicians must be careful when diagnosing fungal infections of the nail

because several other conditions can result in similar symptoms. These include
psoriasis, lichen planus, contact dermatitis, trauma, nail bed tumor, eczema, and
yellow nail syndrome.
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How to Avoid Toe Fungus
Fungus can enter the nail through a cuticle trimming, through an injury near
the nail or even a crack on the surface of the skin near the nail. Killing the nail
fungus not is only treatment, we need hygieny protocol: practice good foot
hygiene and preventive control, avoid moist, wet environments, meaning public
showers, pools and locker rooms, and check the shoes. We need be careful
when we go to the Beach or swimming pool or when we go for a pedicure. The
pedicurist should avoid trimming the cuticles too short, which creates more
opportunities for fungus to infect the nail or use contaminated Tools.
What nail fungus treatments are there?
Treating nail fungus infections can be a long and expensive process. There are
oral antifungal medications, topical ointments, and alternative therapies. Over
the-counter creams and ointments are available, but they have not proved very
effective.
Oral medications for nail fungus infection include Itraconazole,Fluconazole

(Diflucan), and Terbinafine which typically take up to four months before fully
replacing the infected nail with uninfected nail.
Topical nail fungus treatments include antifungal lacquer or nail polish such as
ciclopirox in addition to other creams. Use of topical remedies can clear nail
fungal infections, but often does not completely cure the infection.
In some extreme cases, a physician will opt to remove the entire nail.
Alternative medicines used to treat nail fungal infections include Australian tea
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tree oil and grapefruit seed extract. However, there is no scientific evidence
supporting the use of these products.
Medication that are used for fungal infection carries the possibility of kidney
failure. The fungi are so hardy that popular antifungal pills, which carry a small
risk of liver damage, are completely successful less than half of the time.
Americans currently spend about $1.26 billion annually on oral and topical
prescriptions for nail fungus, according to IMS Health, a health care information
company. That is in addition to millions spent on unproved home remedies like
tea tree oil, Vicks VapoRub, Listerine and Clorox. Industry analysts and
executives estimate that more effective treatments could expand the market to
as much as $3 billion annually.
Why laser?
-No oral or systemic drugs 
- No harmful UV radiation 
-no bleeding
-Increase the local blood circulation
- No analgesia required 
- No unpleasant side affects 
-good recovery
- Effective for toenails and fingernails 
- Suitable for all ages 
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- Approved for treatment in Europe and USA
Types of Laser Toenail Fungus Treatment
Some wavelengths of light used in laser toenail fungus treatment

include:
-1064nm Nd:YAG
-660nm red visible Light
-810 nm
-940nm near infrared Light
-Er,Cr: YSGG: 2790 nm
How Laser Toenail Fungus Treatment Works
When undergoing a laser toenail fungus treatment, a medical

professional will apply a directed focused and defocused light
source on to a toe that is infected. The laser toenail fungus
treatment will target the fungal infection in the toenail and the area
below called the toenail matrix. Laser toenail fungus treatment will
destroy the fungal infection and should be relatively painless
because the toenail is deadcells. The specific wavelength of the laser
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toenail fungus treatment targets only the living fungi.
Normally we apply Er,Cr: YSGG 1.5 WATTS in continuos mode in

the nail, and 0.5 WATTS around of the nail matrix. At first we
appllied the laser radiation in difuminated way around of the nail
and matrix during 2 minutes and then applied during 2 minutes in
focused mode in the nail and in the matrix. In most affected area we
can made a hole in the nail and put inside the laser radiation. At
fisrt we need cut and clean the nail for laser tratment.
Then use DIODE LASER Turing 5 minutes in 0-5 WATTS in

continuos mode around all the nail and matrix tisúes.
Effects of Laser Toenail Fungal Treatment
Increase the local flow blood, decrease the fungal contamination,

increase the tissue recuperation and the collagen metabolism for
recovery tissues. A fungal infection is fungus living in cracks and
pores of toenail. If a lifestyle change is not made (throw old shoes
out) the fungi will return to the nails. Therefore laser toenail fungal
treatment is part of an overall protocol which a complete protocol.
This could include nutrition aspects, topical medicine, hygiene or
changes to lifestyle.
Number of Visits to Perform Laser Toenail Fungus Treatment
This depends on the severity of the infection as determined by the

evaluating conditions. Normally we need 1 session every 15 days at
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first during 2 months, and then 1 session every months during 6

months.
Restrictions on Laser Toenail Fungus Treatment
Generaly there are no health or age restrictions with laser toenail

fungus treatments. In most clinical studies there were no bad
reactions, contraindications or side effects involving laser toenail
fungus treatment. Only the Light hipersensibility or when patient
take medications that promove hipersensibility to Light.
María Pilar Martín Santiago
June 2012
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Dr. María del Pilar Martín Santiago.Canary Islands. Tenerife.

European Master Degree in Laser Applications