title: A 1,320-nm Nd: YAG laser for improving the appearance of onychomycosis.
abstract: BACKGROUND
  Onychomycosis is a therapeutic challenge because of the toxicities of systemic medications. This has led to the investigation of light-based technologies for safe and effective alternative treatment modalities.
  
  
  OBJECTIVE
  The purpose of this study was to determine the safety and efficacy of 4 treatments with a 1,320-nm neodymium:yttrium aluminum garnet (Nd:YAG) laser in improving the appearance of onychomycosis.
  
  
  METHODS
  This study was a 24-week, single-center randomized placebo-controlled study. Ten subjects were enrolled with culture-proven, bilateral great toenail onychomycosis. The subjects received 4 treatments with the 1,320-nm Nd:YAG laser to the treatment toenail on Days 1, 7, 14, and 60. The control toenail received a sham treatment of cryogen cooling only. Mycologic cultures were obtained at 3-month follow-up visits.
  
  
  RESULTS
  Fifty percent of mycologic cultures were negative at the 3-month follow-up after 4 laser treatments. Toenails had improvement in subungual debris, hypertrophy, and yellowing. Patient satisfaction was upheld as assessed by the Nail Quality of Life Questionnaire.
  
  
  CONCLUSIONS
  The 1,320-nm Nd:YAG laser may be a safe and effective therapy for improving the appearance of onychomycosis. Additional therapy may be necessary to enhance long-term results. Further investigation needs to explore the optimal treatment settings and the most effective treatment schedule.
authors.affiliation: *Division of Dermatology, University of California, San Diego, San Diego, California; †Private Practice, Los Angeles, California; Departments of ‡Dermatology, and §Surgery, University of California, Irvine, Irvine, California.
authors.forename: Arisa E
authors.initials: AE
authors.lastname: Ortiz
authors.forename: Sam
authors.initials: S
authors.lastname: Truong
authors.forename: Kathryn
authors.initials: K
authors.lastname: Serowka
authors.forename: Kristen M
authors.initials: KM
authors.lastname: Kelly
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D014009:Onychomycosis / Q000532:radiotherapy*; D017060:Patient Satisfaction; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014034:Toes; D016896:Treatment Outcome