title: Laser therapies for onychomycosis - critical evaluation of methods and effectiveness.
abstract: The number of medical devices designed specifically to treat onychomycosis has recently increased, although their mechanism of action is not clear. We evaluated available laser therapies for onychomycosis by reviewing the existing literature. Twenty-two reports, published in peer-reviewed journals and as white papers out of 926 initial search results conveyed enough details to be included in this study. In most cases, the methodology of the trials described in the papers we reviewed was not comprehensive and the reporting of outcomes was not unified. We therefore found it hard to compare different clinical trials to one another. The majority of studies (81.82%) reported using an Nd:YAG laser device to treat onychomycosis. A total of 47.37% of the studies which used a 1064 device (and 47.83% of all studies we reviewed) reported that all treated patients responded positively to laser therapy. A total of 60% of studies reported achieving a complete cure (no clinical symptoms, nor negative mycology) in at least 50% of the treated patients. A low number of adverse events and their mild intensity were consistently reported across all studies, which makes this form of therapy particularly attractive to patients with contraindications for receiving systemic antifungal medication. In order to achieve more unified, comparable studies in the future, we suggest that researchers report a minimum set of outcome measurements: the calculation of the infected nail area pre- and posttreatment, as well as the number of patients achieving mycological, clinical and complete cures.
authors.affiliation: Klinik für Dermatologie, Venerologie und Allergologie, Charité Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Francuzik
authors.affiliation: Hautaerzte und Laserzentrum Landau, Landau in der Pfalz, Germany.|Department of Dermatology and Health Sciences, University Osnabrück, Osnabrück, Germany.|2nd Department of Dermatology Colentina Hospital - EADV Center of Excellence on Corrective Dermatology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: K
authors.initials: K
authors.lastname: Fritz
authors.affiliation: 2nd Department of Dermatology Colentina Hospital - EADV Center of Excellence on Corrective Dermatology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: C
authors.initials: C
authors.lastname: Salavastru
mesh_terms: D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects / Q000379:methods* / Q000592:standards; D014009:Onychomycosis / Q000628:therapy*