Laser Treatment of Fungal Nails using Q-Clear™

Laser Treatment of Fungal Nails using Q-Clear™ Nd:YAG Laser System

Why do we use a laser system to treat Fungal Nails?
Our doctors use the Q-Clear™ Nd:YAG laser system, which has been FDA approved for treatment of fungal nails and for a variety of other podiatric and dermatologic conditions. Clinical studies have shown this laser system to be highly effective in improving nails that have been discolored or deformed due to fungal and certain other infections. In clinical use, treatments using the Q-Clear™ laser system have been shown to be substantially more effective in clearing nails than treatments relying on topical or systemic medications. There have been no reported incidents of any significant adverse effects due to these treatments.

How does the laser treatment work?
The Q-Clear™ laser system targets the fungi disrupting the growth of healthy nails. It is designed not to harm (“anti-target”) the healthy tissues surrounding the nail. It does this by sending a high intensity burst of light, with just the right characteristics (wavelength, fluence, and temporal format) to pass through the nail plate without injuring the underlying skin. At the time of treatment, no visible change is seen. A more normal nail is expected to appear as the nail grows out. Usually some improvement can be seen within a few months following treatment, but complete regrowth of the nail may take up to a year.

What pre-treatment preparation is required?
It is important to remove all nail polish prior to your treatment. It is also important to have all nails as clean and clear as possible. An extra pair of clean, unworn socks should be taken with you to the treatment session.

What is the recovery period?
In most cases, no recovery period is needed. You may resume all normal activities immediately. You can even apply nail polish immediately after the laser treatment. In some cases, usually those involving prolonged fungal infections or open lesions in or around the nail, some additional therapy, and some recovery period may be needed. To forestall reinfection, use of a topical anti-fungal medication may be recommended. After treatment, attention should be given to keep shoes disinfected and dry. If you have any concerns or questions, please contact our office.

Is the procedure painful?
Most people do not feel any pain. Some patients may experience slight warmth or an occasional snapping sensation during the procedure. If you experience any unpleasantness during the procedure, please let us know immediately, as the laser settings can be adjusted to alleviate it. No anesthesia is used before or during treatment.

How long does the procedure take?
The amount of time varies on the degree of involvement of the nails. Very thick nails may be mechanically or chemically reduced to a more normal thickness prior to treatment. The laser treatment is then applied. Typically, the treatment takes only a few minutes. A visit for consultation and treatment will usually take less than 30 minutes.

How many treatments will be needed?
Most often one treatment is sufficient to permit the nail to begin more healthy growth. In some cases, particularly those where there had been prolonged or more severe involvement, additional treatments may be needed. Observation and retreatment, if needed, is usually done at two to three month intervals. It is important to continue preventative measures to reduce chances of reinfection.

Can the nail not improve?
The nail is expected to improve with just one treatment. Clinical reports to date have been encouraging with most patients noticing significant improvement. However, as with all medical procedures, a 100% guarantee is not possible. Please ask about additional measures that you can take to maintain healthy nails. Changing socks and shoes frequently is always helpful. Fungi love to grow in warm wet places, so keeping shoes and socks dry is important. In addition, the use of certain topical antifungal medications may help prevent reinfection.

Is the laser treatment covered by my health insurance?
The procedure is not usually covered by health insurance. If you are diabetic, paraplegic, or have a problem with circulation to your feet, your insurance may cover some or all of the cost of treatment.

How much does laser treatment cost?
The cost varies depending on the number of nails involved and severity of the infection. We will be happy to discuss our fee schedule with you prior to your treatment.

What are my options?
Laser treatment of the nail may reduce excessive thickness, improve appearance, and make trimming easier. It may also resolve the underlying fungal infection and prevent additional infection by opportunistic organisms. Generally speaking, the earlier treatment is begun, the better the outcome. That said, treatment of fungal or dystrophic nails is not generally considered medically necessary unless other factors are present such as diabetes, poor circulation, excessive pressure, pain, or lack of normal sensation.

Other options include:

  • Not having any treatment and living with the condition.
  • Treatment using antifungal topical medications. These can be over-the-counter or more effective prescription medication. The reported efficacy for these treatments is typically 10- 20%.
  • Treatment with prescription oral medications, such as Lamisil™. These report 50 – 70% improvement rates, but require a many-month course, have potentially serious side effects, and need blood tests to monitor for possible liver damage.
  • Treatment using other laser systems or light-based modalities or simply using heat. These are generally significantly less effective than the Q-Clear™ laser system treatment we employ.

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