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Laser for Onychomycosis

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Lasers, Lights and Other Technologies

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Abstract

Onychomycosis is a common fungal infection that affects the nail plate or the nail bed and is responsible for approximately 50% of the pathologies affecting the nails (Ghannoum Microbiology 157:3232–42, 2011). Its treatment remains a challenge, even though progress has occurred with the introduction of new antifungal drugs in the 1990s, since many cases linger for decades without a clinical cure (Sigurgeirsson J Europ Acad Dermatol Venerol 24:679–684, 2010). Most cases are caused by dermatophyte fungi; however, in recent years there has been a progressive increase of records of onychomycosis caused by nondermatophyte fungi (yeast and filamentous fungi) that do not respond to antifungal agents (Ranawaka et al. Dermatol Online Journal 18(1):7, (2012); Hwang et al. Ann. Dermatol 24(2):175–180, 2012). Photobiomodulation and photoinactivation studies indicate that lasers in the range of the infrared electromagnetic spectrum (870, 930, 1,064 nm), when applied with biochemical energy, are able to improve the microcirculation, to stimulate the metabolism of cells, and to inhibit the fungal and bacterial multiplication through the action in the wall of the microorganisms, by altering the electric charges and favoring the formation of ROS (singlet oxygen radicals, free radicals). This technique can be associated with the application in the nails of the fractional CO2 laser so that in a drug delivery system it can be associated with antifungal and/or antibacterial agents in order to act synergistically and thus reduce the number of sessions of sub-millisecond 1,064 nm laser.

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Authors and Affiliations

  1. Private Practice, Av. Nossa Sra. de Copacabana, 435 sala 903, Rio de Janeiro, Brazil

    Claudia Maria Duarte de Sá Guimarães

  2. Laboratory of Cell Biology of Fungi, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil

    Taissa Vieira Machado Vila

  3. Department of Histology and Embryology, Histology and Embryology, UFRJ, Souza Marques School of Medicine, Av. Nossa Senhora de Copacabana 605/907, CEP 22050-902, Rio de Janeiro, RJ, Brazil

    Sergio Bittencourt-Sampaio

  4. Souza Marques School of Medicine, Rio de Janeiro, Brazil

    Sergio Bittencourt-Sampaio

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  1. Claudia Maria Duarte de Sá Guimarães
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  2. Taissa Vieira Machado Vila
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Correspondence to Claudia Maria Duarte de Sá Guimarães .

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  1. Universidade Federal Fluminense, Niterói, São Paulo, Brazil

    Maria Claudia Almeida Issa

  2. Lexbios Medica S/S, São Paulo, São Paulo, Brazil

    Bhertha Tamura

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Guimarães, C.M.D., Vila, T.V.M., Bittencourt-Sampaio, S. (2016). Laser for Onychomycosis. In: Issa, M., Tamura, B. (eds) Lasers, Lights and Other Technologies. Clinical Approaches and Procedures in Cosmetic Dermatology. Springer, Cham. https://doi.org/10.1007/978-3-319-20251-8_20-1

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