Laser Nail Treatment
Why nails become thick and discolored
Onychomycosis is a fungal infection of the fingernails or toenails. It is more common in the toes because shoes create a warm, damp environment where fungus can grow. It affects about 14% of people in the United States. The fungus lives in and under the nail, which interferes with how the nail grows. Over time, this can change the way the nail looks and feels.
Common signs and symptoms include:
- Thickened nails
- Yellow, white, or brown discoloration
- Brittle or crumbly nails
- Misshaped nails
- Debris under the nail
Sometimes the nail may lift from the skin underneath. Without treatment, the infection can persist, slowly get worse, and spread to adjacent nails.
How Onychomycosis is typically treated
Effective treatment of onychomycosis requires delivering medication to the infection within and beneath the nail plate. Oral antifungal medications, most commonly terbinafine, are considered first line therapy because they reach the nail through the bloodstream and provide the highest rates of mycologic cure. These medications are not appropriate for all patients because they can affect liver function and may require monitoring.
Topical antifungal therapies, including medicated lacquers and solutions, offer a non‑systemic option with fewer systemic risks. Their limitation is penetration. The nail plate acts as a barrier and reduces the amount of medication that reaches the underlying infection. As a result, topical treatments tend to have lower success rates when used alone, especially in more advanced cases.
Adjunctive measures such as mechanical debridement or thinning of the nail can reduce fungal burden and improve the ability of medications to reach the affected area. In clinical practice, combination therapy is often considered to improve outcomes based on the severity of the infection and individual patient factors.
High intensity laser therapy is FDA cleared to allow nail growth to appear clear in patients with onchomycosis. The success rate for nail clearing varies depending on which study is cited and what frequency of laser was utilized. High intensity laser therapy is not FDA cleared to treat the underlying fungus, but some studies have shown possible antifungal effects of laser therapy; however, findings are inconsistent and further research is ongoing.
Treatment Protocol
The treatment frequency is 1 treatment every 10 days for a total of 3 treatments. A final treatment is given at a 20 day follow up appointment. New clear nail growth is expected to be visible in 6-10 weeks. It may take up to 1 year for the nail to completely clear.
What to Expect
The existing nail will not become clear immediately. Cosmetic improvement occurs gradually as the nail grows out and is replaced by new nail. In many cases, new nail growth at the base may begin to appear clearer within approximately six to ten weeks. Visible improvement continues over several months as new nail replaces the older discolored nail. Because nails grow slowly, full cosmetic improvement may take up to a year depending on individual nail growth rates.
How much does it cost
Treatment is billed based on 15-minute increments of time. The total cost depends on the number of nails treated and the time required during each session. Session length can vary based on the thickness of the nails and the extent of involvement, so total treatment time is determined on an individual basis.
Laser treatment for Onychomycosis is considered a cosmetic procedure and is not covered by insurance.
Please contact the office for current pricing and to schedule an appointment.