Tuesday, April 27, 2010

NAIL LASER UPDATE

Onychomycosis is a common infection of the nail, and it may affect approximately 6.5% to 8.7% of the North American population. Visual description includes: yellowed, discolored, thickened and flakey nail / nail debris. The fungus causes a breakdown of the keratin within your nail plate. The byproduct is termed subungal debris which harbors both keratin and fungal elements. The same fungus that is responsible for toenail fungus is also responsible for athletes feet aka tinea pedis. An infected nail can act as a breeding ground for recurrent athlete's feet and mold.

The Family Foot & Leg Center is now proud to present the custom , gentle cool touch laser for your fungal nails in addition to keryflex total nail resurfacing technology.

http://www.gentlenaillaser.com/resources/BeforeAfter.pdf

Why the cool touch laser vs others? The cool touch uses a 1320 nm beam, a much safer and cooler beam than the 1064 nm of the competition. For additional safety and comfort, a cryogen spray is used when the nail is heated to the optimal treating temperature. A large 10mm beam diameter, controlled depth provides a reproducible safe procedure while treating the offending pathogen.
The laser is not new to the medical profession, but the use in treating fungal nails has picked up steam recently as additional research is being done. Lasers have been used for vein removal, wart distruction, removal of fine lines / wrinkles, hair, acne and tatoo removal. We at the Family Foot and Leg Center (FFLC) have done our research into various laser modalities currently on the market and has found the 1320 nm laser by cool touch to be the most effective and gentle on the nail bed but tough on fungal cells. We also have a 1064 nm laser (similar to the competition) but we reserve such for spider veins and less sensitive areas.

Initially, a comparison was made between the Noveon and Pinpointe lasers. With more research,different promising options became clear that combined superior treatment and safety features. While the Noveon was promising, it failed its initial FDA approval for onychomycosis and ran into financial problems. Additionally, some of the lower wavelengths had questionable results and the safety features with the Noveon added additional costs to the procedure. As of this writing, the Noveon is not available but may be in the future. It should also be noted that the laser also was initially developed for dental procedures. All of the lasers mentioned here have been FDA cleared for podiatry, dermatology and general surgery use. So they are appropriate for toenail treatments if proven worthy by your doctor.

As research proceeded, Dr. Katz liked the Cooltouch CT3 Plus Zoom laser, one of the most proven lasers on the market today with a track record. The Cooltouch allows for various types of skin treatments for many issues. Dr. Katz points out that toenails are simply modified skin, so the Cooltouch laser makes sense. He also liked the higher wavelength of the beam and feels that the hard thick nail can be more safely penetrated and treated with this different wavelength. In addition there are added features that improve the appearance of the nail by resurfacing, similar to skin resurfacing and rejuvenation. This is only a Cooltouch feature.

The CoolTouch CT3Plus CoolBreeze produces 1320nm laser energy that is specifically absorbed by water and water associated with collagen in the tissues of the nail matrix. The laser is so sophisticated that it can detect and reach the proper target temperature set by the doctor leading to death of the fungus. The treatment then stops immediately and then the nail is cooled with a spray. This allows for fungal death without damaging the skin or the nail growth plate. Cooltouch's impeccable safety emanates from its incorporating pulsed cooling and real-time temperature feedback into its treatments. In addition, the CoolBreeze Handpiece features an adjustable spot size from 3 mm to 10 mm allowing for adjustments based on nail size for most effectiveness. Other lasers currently being used do not incorporate these advanced features for patients leading to less desirable outcomes and minimal safety features. The Cooltouch laser can be completely controlled. The treatment temperature to kill the fungus can occur automatically while incorporating safety. Each patient can receive a customized treatment leading to the best possible outcome. This is truly unique.

There are different growth phases of the nail and fungus and the best results occur when the patient receives at least 2 treatments. The cost of 2 treatments with the Cooltouch is usually the same or less compared to only one treatment with the Pinpointe laser. This certainly benefits the patient.

Dr. Katz feels that the laser is superior to all other remedies for fungal toenails. However, patients need to follow a comprehensive maintenance regimen to prevent recurrence of the toenail infection.