A randomised comparative study of 1064 nm Neodymium-doped yttrium aluminium garnet (Nd:YAG) laser and topical antifungal treatment of onychomycosis

Mycoses. 2016 Dec;59(12):803-810. doi: 10.1111/myc.12534. Epub 2016 Jul 12.

Abstract

Conventional treatments for onychomycosis include oral and topical antifungal agents. Although Nd:YAG laser has been reported to be effective, controlled studies combined or compared with conventional treatments are needed. To evaluate the efficacy of 1064 nm Nd:YAG laser for onychomycosis and compare outcomes with those of topical antifungal treatment and combination therapy. Patients were randomly divided into three groups: Laser (L); laser with topical antifungal therapy (L + T); and topical antifungal treatment (T). Laser treatment consisted of three or four sessions at 4 week intervals. Outcomes were assessed clinically and mycologically. In 217 nails of 56 patients, 76% in the L group and 71.8% in the L + T group experienced clinical responses, and 15.2% and 22.5%, respectively, were cured at 24 weeks. The clinical and cure rates of both groups were significantly greater than those of the T group. Six patients of the L group developed new infections, as did one patient in the L + T group and two patients in the T group. 1064 nm Nd:YAG laser shows clinically good responses in onychomycosis. Addition of topical antifungal agent did not appear to improve efficacy, but may have protected against new infection.

Keywords: Fungus; Nd:YAG; laser; naftifine; onychomycosis.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Administration, Topical
  • Adult
  • Aged
  • Antifungal Agents / therapeutic use*
  • Arthrodermataceae / drug effects
  • Arthrodermataceae / isolation & purification
  • Arthrodermataceae / physiology
  • Arthrodermataceae / radiation effects
  • Combined Modality Therapy
  • Female
  • Humans
  • Laser Therapy*
  • Lasers, Solid-State / therapeutic use*
  • Male
  • Middle Aged
  • Neodymium / therapeutic use*
  • Onychomycosis / drug therapy
  • Onychomycosis / therapy*
  • Treatment Outcome

Substances

  • Antifungal Agents
  • Neodymium