Therapeutic Efficacy of Q: Switched Nd: Yag LASER in Onychomycosis

Background: Onychomycosis (OM) is a slow-growing nail fungal infection that if left untreated, may result in the total loss of the nail plate. Oral and topical antifungal therapy are usually prescribed to patients for treating onychomycosis. Non-pharmacological therapeutic techniques such photodynamic therapy, diode lasers, long pulse and Q switched-Nd-YAG LASER, and fractional CO2 lasers have recently become popular for treating the OM. Objective: This study was conducted with the aim to study the safety and efficacy of Q switched Nd: Yag LASER in OM. Methodology: Total 130 nails from 11 PAS positive onychomycosis patients were selected based upon the inclusion and exclusion criteria. Each nail received 4 sessions for fingernails and 6 sessions for toe nails of Q-switched Nd-Yag LASER (nanosecond pulse) therapy at 2 weekly intervals. In each session three passes were given at a gap of 30 seconds. Evaluation by OSI was carried out before starting therapy and then every 2 weeks for 3 months and then monthly till end point of therapy. Results: The mean age of the patients was 45.09 ± 12.06 years with a predominance of females (63.63%). The mean size of the infected area was 4.63 ± 1.02 mm. The morphology of the nail indicates DLSO in 44 (33.85%) nails, endonyx in 19 (14.62%) nails, PSOM in 37 (28.46%) nails, and WSO in 30 (23.08%) nails. The mean OSI exhibited a significant linear declining trend over the increasing number of therapy sessions. Conclusion: In patients with onychomycosis, we think the Q Switched Nd: YAG (1064 nm) laser is a safe therapy option. It may be especially advised for people who are contraindicated or who would prefer not to use oral antifungals. Nonetheless, we believe that in order to be effective, lengthier follow-up times and sessions may be required.