Clinical Research Trends of Laser Therapy for Onychomycosis in Korea, China, and Japan, and Its Applicability in Korean Medicine: A Scoping Review

Objectives : This scoping review systematically mapped clinical research trends and application patterns of laser-based treatment for onychomycosis across Korea, China, and Japan, examining laser types, treatment parameters, combination strategies with antifungal agents, and safety profiles including pain-related adverse events.Methods : Following PRISMA-ScR guidelines and the PCC framework, we searched CNKI (China), CiNii Research (Japan), and OASIS, RISS, KISS, DBpia, KoreaMed, and PubMed (Korea); J-STAGE and PubMed were additionally used for full-text retrieval of Japanese studies.The initial search was conducted on April 1, 2026, with an updated search on May 1, 2026.Original clinical studies involving human participants were included regardless of study design; secondary and non-clinical studies were excluded.Data were synthesized narratively.Results : 63 studies were included (China: 46, Korea: 16, Japan: 1).Nd:YAG 1,064 nm (34 studies) and CO2 fractional laser (22 studies) were the predominant modalities.Laser-antifungal combination therapy (28 studies) reported higher clinical outcomes than www.kjacupuncture.org김서영ㆍ곽도원ㆍ우호정ㆍ이형원ㆍ유지은ㆍ양예진ㆍ이재현ㆍ장인수ㆍ서형식 KOREAN JOURNAL OF ACUPUNCTURE monotherapy in most Chinese and Korean studies (p＜0.05).One Korean RCT reported a cumulative cure rate of 71.88% with laser plus topical antifungal versus 20.31% with topical antifungal alone (p＜0.0001).Treatment response differed significantly by subtype and severity (SWO＞DLSO＞PSO＞TDO; non-matrix involvement 80.56% vs. matrix involvement 22.73%, p＜0.001).Complete laser parameter reporting was found in only 34 of 63 studies (54.0%).Of the 47 studies reporting adverse events, pain during treatment was explicitly noted in 13 (27.7%),predominantly in high-fluence long-pulsed Nd:YAG studies, while low-level laser modalities reported no pain.Only one study specified a pain management protocol.Conclusions : Laser-based treatments for onychomycosis have been investigated mainly in China and Korea, with limited eligible evidence from Japan.Future large-scale RCTs with standardized parameters, severity-stratified analyses, and extended follow-up are warranted, along with the standardization of pain assessment and management strategies.