Last year, the Food and Drug Administration cleared the first laser, PinPointe, for “temporary increase of clear nail” in patients with onychomycosis, the medical term for a fungal infection of the nail. The FDA cleared a second one, GenesisPlus, in April. Practitioners have been using other lasers on toenail fungus since about 2009.
‘No side effects’
Kominsky has treated 400 to 500 patients with the PinPointe laser. Compared with oral medication, he says, “the odds of success are better with the laser; plus, there’s no side effects.”
The most common oral treatment, Lamisil, works for about two out of three patients, according to Lamisil’s FDA-approved prescribing information, but it has been associated with rare cases of serious liver problems. Other potential side effects include diarrhea, headache, rashes and changes in taste. According to Lamisil’s manufacturer, Novartis, the relapse rate is 15 percent one year after completing treatment.
In one small study about laser treatment for toenail fungus, which appeared last year in the Journal of the American Podiatric Medical Association, “26 eligible toes (ten mild, seven moderate, and nine severe)” were treated with a laser produced by Nomir Medical Technologies, which is still seeking FDA approval. After six months, 85 percent of the toenails had improved.
“I never use the term ‘cured’ with toenail fungus,” Kominsky says. “With a cure, people think there’s no chance for a recurrence. In this case, there is a chance.”