Summary
[pull_quote align=”right” ]It is important to develop a standardised research protocol to unify study results and make them comparable.[/pull_quote]
In summary, device-based antifungal therapy is a safe method, but its efficacy is still to be assessed by randomised controlled trials. Available studies are often small in sample size, lack control groups, and are not reproducible. It will be essential to perform trials for various fungi species and the different clinical types of nail fungus related to wavelength, duration of heat delivery, number of passes needed, and length of intervals; as well as the number of sessions needed to achieve clinical cure, mycological cure, and to prevent recurrence of the disease.
For a proper evaluation of such treatment, the statement made by Effendy et al is also true for laser therapy33:
‘To simplify the choice of an appropriate treatment, onychomycosis may be divided into just two clinical groups: onychomycosis with and without nail matrix area involvement. However, the distinct clinical findings (number and type of affected nails, multimorbidity, drug interaction, etc.) in each individual case must be taken into account to ensure an appropriate treatment decision.’
It is important to develop a standardised research protocol to unify study results and make them comparable. It might become an easy and inexpensive alternative if available technologies are used to treat nail fungus.
Conclusion
Onychomycosis is a common condition that significantly decreases the quality of life of patients. This disease is difficult to treat owing to the absence of effective antifungal drugs, high toxicity of systemic treatment options, and high recurrence rates of the disease.
New treatment modalities are becoming increasingly popular for their safe and relatively high effectiveness in eradicating nail fungi. Lasers are a promising candidate for providing high effectiveness without the toxic adverse effects associated with the use of oral drugs. Their action is confined only to the affected area and they are capable of specifically targeting fungal cells. Another advantage of laser therapy in onychomycosis is the treatment protocol of only a couple of painless procedures.
It is clear that more clinical studies are needed to assess the best parameters of laser devices and the most effective treatment protocols for onychomycosis.
