Can LED or Laser Devices Be Effective for Nail Fungus?

Ever felt embarrassed to hide your feet due to discolored, thickened nails? If so, you're not alone. Nail fungus affects millions of people worldwide, impacting not just aesthetics but also your confidence. While traditional treatments have existed for a while, modern options like laser and LED therapy are gaining popularity. But are they truly effective? That's the question we'll try to answer.

What is nail fungus?

Nail fungus is an infection of the nail, also called onychomycosis. Onychomycosis is the most common nail disorder. Fungal nail infections may be painful and cause your nails to become brittle, discolored, thick, or cracked. The nail might also become separated from the nail bed.

How do I know if I have nail fungus?

A fungal infection is more likely to affect your toenails, but you can also get it on your fingernails. It often takes a while to develop and spread, so you may not notice it at first. The fungi are usually found on your body and often do not cause any issues. However, in your feet, the fungus can become a big problem. You can also get the fungi from someone else, like at a nail salon, if all the tools aren’t sterilized properly.

Fungus infection usually happens when the fungi enter through the cracks in the toenails, start overgrowing, and infect the tissue in or under the nail. Fungi just love a warm, moist environment and will find that in the toenail.

Also, identifying nail fungus isn't always straightforward because other conditions can mimic its appearance. Your best bet is to get your toenails checked by your podiatrist using laboratory testing.

Traditional treatments for nail fungus

According to the CDC, nail fungi are difficult to treat, and treatment is more effective when started early. Treatment for toenail fungus depends on the severity of your condition. It may take months to see results. And even if your condition improves, repeat infections are usually common. A healthcare professional will determine the best treatment plan. Some of the treatments include:

1. Oral medication

Oral antifungal medications are often the first choice. One option that your doctor might prescribe is itraconazole. You usually take this type of drug every day for 6–12 weeks. It may take several months or even longer to eliminate an infection. Oral antifungal medications may also cause side effects like rash, stomach discomfort, headache, and liver damage, or they can interfere with other prescription medications. With these types of drugs, you might need occasional blood tests to check on how you are doing.

2. Topical medications

If you have a mild infection, your doctor may prescribe a topical cream, such as tavaborole (Kerydin) and efinaconazole (Jublia). Although they are less effective due to their reduced ability to penetrate the nail plate, they are associated with a more favorable safety profile. Topical creams might work better if you first thin your nails. This will help the medication get through the hard toenail surface to the underlying fungus. Topical nail creams may cause side effects, such as redness and swelling.

3. Combination treatment

Studies show that taking antifungal medications and applying creams to your nails may be more effective than using either treatment alone.

Laser and LED therapy for nail fungus

Until recently, nail fungus treatment had been limited to oral medication and topical creams. Since these treatments were not ideal, doctors began looking for alternatives. That’s where laser and LED therapy come in. They are modern treatment methods used with professional help and as at-home devices.

As studies show laser and light therapy success in treating fungal infection, it is emerging as an alternative option to oral and topical medication for treating toenail fungus. Moreover, some laser devices have been cleared by the FDA to provide a temporary improvement in clear nail growth. While both laser and LED therapy fall under light therapy, they differ in technology and application.

Laser therapy

Laser nail therapy usually delivers short, intense pulses of light to penetrate through the toenail. Laser light penetrates the nail bed and evenly heats throughout the infected nail and skin tissue, which may weaken and kill the fungi.

Laser treatment for toenail fungus has a great safety record. Unlike traditional treatments that are associated with adverse reactions and allergic responses, laser therapy is linked with mild and rare side effects. Moreover, laser treatment for toenail fungus can be completed within a few sessions. The procedure itself is quick and easy, typically taking about 30 minutes to complete.

Once the procedure is done, the doctor will tell you how to keep your toe clean and dry as it heals. The skin will heal in just a few days. Any more treatment sessions are usually spaced two to six weeks apart. It takes 6–12 months for a full new nail to grow.

LED therapy

In LED light therapy, the light-emitting diodes (LEDs) irradiate specific wavelengths of light to the affected nail, in order to disrupt fungal growth. There are different kinds of wavelengths used in LED light therapy, such as red, blue, and near-infrared light. LED is available in both professional and at-home devices.

Professional devices offer higher-powered LEDs and controlled treatment protocols, while at-home versions tend to have lower intensity and require longer treatment durations.

LED therapy is considered a safe and relatively risk-free treatment. The in-office treatment usually lasts about 20 minutes, and after the procedure, you can return to your normal activities. While many brands that market LED devices, suggest you only need a couple of sessions to treat toenail fungus, the research on LED devices is inconclusive, with majority of studies having focused on laser therapy.

Are laser and LED therapy effective for nail fungus?

Research shows laser and LED therapy are relatively safe and may be effective for treating nail fungus. A 2019 meta-analysis showed that laser treatment for toenail fungus has an overall cure rate of 63%. However, a more recent systematic review showed lower cure rates, and highlighted that no study reported a complete cure rate.

While studies show laser and light therapy have the potential to improve the appearance of nails affected by onychomycosis, there is no consensus regarding the effective treatment parameters, such as optimal wavelength or output power. Moreover, it is important to note that the effectiveness of laser and LED therapy for nail fungus depends on many factors, including the exact parameters of the specific device, individual responsiveness to treatment, and severity of onychomycosis, among others.

At-home laser and LED therapy devices

While at-home laser and LED devices might seem convenient, you need to know what to expect before buying them. Unfortunately, there is no evidence to show the effectiveness and safety of these home-use devices. While FDA has cleared several types of laser devices to address onychomycosis, they are typically medical-grade devices that are not available for at-home use.

At-home laser devices can be significantly cheaper than professional laser therapy. However, their long-term effectiveness and safety need further study.

It's also good to note that at-home devices are not FDA-approved for treating nail fungus.

Comparing laser therapy to traditional treatments

Stubborn toenail fungus can leave you feeling frustrated. Luckily, you have more than one option to treat it: traditional treatments, like pills and creams, and modern solutions, like laser and LED therapy.

One benefit of traditional treatment is that it is widely available and sometimes even covered by insurance, which makes it affordable. However, traditional treatments also come with adverse side effects. Oral medications can cause headaches, stomach discomfort, loss of taste, and liver damage and require long-term use. Topical creams may require frequent application and may cause redness, itching, and swelling.

Modern nail fungi treatment may offer faster clearance times compared to topical creams. They are non-invasive, have a more favorable safety profile than oral medication, and are relatively pain-free. However, while some studies show laser therapy may be effective in improving toenail fungi, and you only require a few sessions to treat the fungus infection, there is not enough evidence to conclude that laser therapy is superior to traditional treatment modalities.

Another downside of modern solutions is that they are very expensive. Insurance does not cover these treatments. So, you will have to cover the cost.

Common myths about nail fungus treatment

Here are some of the most common myths about nail fungus you should know.

1. Sunlight or tanning beds can cure nail fungus

Sunlight cannot kill nail fungus. It does not penetrate deep enough to reach through the nail. Tanning beds are even worse — they may damage your skin without affecting the fungus.

2. Cutting the infected nail removes the fungus

A lot of people try to cut back the nail as much as possible. But this can cause more pain and even open more of the nail bed for infection. So, just avoid cutting it back too much and causing this kind of trauma to the nail.

3. Laser therapy is guaranteed to work for everyone

Research shows that laser therapy may help improve the appearance of nails affected by nail fungus. However, it's not a guaranteed cure. Individual factors and the severity of the infection usually influence the outcome.

4. Nail polish can protect against or cure nail fungus

The sad truth is that nail polish will not protect or even cure toenail fungus. In fact, it can make nail fungus worse. Nail polish is a chemical that covers the nail; therefore, it does not let the nail breathe, and may trap moisture under the nail. This provides perfect conditions for fungus to thrive, and may make the infection worse. So, it's best to leave your nails free of nail polish.

5. Only the elderly get nail fungus

That is entirely false. While the risk of developing toenail fungus does increase with age, anyone can get it. Even young adults and children are susceptible to nail fungus.

Toenail fungus is an incredibly common nail infection that can be difficult to treat. Toenail fungus usually isn’t painful, but it can make you feel very self-conscious about how your nails look. If it bothers you, talk to your doctor about your treatment options. A trained specialist can offer the best treatment solution.

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