Onychomycosis, commonly known as toenail fungus, is a prevalent fungal infection of the nails. Traditional treatments include oral antifungal medications and topical applications, which often have long treatment periods, slow effects, and numerous side effects. In recent years, laser therapy has emerged as a new option for treating onychomycosis, with its non-invasive, cekap, selamat, and no-downtime characteristics. This article will reveal the scientific principles behind the treatment of onychomycosis with the 755nm + 1064nm Long Pulse ND:YAG & Alexandrite Laser Beauty Machine.
Principles of Treatment
- Selective Photothermal Effect:
- The 1064nm Nd:YAG laser penetrates the nail, focusing its energy on the pigment or internal moisture of fungal cells. After absorbing the laser energy, the temperature of fungal cells rises rapidly, leading to the destruction of fungal cell structures, such as cell walls and membranes.
- Thermal Effect Destroying Fungi:
- The high temperature generated by the laser can directly kill or inhibit the activity of pathogenic fungi, preventing further reproduction. Selain itu, the heat causes micro-thermal damage to the infected tissue, stimulating the repair and regeneration of the nail matrix and surrounding tissue.
- Absorption Characteristics of Fungi:
- Some fungal cells contain pigments (seperti melanin) or specific molecules that are absorbent to 1064nm laser light. The laser energy selectively targets these tissues while having minimal impact on healthy tissue.
Proses Rawatan
- Cleaning and Preparation:
- Clean the infected nail area before treatment, removing surface dirt or thickened nail tissue to enhance laser penetration.
- Laser Irradiation:
- Use long-pulsed lasers to directly irradiate the infected nails and surrounding tissue. Each nail treatment takes about 10-20 minit, with energy settings adjusted based on the severity of the infection.
- Postoperative Recovery:
- Laser treatment is usually non-invasive and requires no recovery period. The treatment of nail infections takes time and usually requires multiple treatments (2-4 sesi) to completely eliminate the infection.
Advantages of Laser Treatment for Onychomycosis
- Bukan Invasif: Laser treatment does not require surgery or medication, making it suitable for patients who cannot tolerate oral antifungal drugs.
- Kecekapan: The laser acts directly on the site of infection, avoiding systemic side effects.
- Keselamatan: The laser selectively heats fungal cells, causing minimal damage to healthy tissue.
- Tiada Masa Henti: There is no special care required after treatment, and patients can immediately return to normal activities.
Precautions
- Number of Treatments: Nail fungal infections usually require 2-4 rawatan, spaced 3-6 weeks apart.
- Complementary Care:
- Keep nails and feet clean and dry after treatment. Avoid wearing stuffy, non-breathable shoes to prevent secondary infections.
- Limitations:
- Laser treatment is more effective for patients with mild or moderate infections. For those with very severe infections or completely destroyed nail structures, other treatments (such as medication or nail avulsion) may be necessary in combination.
Mastering Laser Parameters for Onychomycosis Treatment
Laser treatment for onychomycosis, commonly known as nail fungus, is a sophisticated procedure where the right energy and frequency settings are crucial for success. The specific parameters need to be adjusted based on the type of equipment, the severity of the patient’s infection, and the skin’s tolerance. Here, we provide general guidelines for setting the parameters for a 1064nm Nd:laser YAG, which is widely used for treating onychomycosis.
Energy Settings:
1. Fluence Range:
- Typical range: 30-70 J/cm².
- Mild infections: Suggested settings between 30-50 J/cm².
- Moderate to severe infections: Recommended increase to 50-70 J/cm².
- The choice of fluence depends on the thickness of the nail and the depth of infection:
- Thicker nails may require higher energy to penetrate.
- Adjustment considerations:
- Too low energy may not effectively destroy fungi.
- Too high energy may cause burns or discomfort, especially in the skin around the nail.
Frequency Settings:
2. Kadar Pengulangan:
- 1-10 Hz, typically set between 2-5 Hz.
- A frequency that is too low can prolong treatment time.
- A frequency that is too high may cause skin discomfort but allows for faster treatment.
- Setting logic:
- Thinner nails: Can use a low frequency (2-3 Hz) combined with low energy.
- Thicker nails: Recommended high frequency (5 Hz) combined with high energy.
Pulse Width Settings:
3. Tempoh Nadi:
- Typical range: 20-50 milliseconds.
- Lebar nadi pendek (20Cik) for thin nails.
- Lebar nadi panjang (30-50Cik) for thicker infected nails.
- Adjustment considerations:
- Short pulse width concentrates energy output but may increase heat sensation.
- Long pulse width disperses heat, reducing skin discomfort.
Treatment Frequency and Course:
4. Single Treatment Duration:
- Each nail is treated for about 10-20 minit.
- Ensure the laser evenly covers the entire infected area, including under and around the nail.
- Treatment course recommendation:
- One treatment every 3-6 minggu.
- Usually requires 3-5 sesi, depending on the severity of infection and nail recovery.
Additional Assisting Settings:
5. Sistem penyejuk:
- Most modern laser devices are equipped with cooling devices, such as spray or contact cooling, to reduce the heat sensation on the skin’s surface and improve patient comfort.
6. Saiz Bintik:
- Typically use a 3-5mm spot size.
- A smaller spot size is convenient for focusing on the nail and infected area.
Precautions:
- Individual Adjustment:
- Adjust energy and frequency in real-time based on the patient’s pain tolerance and the reaction of the treatment area.
- Observe Skin Reactions:
- Patients may feel a slight heat or tingling sensation during treatment. If significant discomfort occurs, reduce fluence or increase cooling.
- Aftercare:
- Keep nails dry after treatment.
- Advise patients to avoid wearing tight, non-breathable shoes to prevent re-infection.
Recommended Starting Parameter Summary:
| Parameter | Setting Range |
|---|---|
| Ketumpatan Tenaga | 30-70 J/cm² |
| Kekerapan | 2-5 Hz |
| Lebar Nadi | 20-50 Cik |
| Saiz Bintik | 3-5 mm |
| Treatment Course | Once every 3-6 minggu, 3-5 sesi |
