The best chance of curing your toenail fungus and giving you better looking nails occurs when the treatment is performed with the laser that is most effective at killing the fungus within your nails. There are many lasers available on the market and they work on different wavelengths of light, have different levels of power and have different methods of attempting to kill the fungus. The reality is that some work well and others do not.
All of the laser manufacturers claim that the lasers they make are the “best”, so it can be very confusing trying to determine the best place to get treatment for your nail fungus. The following information should help you find the best treatment.
After evaluating every laser on the market, we bought the Cutera GenesisPlus for laser treatment of fungal toenails in our Seattle clinic, primarily because it offers our patients the best chance at curing their nail fungus and giving them the best looking nails possible.
Why did we select this specific laser?
Before our office utilizes a treatment modality we need to have a high level of confidence that the treatment will be effective. The Cutera GenesisPlus Laser offers an number of advantages over other lasers:
- More Effective at Killing Fungus: The Cutera GenesisPlus has a patented micro-second technology, a 1064nm long-pulsed wavelength with a 605 nm diode aiming beam. This basically means that the GenesisPlus has deeper penetration of tissue compared to some other lasers, allowing it to more effectively destroy fungus. Also, the 1064nm wavelength is currently the only wavelength that is cleared by the FDA for the treatment of onychomycosis.
- Kills More Fungus per Nail: The GenesisPlus laser has a larger “spot size” than other lasers. Spot size is simply the size of the area hit by the laser beam. Cutera has a 5mm spot size. Other lasers, such as PinPointe (another laser commonly used to treat nail fungus), only have a 1mm spot size. 1mm is about the size of a pencil point. 5mm is about the size of pencil eraser. Now imagine trying to cover an area with dots 1mm instead of 5mm. With the smaller 1mm spot you are sure to miss some parts of the nail. If you use the 5mm spot and overlap about half of each, it is virtually impossible to miss any areas as you go back and forth, then up and down across the nail.
- Targets the Fungus, Not Human Tissue: The GenesisPlus 1064nm wavelength and pulse structure is designed so that the fungus absorbs the laser energy faster than does the patient’s tissue. Thus, the fungus is destroyed before damage to the nail bed or rest of the toe occurs. The very short laser pulses end before tissue is damaged. Other lasers, such as the CoolBreeze, use a 1320nm wave that heats both the fungus and tissue. This is less effective at treating the fungus and makes complications such as burns more likely.
- Adequate Power: There are many lasers coming on the market now that are underpowered. Some doctors are buying them because they are much less expensive than lasers such as the GenesisPlus that have adequate power. GenesisPlus is an 80 watt laser and has the power needed to kill toenail fungus. Other lasers, such as PinPointe, are only 4 watts and underpowered for effective treatment of nail fungus.
- Shorter Treatment Time: More powerful lasers such as the Cutera allow a shorter treatment time as they are more effective at destruction of fungus.
- Automatic Monitoring of Surface Temperature: GenesisPlus is the only nail laser with this feature which allows us to achieve the proper temperature to kill the fungus without risking a burn to the patient.
- Proper Dose Delivered: The GenesisPlus is the only nail laser that automatically recalibrates to ensure the proper dosage of laser energy is delivered. Effectiveness of the laser is dose related. That means that if enough laser energy is not delivered, the fungus will not be killed. This is never an issue with the GenesisPlus laser, but is often a problem with lasers that do not have automatic recalibration.
- Triangulated Aiming Beam: Another feature that is exclusive to the GenesisPlus, this aiming beam ensures consistent and accurate treatment distance. This ensures better anti-fungal effect.
- FDA Cleared: The Cutera GenesisPlus is one of only three lasers cleared for the treatment of nail fungus (onychomycosis).
- Better Company: Cutera is a worldwide leader in laser technology including research and development of the most effective methods to treat nail fungus with laser.
How does the laser work?
Studies are not completely clear on the exact mechanism of action, but it is thought that the 1064nm wavelength laser is absorbed by the fungi causing damage to the fungus before there is any pain or damage to human tissue. There are likely two ways that this occurs: 1. Thermal damage of the fungus cells: Increasing the temperature of the nail plate and nail bed with laser energy to the point of destruction of the fungus cells, but not so hot to damage the nailbed or cause pain. 2. Photo-inactivation of the fungus cells: Photo-inactivation uses intense light, without heat, to destroy the wall of the fungus cell.
Besides the Cutera GenesisPlus, what other lasers are likely to effectively treat toenail fungus? We were also impressed with the Noveon Laser by Nomir. They currently have some good studies showing the effectiveness of their laser at killing fungus, although current published studies only go out 6 months from date of treatment. We didn’t choose the Noveon because they have yet to achieve FDA clearance and have very few installed lasers so there is comparatively little clinical experience to go by when determining effectiveness. We were also concerned because Nomir is a small company without the research and support infrastructure of Cutera. Although we are more confident of treatment success with the GenesisPlus, if there is a doctor in your area who is using the Noveon we think it is a valid treatment and you should be comfortable proceeding.
Do you want laser treatment for your fungal toenails? If you are in the Seattle area, contact us today for an appointment to find out if you are a good candidate for laser therapy for nail fungus. If you are outside of the Seattle metro area, and are interested in the treatment, we recommend finding a doctor who uses either the Cutera GenesisPlus or the Nomir Noveon lasers. We do not currently recommend treatment of fungal nails with other lasers.
Information on treating fungal nails with laser and other treatments is available here:
- Laser Treatment of Toenail Fungus
- Nail Fungus Explained
- Guide to Best Lasers to Treat Toenail Fungus
- Diagnosis of Nail Fungus
- Causes of Thick Nails
- Treatment Thick Toenail
- Nail Fungus Home Treatment
- Prevent Re-infection of Nail Fungus after Treatment
- Oral Medication for Nail Fungus
- Topical Medications for Toenail Fungus
- Before and After Laser Treatment Pictures