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Nail Fungus Onychomycosis

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Nail Fungus or Onychomycosis affects 14% to 28% over 60yo in the United States3 and 11% of the population worldwide. Onychomycosis is not uncommon in young active individuals especially runners, hikers, and other athletes. It is characterized by changes to the nail including discoloring, thickening, debris under the nail and lifting of the nail from the nail bed. There are different types and severities of onychomycosis defined by the amount of involvement and location of the infection.

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Superficial White Onychomycosis on the 4th and moderate onychomycosis on the 3rd

Onychomycosis can cause significant problems with secondary bacterial infections, wounds, and pain. Onychomycosis also causes undo stress and embarrassment in those afflicted, causing them to wear shoes or cover their feet. 80% of nail fungus are caused by dermatophytes the fungi that cause athletes foot infections, there are a number of other pathogens making up the remainder of infections.

Dermatophytes
  • Trichophyton rubrum
  • Trichophyton Mentagrophytes
  • Epidermophyton Floccosum
Nondermatophyte fungi
  • Acremonium species
  • Alternaria species
  • Botryodiplodia theobromae
  • Fusarium species
  • Onycochola canadensis
  • Scytalidium dimidiatum
  • Scytalidium hyalinum
  • Geotrichum candidum
  • Cladosporium carrionii
  • Scopulariopsis brevicaulis
Yeast
  • Candida albicans

Dermatophytes are common skin flora rarely causing issues. The most common dermatophyte involved in onychomycosis is trichophyton rubrum causing 80% – 90% of the cases.1 Treatments over the years have evolved with the technologies and medications available. Today laser treatments with the 1064 nm Nd:YAG are becoming more and more popular as research demonstrates superior results with no side effects. Below is a detailed list of current treatments.

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Anatomy of a Nail

Nail Fungus Treatment

Laser Nail Fungus Treatment
References
  • Ghannoum, MA, Hajjeh RA, Scher R, et al., “A large-scale North American study of fungal islolates from nails: the frequency of onychomycosis, fungal distribution, and antifungal susceptibility patterns,” J Am Acad Dermatol 43, 641-648 (2000).
  • Elewski BE, Leyden J, Rindali MG, et al. Office Practice-Based Confirmation of Onychomycosis A US Nationwide Prospective Survey. Arch Intern Med. 2002;162:2133-2138.
  • HochmanLG. Laser treatment of onychomycosis using a novel 0.65-millisecond pulsed Nd:YAG 1064-nm laser. Journal of Cosmetic and Laser Therapy. 2011; Early Online:1-44.
  • Scher RK, Tavakkol A, Bact D, et al. Onychomycosis: Diagnosis and definition of cure. A Am Acad Dermatol. 2007;56:939-944.
  • Epstein E. How often does oral treatment of toenail onychomycosis produce a disease-free nail? An analysis of published data. Arch Dermatol. 1998;134(12):1551-1554. Review.
  • Elewski BE: Onychomycosis: pathogenesis, diagnosis, and management. Clin Microbiol. 1998;11:415-429.
  • Gupta AK, Ryder JE, Johnson AM: Cumulative meta-analysis of systemic antifungal agents for the treatment of onychomycosis. Br J Dermatol. 2004;150:537-544.
  • Hiruma M. Onychomycosis: recent progress in the epidemiology, diagnosis and treatment. Jpn J Med Mycol. 2006;49:69-73.
  • Watanabe S, Ogawa H, Nishikawa T, et al. A Randomized, Double-blind, Parallel-group Comparison Study of Itraconazole pulse therapy with a one-year follow-up for Toenail onychomycosis: optimal Dosages and Cycles. Jpn J Dermatol. 2004;114:55-72.
  • Gupta AK, Uro M, Cooper EA. Onychomycosis Therapy: Past, Present, Future. J Drugs Dermatol. 2010;9:1109-13.
  • Elewski BE, Tavakkol A. Safety and tolerability of oral antifungal agents in the treatment of fungal nail disease: a proven reality. Ther Clin Risk Manag. 2005;1(4):299-306.
  • Kimura U, Takeuchi K, Kinoshita A, Takamori K, Hiruma M, Suga Y, et al. Treating Onychomycoses of the Toenail: Clinical Efficacy of the Sub-Millisecond 1064 nm Nd: YAG Laser Using a 5mm Spot Diameter. J of Drugs in Dermatol. 2012;4: 496-504.

Keywords: Nail Fungus Onychomycosiss, laser nail, laser fungus westminster,nail infection, nail disease, nail, toenail, Laser toenail, laser fingernail,

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