The use of lasers to treat nail fungus is not new. Researchers have been trying to use lasers to treat onychomycosis since the 1980s. The approach at that time, however, was a little different. Before newer antifungal treatments like Lamisil and Sporanox, the only oral medical treatments that existed for onychomycosis were griseofulvin and, a little later, ketoconazole. these drugs took a very long time to work, had potentially severe side effects at even modest doses, and often did not even work at all. The original application of lasers in the treatment of nail fungus was to use the laser to create holes or channels in the nail. this process, called fenestration, was meant to give topical onychomycosis treatments better access to the fungus. The laser could open up a pathway so that the medicine applied to the nail could get at the fungus and kill it.
This approach did not meet with much success. The process was expensive and did not seem to improve the topical treatment of onychomycosis to any great degree. as lasers were evolving and more widely available to physicians and surgeons, a better approach was adopted. by using a laser with a specific wavelength of laser light energy, the fungus could be targeted and killed, while leaving the skin and nail intact. Instead of making large tunnels in the nail, the light was focused on the fungus directly. In essence, the laser energy heats the fungus to the point that it is killed but does not burn the surrounding tissue.
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