1064nm Nail Fungus Laser Treatment Parameters

The following nail fungus treatment parameters is suggested by our Australia customer:

Generally I have 3 different settings that I use for mycotic infections.

Hallux

500j @10w 10ms on / 5ms off (this yields the best results but a lot of patients cannot tolerate the heat)

500j @10w 10ms on/10ms off (this setting I use if patients get to about 200j with 10/5ms setting and find it too hot)

500j @10w 10ms on/20ms off (I try not to use this protocol as it doesn’t produce enough heat on the nail bed. Ideally the nail bed should get quite hot to eliminate the fungal colony)

Lesser Digits

250j @ 10w as per above settings.

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When applying the laser you should move the beam continuously and not focus it on a point for too long otherwise you will pulse stack the area and it will get hot. Be aware that if the patient says the toe has got hot and you stop, once you restart it will get hotter sooner. The 1064nm wavelength will be absorbed by darker colours such as black and brown so do not focus on these areas for too long. Try it on yourself to gauge what the patient will feel.

You should try to keep some thickness to the nail so that it retains heat while applying the laser beam (think of a double brick cavity wall). Generally do the routine treatment after you have lased the nail/s. Photograph the toenail before treatment to compare later. I generally suggest a further laser treatment @ 12 weeks. For 2 weeks post laser treatment I get patients to spray their toenails with 2% terbafine anti-fungal spray. Get them also to wash all of their stockings or socks in a hot water wash to kill fungal spores.

For soft tissue therapy I generally apply 4500-6000j with spot size 30mm on continuous waveform.

donna@gigaalaser.com