Laser Treatment of Toenail Fungus: Wait a Few More Months

Despite recent government approval for laser treatment of fungal toenails, I recommend patients wait just a little longer before they pursue such treatment.

I served on The Seton Hospital Laser Committee, a North Austin hospital, for some years and have reviewed the research on the treatment options carefully in order to recommend lasers the hospital should purchase for treating patients. Invariably over the years, after one product received FDA approval, within six months there were new, superior lasers on the market making that first-approved laser literally a “piece of junk.” I have personally spoken to experts in the laser field. These people say that the nearly approved lasers are superior to the Pinpointe laser and should treat the problem much more efficiently.

Ten percent of the U.S. population – some 35 million Americans – suffers from nail fungus. Until now, the only approved treatments were topical antifungal treatments, which were often not effective, or an oral medication that had serious potential side effects, like liver damage.

In October, the use of the PinPointe™ FootLaser™ (PathoLase) was approved for the treatment of nail fungus (onychomycosis) by the U.S. Food and Drug Administration, FDA. PinPointe USA, Inc., the company that makes the laser, is heavily advertising this approval. But before you rush out to have your nails zapped, I advise caution.

First, the announcement is somewhat misleading and overstated. The approval is for the temporary clearing of fungal toenails. The approval is also for a type of laser protocol used for fungal toenails. Cast your attention on the word “temporary.” Fungal toenail infections are notoriously difficult to treat because they return again and again, largely due to the moist, dark environment inside the shoe, which offers a perfect growth environment.

Second, the other thing I had against the Pinpointe laser is that the company charges a sizable fee every time the machine is used. I believe that this artificially inflates the costs of the laser treatment.

Finally, in just a few months other laser manufacturers may receive approval from the FDA for better lasers.  None of these other laser manufacturers charge a fee every time the laser is turned on. This should bring down the cost of treating fungal nails with the laser significantly!

So I advise my patients to hold your horses and wait for a more long-lasting and less expensive treatment option. Meanwhile, they may consider a combination of an ancient treatment with a newer topical medication. Read more about that here.