7 Keys for excellence in the treatment of onychomycosis with laser Podylas ™

The effectiveness of the Podylas™ system in the treatment of nail fungus is a reality that hundreds of podiatrists throughout Spain can attest to. In this article, we provide some guidelines on how best to achieve excellence in procedures, fully ensure satisfactory results and minimise the risk of recurrence.

1. Make a correcdiagnosis of the disorder by culture

Before starting a medical treatment, it is crucial to accurately identify the disorder. In the case of onychomycosis, it is essential to perform a differential diagnosis by culture to ensure that it is not psoriasis, lichen planus, a bacterial infection, contact dermatitis or another nail condition. If the result is a positive diagnosis of onychomycosis, laser treatment can then be performed. This is key to ensuring successful treatment.

2. Photographs, consent and realistic expectations
Pre-procedure preparation is very important for achieving good results. Before starting laser treatment, it is recommended to take photographs of the affected nails so that their evolution can be compared throughout the process. Patients should receive written information about the details of the treatment and sign an informed consent form. Finally, it is vital to ensure that patients have realistic expectations and reiterate that it can take a long time to see results given that nails grow slowly.

3. Thoroughly clean or debride the infected nails
In addition to cleaning away all traces of nail cream and polish from the patient’s nails, it is necessary to remove as much of the hyperkeratosis of the nail as possible before starting laser sessions. This step, which will help eliminate much of the infected area of the nail, is essential to achieving optimum treatment results. To perform the debridement, it is necessary to file down all of the section of nail plate that contains the fungal infection.

4. Use a laser with the appropriate power and wavelength
Different models of laser exist on the market for the treatment of onychomycosis, but not all are effective. To ensure effectiveness on the nails, an appropriate wavelength and power are necessary to allow the nail plate to be penetrated and the fungi to be destroyed without damaging the surrounding tissue. The Podylas™ 1064nm laser offers deep penetration and a genuine thermal effect on the tissue to eliminate all types of fungi.

5. Apply the laser to the entire surface of the nail
Successful laser treatment of onychomycosis depends to a large extent on correctly applying the laser energy to the affected nails. The laser must be applied to the entire surface of the nail, making sure that the nail bed, nail matrix and the lateral folds are all treated. This ensures that no non-irradiated fungal hyphae remain to promote reinfection.

6. Avoid reinfection to prevent recurrence
One of the most important factors in ensuring successful treatment of onychomycosis with the Podylas™ laser is preventing recurrence. When advising the patient, the podiatrist should reiterate the importance of taking hygiene measures to prevent relapse and recurrence of infection, such as disposing of old shoes or disinfecting all footwear with an antifungal spray or zinc oxide powder, avoiding walking barefoot in public places, using cotton socks and keeping the feet fresh and clean.

7. Set guidelines and plan appropriate retreatment sessions
Last but not least, the podiatrist should make the patient aware of the importance of completing treatment with the necessary laser sessions until the disappearance of the fungi can be definitively confirmed. The number of sessions will depend on the number of nails affected, the degree of infection in each nail and the patient’s particular evolution.