Frequently, we hear complaints of the tedious process of topical treatments or the arduous process in acquiring oral anti fungal medication (which can impact the liver). This often leaves patients feeling hopeless or resigned to a life with fungal nails.
What are my options?
Can always choose this but you run the risk of it spreading to the nail root, affecting other nails or the other foot. It can also lead to fungal skin infections and migration to other areas.
Available as prescription or over the counter, they are convenient and low cost but often ineffective due to compliance, short application time, low penetration or not addressing reinfection factors.
A popular option, but success is limited due to the how focused the treatment area is and missing fungal areas. Can also be uncomfortable and painful.
A procedure where the affected portion of the nail is removed. Unfortunately, this does not address the nail bed where the fungus usually resides. Total nail removal could alleviate the issue but does lead to potential for abnormal nail growth or if permanent curing of nail bed, no more toenail.
Conditions of the big toe we see are:
- Hallux valgus aka Bunions
- Turf toe (Hyperextension)
- Gout and Pseudogout
- Muscular strain
Generally requiring a blood test to assess liver function every 4 to 6 weeks, and a course either 3 to 6 months long. Has good success but can be harsh on the liver.
More well tolerated than hot laser, able to effectively target and treat toenail fungus safely without medications or surgery.
Some conditions we treat include;
- Chondromalla Patellae (Runner’s Knee)
- General Knee pain (Patellofemoral Pain Syndrome)
- Meniscal injuries
- Patellar tendinopathy (Jumper’s Knee)
- Anterior knee pain
- Baker’s Cyst (Popliteal cysts)
- Knee tracking issues
- Ligament tears
Lunula Cold Laser for Fungal Nails
A safe, painless and superior option to treat toenail fungus!
What is Cold Laser & how does it work?
The Lunula combines two beneficial wavelengths: 405nm and 635nm. The synergistic effect of both is capable of stimulating a cascade of effects that help the body to clear the fungus, and grow clear and healthy nails.
The 405nm wavelength targets NADPH oxidase (NOX), a membrane-bound enzyme and increases the production of Reactive Oxygen Species (ROS), which can cover to H2O2. This increased production leads to increased fungal spore susceptibility to the body’s immunity.
The 635nm wavelength stimulates Cytochrome C Oxidase (CCO), this is an important enzyme for Adenosine Triphosphate (ATP) and ROS production. Increased ATP activates pathways that increase Nitric Oxide (NO) production, a significant factor for improved circulation and nutrient delivery and infiltration of immunological cells. In the presence of increased ROS which then coverts into cytotoxic H2O2, this enhances performance of the immune mediates such as circulating macrophages and neutrophils.
Essentially, the synergistic effect of the two lasers produce increase spore susceptibility, whilst boosting circulation and penetration to key areas and stimulating the body’s immunity.
Cold Laser Key Benefits:
Effectively kills nail fungus in a few treatments
Stimulates your own immune response
Completely safe, no side effects, pain or recovery time required
Works on both toenails and fingernails
Improves healthy nail growth, key to successful outcomes
Your first visit will include assessing your health and medical history, your background with fungal infections and talk you through how we use cold laser.
2. Photo taking to assess baseline
Tracking your progress is paramount to assess your response to treatment. Therefore we take some photos of your nails at the initial consultation, halfway through your treatment program and at the last session.
3. Electronic Filing
If excessive thickening is present, use of a professional nail burr is used to reduce the thickening of the nail, and optimise penetration and effectiveness of the laser.
4. Shoe Sterilisation
We will also sterilise your shoes with a special ultraviolet light that kills 99% of fungus, this can be done for up to 3 pairs of shoes. This can be done at each appointment. This is also available for purchase to sterilise your shoes at home.
5. Cold Laser (weekly for 4 weeks- 12 mins per foot)
The standard duration for laser is 12 minutes for each foot. This is totally safe, and pain-free. Some patients report a slight tingling sensation during the treatment.
6. Preventing Reinfection
We want to prevent the cycle of reinfection, with shoes and socks posing a high risk of harbouring fungal spores. We educate you on how to disinfect these items effectively with strategic use of anti-fungal laundry rinses.
Frequently Asked Questions
Our clinic prides itself on the highest level of care, and provision of the latest techniques and equipment that achieve the best outcomes for our patients.
This is dependant on the extent of infection and the speed at which your nails grow. Most nails grow around 4mm per month, so there should be a noticeable difference within 4-6 months. We would normally assess that this new growth is healthy.
Fungal nails or onychomycosis is very common, with at least 10% of the population affected by it in their lifetime. It can affect people of any age or gender but it can be more prevalent in the elderly. The predominant pathogens that are responsible are dermatophyte fungi, but yeasts and non-dermatophyte moulds can also be involved.
The risk factors are numerous, however some of the more common causes are listed;
- Weakened immune system due to preexisting medical condition such as diabetes or treatment with immunosuppressive drugs
- Nail trauma from impact, footwear etc.
- Poor hygiene – visiting nail salons that do not sterilise equipment, wearing damp shoes/socks etc
- Having a fungal skin infection which can migrate to the toenails
The longer the infection is not treated the more well established and stubborn to treat the fungus can be. The cosmetic change to your nails such as discolouration, change in texture and sometimes malodorous can make the condition hard to live with. It can lead to ingrown toenails, and potentially migrate to surrounding skin causing tines for example. Once it is well established there can be systemic infection which is not only affecting your feet but other areas of the body.
The initial consultation will be $250 which includes assessment, electronic nail filing, UV shoe sterilisation for up to 2 pairs and of course Cold Laser. Subsequent sessions are $165, for up to 6-7 weekly sessions.
If you have reached 8 sessions, and have had improvement but it is not completely resolved, we will continue your 9th and 10 session at no out of pocket cost. We want to ensure you are completely satisfied with your result.
An additional two sessions can be performed. Generally results that are not satisfactory can be due to factors such as slow nail growth, circulation or a poor immune response, or too much time in between sessions or reinfection from outside sources.
This goes in accordance with the protocol recommended in trials where the highest success was attained. The treatment will boost the immune response and weaken the fungus, and a week later the body is primed again for another boost. Higher frequency or lower frequency may compromise the treatment effect.
The combination of laser, post-treatment protocols and your innate immune response will ensure the chance of recurrence is minimised.
The chances are you have already tried topical treatments, with little success or slow progress. Oral antifungals can have unwanted side effects and be harsh on your liver.
Unfortunately, hot laser attempts to burn the fungus, which can be painful, produce toxic plume and does not engage an immune response. They can also poorly target the fungus as it is pinpoint in nature, rather than targeting the nail bed where the fungus usually resides
There may be a slight tingling sensation during and post treatment, due to the stimulation of the the circulation in your toes. The treatment is pain-free however, and there are no side effects.
Using services that ensure their equipment is sterilised, using your own nail polish, thoroughly cleaning your socks and shoes regularly or cleansing with anti-fungal agents.
The initial sign might be some discolouration or change in nail texture (brittle, thickening etc). This could be yellow-brown or even darker patches of green on a particular part of the nail This is dependant on the particular pathogen. The skin around the toenail could also be affected with flaking being a common sign.