Thickened, deformed and discoloured nails. We see it every day in the clinic and it is a great source of frustration for many patients. It affects a large percentage of the population. Despite not being painful in most cases, patients are very keen on treating it as quickly and effectively as possible as it’s often unsightly.
There are hundreds of topical treatments available, some oral treatments and a recent, popular treatment is laser. Many clinics boast success in 1-2 treatments and show stunning before and after pictures to support the use of laser. It can be expensive but is said to have no side effects or pain during treatment.
So does it work?
Overall, the evidence is not great. Studies have been done on effectiveness in clearing the infection and patient satisfaction. Unfortunately, there are no well conducted or large studies existing that support the use of laser in the treatment of these infections. There have been some small studies showing positive results but there are also many studies that show no improvement in nails after treatment. There is poor evidence particularly for laser’s use in more severe and deeper nail infections. Laser seems to be effective in superficial or minor infections and may be worth a try, especially if you have unsuccessfully tried the topical treatments available.
So what should you do?
Number 1 is to see a Podiatrist to get a correct diagnosis. Not all thickened and discoloured nails are fungal. They can be caused by trauma, footwear and even can be genetically inherited. This is no point using antifungal treatments on these nails and improvements can be made usually with one simple consult.
If your podiatrist confirms a fungus they can significant reduce the amount of affected nail for treatment. This can increase the chance of topical or other treatments working and can clear a majority of minor infections. For more severe infections the only treatment that has shown to be effective is oral antifungal treatment. This requires a positive pathology sample of the nail taken by the Podiatrist and then referral to your GP to approve start therapy.
You can save yourself a lot of time and money with the right advice.