What does science say about light therapy for nail fungus?

Fungal nail infections, or onychomycosis, are persistent and difficult to treat, often requiring long-term systemic and topical antifungal therapy, which can have severe side effects. Light therapy, including laser and photodynamic therapy (PDT), has emerged as a promising alternative with fewer side effects and potentially greater efficacy.

Mechanisms of action

  • Laser therapy: Various laser systems have been investigated, such as neodymium doped yttrium aluminum garnet (Nd:YAG) and intense pulsed light (IPL). These lasers work by photothermal and photoablative actions, targeting fungal cells without damaging surrounding tissues. 2 5 6.
  • Photodynamic therapy (PDT): PDT involves the use of a photosensitizer activated by light in the presence of oxygen, producing reactive oxygen species that inactivate fungi and bacteria. This method has shown efficacy in reducing fungal viability and achieving clinical and microbiological cure.

Efficacy and safety

  • Clinical results: Light therapy cure rates are comparable to or better than traditional antifungal treatment, often in a shorter time and with fewer side effects. Studies have shown significant reductions in fungal cell viability and high clinical and microbiological cure rates. 1 3 5 9.
  • Combination treatment: Combining PDT with oral or topical antifungals can increase treatment efficacy, shorten the duration of antifungal therapy, and reduce adverse effects. This approach has shown higher cure rates than monotherapy. 3.

Types of light therapy

Various laser systems have been used to treat onychomycosis, including Nd:YAG, 870/930 nm combination, and femtosecond infrared lasers. These systems are minimally invasive and can restore clear nail growth in relatively few sessions. 2 6

PDT using photosensitizers such as methylaminolevulinate (MAL) and light sources such as red-light LED lamps has shown promising results in clinical settings. 3 4

Infrared therapy has also been studied and has shown effectiveness in many patients, especially for toenail infections. 9

What does the future hold?

Challenges and future directions

Device development

The ongoing development of portable and cost-effective light therapy devices aims to improve accessibility and ease of use, which may increase the adoption of these treatments in clinical practice.

FDA approval

The ongoing development of portable and cost-effective light therapy devices aims to improve accessibility and ease of use, which may increase the adoption of these treatments in clinical practice.

Conclusions

Light therapy, including laser and photodynamic therapy, is a promising alternative to traditional antifungal treatments for onychomycosis. These therapies offer effective, minimally invasive options with fewer side effects and shorter treatment times. Continued research and development are necessary to standardize protocols and achieve wider clinical acceptance.

Choose your device

  1. J. Houang et al. 2017. Light treatments of nail fungal infections. Journal of Biophotonics.
  2. J. Ledon et al. 2014. Laser and light therapy for onychomycosis: a systematic review. Lasers in Medical Science.
  3. A. Navarro-Bielsa et al. 2022. Combination of Photodynamic Therapy and Oral Antifungals for the Treatment of Onychomycosis. Pharmaceuticals.
  4. Ana Paula Silva et al.2015 Development and comparison of two devices for treatment of onychomycosis by photodynamic therapy. Journal of Biomedical Optics.
  5. T. Vila et al. 2015. A new model of in vitro fungal biofilms formed on human nail fragments allows reliable testing of laser and light therapies against onychomycosis. Lasers in Medical Science.h.
  6. A. Ortiz et al. 2014. A review of lasers and light for the treatment of onychomycosis. Lasers in Surgery and Medicine.
  7. Aditya K. Gupta et al. 2021. Efficacy of lasers for the management of dermatophyte toenail onychomycosis. Journal of the American Podiatric Medical Association.
  8. Sheng Lu et al. 2012. Application of light therapy in onychomycosis. International Journal of Dermatology and Venereology.
  9. Rabia A Ghafoor Sadal et al. 2023. The Efficacy of Infrared Light Therapy in the Treatment of Onychomycosis. Pakistan Armed Forces Medical Journal.
  10. JC Amorim et al. 2012. Phototoxic action of light emitting diode in the in vitro viability of Trichophyton rubrum. Anais brasileiros de dermatology.