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Combination of Q-switched 1,064 and 532 nm Nd: YAG laser in the treatment of toenail onychomycosis: a pilot study

Summary

This study tested a dual-wavelength laser treatment for toenail fungal infections (onychomycosis) in 15 patients. The laser therapy successfully cured about one-third of patients with mild infections, but was less effective for severe cases. The treatment was safe and well-tolerated, though patients experienced moderate pain during sessions.

Background

Onychomycosis is a chronic fungal infection of nails accounting for approximately 30% of cutaneous fungal infections. Laser-based therapies have emerged as non-pharmacological alternatives to conventional antifungal treatments, offering high safety margins and suitability for patients where systemic antifungals are contraindicated.

Objective

To assess the effectiveness of a Q-switched Nd:YAG laser using dual wavelengths (1,064 nm and 532 nm) for the treatment of toenail onychomycosis in a pilot clinical trial.

Results

At week 43, mycological cure rate and complete cure rate were both 33.3% (5 of 15 patients). Complete cure was achieved in 100% of mild cases, 40% of moderate cases, and 22.2% of severe cases. The therapy was well-tolerated with no adverse effects, though pain scores averaged 6.5-7.8 during treatment.

Conclusion

The dual-wavelength Q-switched Nd:YAG laser shows promise as a treatment option for mild onychomycosis but has limited effectiveness in severe cases. Further optimization of laser parameters, session frequency, and follow-up duration is needed to maximize therapeutic outcomes.
  • Published in:Lasers in Medical Science,
  • Study Type:Clinical Trial,
  • Source: PMID: 41136799, DOI: 10.1007/s10103-025-04712-4
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