Treatment of idiopathic onychodystrophy with a 1064 nm picosecond neodymium-doped:yttrium aluminum garnet laser: A retrospective study

Laser Treatment in Nail Disorders: A Comprehensive Review

Background

Laser therapy has emerged as an innovative approach for managing various nail conditions, offering precise targeting, minimal invasiveness, and favorable safety profiles. This review analyzes the literature on laser therapy for nail indications, encompassing onychomycosis, nail psoriasis, nail warts, ingrown toenails, onychodystrophy, nail pigmentation disorders, and nail tumors.

Methods

PubMed and Google Scholar databases were searched to identify articles on laser therapy using specific key terms related to nail conditions (e.g., onychomycosis, nail psoriasis). Relevant articles were shortlisted based on laser treatment in nail disorders, its mechanisms of action, research outcomes, and clinical applications.

Results

Nd: YAG or CO2 lasers showed efficacy in onychomycosis by targeting fungal cells. Studies suggest that laser treatments offer comparable results to traditional therapies, often enhancing outcomes when combined with topical agents such as calcipotriol/betamethasone in nail psoriasis. For nail warts, ingrown toenails, onychodystrophy, and nail pigmentation disorders, lasers provide alternative or adjunctive therapies, achieving positive outcomes lesion clearance and symptom improvement. Conclusion: This review underscores the transformative potential of laser therapy in nail disorder management, providing clinicians with innovative treatment alternatives. Nevertheless, further studies are needed to refine protocols, evaluate long-term outcomes and explore its application in specific conditions such as nail tumors.

Successful Treatment of Dystrophic Nails Caused by Onychotillomania Using Pulsed Dye Laser 595 nm: A Case Report

Onychotillomania is characterized by an irresistible urge to pick or pull at one's nails, resulting in significant damage to the nail and surrounding tissue. In severe cases, it can cause onychodystrophy, which leads to abnormal changes in nail shape, color, texture, and growth. Managing onychotillomania can be challenging due to the lack of standard treatment and concurrent behavioral disorders. Pharmacotherapy and behavioral therapy have shown some positive outcomes from reported cases. The treatment for onychodystrophy varies depending on the underlying cause and may entail the application of topical, systemic, or laser therapies. Nevertheless, there is currently no consensus on the most effective treatment approach. This report presents a case of onychodystrophy caused by onychotillomania successfully treated using a pulsed dye laser 595 nm. The treatment was administered four times, with a two-week interval between sessions. Significant improvement was seen within four weeks of starting the treatment, and by the end of the eight-week program, the dystrophic thumbnails had almost completely resolved. After a thorough ten-month follow-up, it has been determined that the dystrophic nails have not reappeared. Moreover, there has been a significant decrease in the patient's tendency to pull her nails.