How Many Laser Treatments Does It Take To Cure Toenail Fungus?
'One question we often get is “how many laser treatments are required to cure toenail fungus?” This is a good questions since some podiatry practices offer single treatments, some recommend multiple treatments and some others even recommend ongoing “maintenance” treatments.
Given that there is generally more cost and more time taken out of your schedule with more treatments, it may be helpful to understand the benefits of different laser treatment regimens.
The first thing you must understand about laser treatments is that you have to get rid of ALL of the fungus if you really want to have clear toenails.
Getting rid of ALL of the fungus means getting rid of the fungus in 3 sources:
1. Toenail fungus: you must kill all of the fungus living in the toenails.
2. Skin infection: you must kill all of the toenail fungus living in the skin on the toes and feet in the form of athlete’s foot.
3. Fungus in your shoes and socks: you must destroy all of the toenail fungus spores that have been shed from the infected toenails.
If you have a laser treatment that effectively removes all of the fungus from the toenails, but you have a skin infection with the same fungus (in the form of athlete's foot), the athlete's foot fungus will quickly spread back into the damaged toenails and re-infection then toenails. In the end, you won’t see any improvement in the condition of the toenails.
If you have a laser treatment session that kills all of the fungus from the toenails, but you have fungal spores in your shoes or socks, the fungal spores can easily get back into the cracking, splitting, crumbling toenails. In the end, you won’t see any improvement in the condition of the toenails.
The good news is that fungus is dead at the time the laser toenail fungus treatment is performed: if the person performing the procedure doesn’t miss any spots. Because it is possible to kill the fungus in one treatment, one treatment can be enough. The laser destroys the fungus. So no, it is not always necessary to have multiple laser treatment sessions.
The biggest limiters are time and heat. More laser treatment takes longer, simple as that. Also, the more laser treatment you have in one session, the more heat can build up in the toenails.
Heat build-up is not a problem as long as you can tell your doctor that the toes are getting hot. The moment the laser beam is moved to a different area of the toenail, the heat goes away.
The toenail laser delivers light impulses in a very specific way. However you can’t really “turn up” the volume on the laser. But you can deliver more laser killing power with more time under the laser beam.
If your laser treatment uses only the minimum amount of laser energy that may be reasonably expected to kill the toenail fungus, it takes less time.
Here’s an example. Let’s say that your doctor thinks 50 Kilojoules (Kj) of laser energy might be enough to cure the fungus. If it takes 2 minutes to deliver 50Kj of laser energy to each toenail, and you have ten toes, that means your doctor has to spend a total of 20 minutes treating your toes.
But if your doctor instead delivers 100Kj of laser energy to each toe (doubling the odds of killing all of the fungus) that would take 40 minutes; which is twice as much time.
Because most doctors simply charge a flat fee for each laser treatment session, there is actually more financial incentive for your doctor to perform multiple laser treatments in multiple sessions. Each additional session is additional income for the doctor.
But it isn’t all about money...
The doctors that recommend multiple treatments are trying to make sure of 3 things:
1. The doctor wants to make sure that all of the fungus is removed by hitting all of the spots where the fungus is on, under, or inside the toenail.
2. The doctor wants to lower the risk of any discomfort during the laser procedure. Less laser = less heat = less risk of discomfort.
3. The doctor wants to kill any fungus that gets back into the toenails after the procedure. If you don’t get rid of the fungus in your skin, shoes or socks, the spores might cause a re-infection. Treating the toenails again a few weeks later can kill any fungus that might have re-infected the toenails.
So, keep in mind that when you walk into a doctor’s office to have your laser toenail fungus treatment:
The fungus is still in your shoes.
The fungus may be in your skin.
And if you don’t get rid of ALL of the fungus at the same time, you shouldn’t expect to be cured of the toenail fungus infection.
Make sure a doctor is performing the procedure.
Believe it or not, some practices let non-physicians perform the laser procedure. The person may be called a “medical assistant,” “physician assistant,” or “nail care technician.”
In most of these cases a doctor is “supervising” the unlicensed non-doctor who is actually performing the laser toenail fungus treatment. This is legal in many states. The doctor simply tells the technician the basic ideas of treating toenail fungus with the laser. The person may be told how much time or how many Kilojoules (Kj) of laser energy to deliver to each infected toenail.
The doctor doesn’t actually even need to be present when the laser treatment is performed. The doctor may be down the hall in another room removing stitches, looking at x-rays or filling out paperwork.
Because the unlicensed person is not actually allowed to make decisions regarding your medical treatment he or she must simply follow the instructions of the doctor. The doctor may keep the laser limit lower to prevent any risk of building of heat in the toenail that could cause a burn in the toenail bed.
If the non-doctor is restricted in how much laser energy can be applied to each toenail during your laser toenail fungus treatment, the treatment may not kill all of the fungus in the first treatment session. But with several sessions, it is much more likely that all of the toenail fungus will be killed and the toenail infection will be cured. This is one other reason why some practices recommend multiple laser treatments.
When trying to decide how many laser treatment sessions you will need in order to cure your toenail fungus infection simply have to take a few different variables into account.
1. Cost
The lowest cost treatment is the one that is the most effective. If you base your cost analysis of a laser treatment session on a “package deal” that includes multiple treatments, this may be the cheapest option per treatment. However, if you don't need multiple treatments of the toenails, then a single treatment may be the lowest cost option.
2. Time
There is no doubt that a single effective treatment session takes much less time than going to a doctor's office for multiple treatments. You can choose a longer initial treatment session that actually kills all of the fungus in one treatment session, or you may prefer multiple treatment sessions which also can kill all the fungus, but just takes a few separate sessions. In addition, if the doctor will bring the laser to your home so that you don't have to travel to a physician’s office, this will save additional time as well.
3. Effort
Some effort will be required on your part if you really want to have a successful treatment. You have to wash your socks in hot water, disinfect your shoes and treat any skin infection that may be present. This takes effort. You must be honest with yourself in determining whether or not you're willing to spend the time and effort to take these additional steps on your own before or after your laser treatment. If you feel that it is unlikely that you're going to take these additional steps yourself, you're probably better off having multiple treatments that can kill any ongoing reinfection that might occur as a result of having fungal spores present where they can get back in the toenails and start growing again.
Once you consider all of these variables you can make a decision about how many laser treatments and which treatment regimen is best for you.
Given that there is generally more cost and more time taken out of your schedule with more treatments, it may be helpful to understand the benefits of different laser treatment regimens.
The first thing you must understand about laser treatments is that you have to get rid of ALL of the fungus if you really want to have clear toenails.
Getting rid of ALL of the fungus means getting rid of the fungus in 3 sources:
1. Toenail fungus: you must kill all of the fungus living in the toenails.
2. Skin infection: you must kill all of the toenail fungus living in the skin on the toes and feet in the form of athlete’s foot.
3. Fungus in your shoes and socks: you must destroy all of the toenail fungus spores that have been shed from the infected toenails.
If you have a laser treatment that effectively removes all of the fungus from the toenails, but you have a skin infection with the same fungus (in the form of athlete's foot), the athlete's foot fungus will quickly spread back into the damaged toenails and re-infection then toenails. In the end, you won’t see any improvement in the condition of the toenails.
If you have a laser treatment session that kills all of the fungus from the toenails, but you have fungal spores in your shoes or socks, the fungal spores can easily get back into the cracking, splitting, crumbling toenails. In the end, you won’t see any improvement in the condition of the toenails.
The good news is that fungus is dead at the time the laser toenail fungus treatment is performed: if the person performing the procedure doesn’t miss any spots. Because it is possible to kill the fungus in one treatment, one treatment can be enough. The laser destroys the fungus. So no, it is not always necessary to have multiple laser treatment sessions.
The biggest limiters are time and heat. More laser treatment takes longer, simple as that. Also, the more laser treatment you have in one session, the more heat can build up in the toenails.
Heat build-up is not a problem as long as you can tell your doctor that the toes are getting hot. The moment the laser beam is moved to a different area of the toenail, the heat goes away.
The toenail laser delivers light impulses in a very specific way. However you can’t really “turn up” the volume on the laser. But you can deliver more laser killing power with more time under the laser beam.
If your laser treatment uses only the minimum amount of laser energy that may be reasonably expected to kill the toenail fungus, it takes less time.
Here’s an example. Let’s say that your doctor thinks 50 Kilojoules (Kj) of laser energy might be enough to cure the fungus. If it takes 2 minutes to deliver 50Kj of laser energy to each toenail, and you have ten toes, that means your doctor has to spend a total of 20 minutes treating your toes.
But if your doctor instead delivers 100Kj of laser energy to each toe (doubling the odds of killing all of the fungus) that would take 40 minutes; which is twice as much time.
Because most doctors simply charge a flat fee for each laser treatment session, there is actually more financial incentive for your doctor to perform multiple laser treatments in multiple sessions. Each additional session is additional income for the doctor.
But it isn’t all about money...
The doctors that recommend multiple treatments are trying to make sure of 3 things:
1. The doctor wants to make sure that all of the fungus is removed by hitting all of the spots where the fungus is on, under, or inside the toenail.
2. The doctor wants to lower the risk of any discomfort during the laser procedure. Less laser = less heat = less risk of discomfort.
3. The doctor wants to kill any fungus that gets back into the toenails after the procedure. If you don’t get rid of the fungus in your skin, shoes or socks, the spores might cause a re-infection. Treating the toenails again a few weeks later can kill any fungus that might have re-infected the toenails.
So, keep in mind that when you walk into a doctor’s office to have your laser toenail fungus treatment:
The fungus is still in your shoes.
The fungus may be in your skin.
And if you don’t get rid of ALL of the fungus at the same time, you shouldn’t expect to be cured of the toenail fungus infection.
Make sure a doctor is performing the procedure.
Believe it or not, some practices let non-physicians perform the laser procedure. The person may be called a “medical assistant,” “physician assistant,” or “nail care technician.”
In most of these cases a doctor is “supervising” the unlicensed non-doctor who is actually performing the laser toenail fungus treatment. This is legal in many states. The doctor simply tells the technician the basic ideas of treating toenail fungus with the laser. The person may be told how much time or how many Kilojoules (Kj) of laser energy to deliver to each infected toenail.
The doctor doesn’t actually even need to be present when the laser treatment is performed. The doctor may be down the hall in another room removing stitches, looking at x-rays or filling out paperwork.
Because the unlicensed person is not actually allowed to make decisions regarding your medical treatment he or she must simply follow the instructions of the doctor. The doctor may keep the laser limit lower to prevent any risk of building of heat in the toenail that could cause a burn in the toenail bed.
If the non-doctor is restricted in how much laser energy can be applied to each toenail during your laser toenail fungus treatment, the treatment may not kill all of the fungus in the first treatment session. But with several sessions, it is much more likely that all of the toenail fungus will be killed and the toenail infection will be cured. This is one other reason why some practices recommend multiple laser treatments.
When trying to decide how many laser treatment sessions you will need in order to cure your toenail fungus infection simply have to take a few different variables into account.
1. Cost
The lowest cost treatment is the one that is the most effective. If you base your cost analysis of a laser treatment session on a “package deal” that includes multiple treatments, this may be the cheapest option per treatment. However, if you don't need multiple treatments of the toenails, then a single treatment may be the lowest cost option.
2. Time
There is no doubt that a single effective treatment session takes much less time than going to a doctor's office for multiple treatments. You can choose a longer initial treatment session that actually kills all of the fungus in one treatment session, or you may prefer multiple treatment sessions which also can kill all the fungus, but just takes a few separate sessions. In addition, if the doctor will bring the laser to your home so that you don't have to travel to a physician’s office, this will save additional time as well.
3. Effort
Some effort will be required on your part if you really want to have a successful treatment. You have to wash your socks in hot water, disinfect your shoes and treat any skin infection that may be present. This takes effort. You must be honest with yourself in determining whether or not you're willing to spend the time and effort to take these additional steps on your own before or after your laser treatment. If you feel that it is unlikely that you're going to take these additional steps yourself, you're probably better off having multiple treatments that can kill any ongoing reinfection that might occur as a result of having fungal spores present where they can get back in the toenails and start growing again.
Once you consider all of these variables you can make a decision about how many laser treatments and which treatment regimen is best for you.
How many laser treatments do we recommend?
In our practice we have found that the vast majority of our patients have success with a single treatment. We choose to spend more time during the initial treatment making sure that you understand all that you must do to ensure removal of the fungus from your shoes, socks and skin. Then we simply do a much longer laser treatment session. In that way, we cover all areas of the toenail several times, with several times the amount of laser beam exposure than the minimum required to kill the toenail fungus. This seems to work for our patients in the overwhelming majority of cases.