A comparative clinical and mycological study of Nd-YAG laser versus topical terbinafine in the treatment of onychomycosis

J Dermatolog Treat. 2015 Oct;26(5):461-4. doi: 10.3109/09546634.2014.998607. Epub 2015 Feb 11.

Abstract

Background: Topical treatment of onychomycoses is time consuming, cost-intensive and subject to relatively high failure rates. Light-based devices may be effective treatment modalities. Aim of this work: To compare the clinical and mycological efficacy of Nd-YAG laser versus topical terbinafine in the treatment of onychomycosis.

Patients and methods: This study included 40 patients with onychomycosis randomized to receive four sessions of Nd-YAG laser (group A) or topical terbinafine twice daily for six months (group B). Follow-up was performed monthly. Mycological examination was done at third and sixth months following the start of treatment.

Results: After six months, all patients in group A showed marked improvement, while in group B only 50% of patients showed mild to moderate improvement. In addition, by the end of six months, 80% of the patients in group A showed mycological clearance, while all patients in group B still had positive cultures.

Conclusion: Long pulse Nd-YAG laser therapy of onychomycosis is a safe and efficient method for treating onychomycosis. It is especially beneficial in elderly, compromised and hepatopathic patients for whom other alternative treatments could present some risks.

Keywords: Nd-YAG laser; onychomycosis; topical terbinafine.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Administration, Cutaneous
  • Administration, Oral
  • Adult
  • Antifungal Agents / therapeutic use*
  • Drug Therapy, Combination
  • Female
  • Humans
  • Lasers, Solid-State / therapeutic use*
  • Light
  • Male
  • Middle Aged
  • Naphthalenes / therapeutic use*
  • Onychomycosis / drug therapy*
  • Onychomycosis / microbiology
  • Onychomycosis / radiotherapy*
  • Terbinafine
  • Treatment Outcome
  • Trichophyton
  • Young Adult

Substances

  • Antifungal Agents
  • Naphthalenes
  • Terbinafine