Monday, October 6, 2014

The War on Nail Fungus...the many battles you must fight to kill nail fungus!!! treatment modalities for different medical conditions come and go. When we first heard about the PinPointe Laser for toenail fungus we were certainly skeptical about it being a miracle cure for fungus.This laser has been available on the market since 2007 and when we first heard of this laser, we thought here goes another trend that will cost the patient a lot of money and won't work. I thought this device would leave as quick as it came. This did not happen, in fact, we started to have patients that we refer to as "Snowbirds" living here in Florida only part time, that had this procedure done up North with great success. Yes they had to wait 9 months or longer to see the return on their investment, but happy when they saw their result. This prompted us to investigate the PinPointe Laser in more depth. At the time, the PinPointe Laser was the only laser built from the ground up to kill nail fungus and was cleared by the FDA based on peer reviewed studies. When introducing a modality into your office for patients, you take a certain leap of faith that what you know from research and speaking to other physicians success stories will translate into success for your patients. 2012 the Center for Ankle and Foot Care introduced to PinPointe Laser for nail fungus into our practice.

We jumped into the laser for nail fungus feet first!(yes pun intended) We acquired our laser in February of 2012. Over the last 2 and 1/2 years we have developed protocols for the laser that work best for different case scenarios.  But before I ever discussed with patients the laser, I give them all of their treatment options.  I first discuss the topical approach, I do explain that topical success rate truly depends on if the fungus is under the nail or on top of the nail.  If the patient has a superficial fungus a topical can be effect.  If the fungus is under the nail, no dice! The thick nail and topical anti-fungal is a wildly unsuccessful combination.

If your nail is thick and fungal, an oral medication can be a treatment option.  Lamisil is the drug of choice.  We get what is called a liver function test, blood work to make sure your liver is free from disease.  If your liver function test is normal, you can take the Lamisil.  I make my Lamisil patients follow all of my laser patients after care.  They have to prevent reinfection with the same steps listed below.

The last option I discuss with patients is the PinPointe Laser treatment.  Some people can not take the medicine by mouth or just do not want to take the medicine by mouth.  They want the laser.

Many patients are interested in having the State of the Art PinPointe Laser Treatment for their discolored, thickened fungal toenails.  Before anyone jumps into having this procedure done, we sit down and explain to them why, what they do at home, is just as important as the Laser treatment itself. Yes the PinPointe Laser for toenail fungus is a great procedure, but patients have to be active in their roll to prevent any reinfection!
How the PinPointe Laser works is simple. This patented laser is specially designed to shine through your toenail and destroy the specific pathogens embedded in and under your nail causing the infection.  Unlike other lasers that are used for skin or pain treatments, the PinPointe™ laser is designed and used for only one purpose; to safely destroy molds and bacteria that cause fungus nail infections (Onychomycosis). If the nails is extremely thick it can take up 15 plus treatments and quite a bit of patience, as it truly takes 9 months to a couple years for a whole new nail to grow out.

Before the patient has the PinPointe Laser performed a thorough evaluation of the skin and nails is performed. If the patient has a bad case of athlete's foot, they will be given a prescription for a topical anti fungal for the skin. I would see them back after a couple of weeks before I would perform the laser treatment. I explain that success is dependent on the foot being in an environment that is free of fungus. If a patient has the PinPointe Laser procedure performed, what they do from that moment on can play a role in their success rate. Once we have performed this procedure, patients are given instructions on preventive care for the toes.

What to Avoid After Having the PinPointe Laser Treatment :
  • Any shoes that you have worn before the Laser (especially shoes you have worn without socks)
  • Nylons or panty hose
  • Going barefoot in environments that could expose you to fungus again
  • Pedicures in places that do not AUTOCLAVE instruments and take all precautions to protect you
  • Wet moist environmental exposure to feet(ie. constantly having wet shoes) usually occupational hazard
Why it is Important to Avoid these things After The Laser:
  • Any shoes that you have worn before the Laser was Performed are basically little incubators for the fungus, putting these shoes back on puts you at risk for reinfection!
  • Nylons do not breath, again causing an environment that will be moist and possibly be a red flag for your toes!
  • Taking precautions in environments that you are not familiar with is important, if Joe Schmo has fungus and you walk in his house barefoot, you are increasing your chance of reinfection!
  • Do not get a Pedicure unless you know: that all instruments are autoclaved, they use liners between each client, that the pedicure chairs are pipeless and tubeless, that they do not reuse any files on anyone and that they do not reuse nail polish from client to client!
  • If you are a landscaper, chef or someone whose feet are constantly getting wet at work, you need to change your shoes during the day and even consider spraying your feet with an anti fungal spray during the day while at work!

The laser is not in itself a miracle cure if the patient does not take an active roll in their own care.  The laser can dramatically improve the appearance of the nail and get rid of the fungus, but if you have a nail that has had previous trauma and the nail is deformed you still may wind up with a disfigured nail just fungal free.

   Biggest rate limiting step for patients perceived successful outcome is how slow the nail grows. We do advise those with extremely thick nails, that they will most likely need multiple treatments and recommend our comprehensive care plan of the unlimited zaps until their fungus is gone.  We want people to know if they are serious about getting rid of their nail fungus we have something that actually works and worth the investment for their future good foot health. 

What we charge:
1. If your nails are not thick we recommend the 5 zaps for $500
2. If your nails are thick you should consider the unlimited zaps until your fungus is gone for $1500. We will be with you every step of the way until the fungus is gone!

If you are interested in learning more about the PinPointe Laser Treat for Nail Fungus click the link below. 


  1. Biggest rate limiting step for patients perceived successful outcome is how slow the nail grows. We do advise those with extremely thick nails, that they will most likely need multiple treatments and recommend our comprehensive care plan of the unlimited zaps until their fungus is gone. EmoniNail

    1. What a difference! You can see some of the nail shavings in the background. I used sanding sticks and really worked hard to smooth everything down.Therapy Fungistop

  2. Very helpful article!! Women are always concerned about their nails. I give my nails a makeover with Sakare's nail treatments and am very satisfied with the results.

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  6. Toenails that have grown thicker over time likely indicate a fungal infection, also known as onychomycosis. Left untreated, curved toenail treatment can become painful. Prompt treatment is key to curing the nail fungus.