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

Abstract

Background Laser treatment has emerged as a novel treatment modality for onychodystrophy. Only a few small series have assessed the efficacy of laser treatment in onychodystrophy, most of which were case reports. The therapeutic effect of the 1064 nm neodymium‐doped:yttrium aluminum garnet (Nd:YAG) laser for onychodystrophy has been demonstrated. Recently, the picosecond Nd:YAG (PSNY) laser has been introduced to improve various skin disorders. Aims The aim of this study was to verify the efficacy of a 1064 nm PSNY in management of idiopathic onychodystrophy. Methods We present a case series of dystrophic nails treated with a PSNY for onychodystrophy improvement. Planimetry using ImageJ software was used to calculate lesion reduction and proximal clear nail growth. Clinical improvement was assessed using a 5‐point Global Assessment Scale (GAS). Adverse events were also assessed. Results Twenty‐five patients (11 males and 14 females) with a total of 128 nails (94 finger nails and 34 toe nails) were treated. The mean treatment number was 8.7 ± 6.2, and the mean total duration of treatment was 33.4 ± 34.6 weeks. The average proportion of the lesion area decreased significantly (from 65.9% to 46.6%) after PSNY treatment (P < .001). The mean GAS (3.16 ± 1.18) exhibited fair improvement, and there were no serious adverse events. Conclusion The 1064 nm PSNY laser can provide fair improvement for onychodystrophy with a good prognosis at least during the follow‐up period and optimal cosmetic results in Asian patients.

Treatment of pincer nail deformity with 1064‐nm Nd:YAG laser

“…The efficacy of the Nd:YAG laser in the treatment of onychomycosis in a case report has been reported from Düsseldorf, Germany 9 . A case series related to the therapeutic effect of the 1064‐nm Nd:YAG laser for onychodystrophy in Asian patients has also been reported 10 . They stated the possible mechanism of action of the Nd:YAG laser on dystrophic nails according to previous reports, collagen rejuvenation associated with the photothermal effect or reduction of inflammatory cytokines in nail matrix and proximal nail fold by reduced oxidative stress and increased antioxidant enzymes.…”

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

“…Specific laser therapies, such as the fractionated carbon dioxide laser, 1064 nm quasi-long pulsed Nd: YAG laser, and 1064 nm picosecond Nd: YAG laser, have been reported successful in treating onychodystrophy that does not respond to conventional treatment methods. [15][16][17][18][19] The complete understanding of the mechanism behind these laser treatments remains to be discovered. According to previous reports, lasers may function through photothermal effects that rejuvenate collagen, decrease inflammatory cytokines, and cause microscopic damage that enhances blood flow.…”

“…According to previous reports, lasers may function through photothermal effects that rejuvenate collagen, decrease inflammatory cytokines, and cause microscopic damage that enhances blood flow. 15 Nevertheless, no therapy for onychodystrophy has been consistently effective enough to become the standard of excellence. This patient's primary concern during her visit to the doctor is her nail deformity.…”

Brown pigmentation on skin post intravenous ferric carboxymaltose

“…Pigmentation lasers can be offered after consultation with the dermatologist and patient. Pigmentation lasers have been shown to be efficacious in various case reports and case series in patients with cutaneous siderosis 3–5 . The choice of wavelength of laser depends on the pigmentation color 3 .…”