Laser Treatment for Nail Fungus – What You Need to Know

Laser Treatment for Nail Fungus (Onychomycosis)

For a complete overview of all of the causes and treatments for fungal, thick and ugly toenails, please read our Guide to Toenail Fungus Treatment. In it you will learn everything you need to know to make an educated decision on the best treatment for your toenails.

On this page we provide detailed information on laser treatment for toenail fungus.

Need to make an appointment right away? Make an appointment online or Call (206) 344-3808

Laser therapy is the newest treatment we offer for fungal toenails and improves the appearance of the nails in many patients. The laser works by penetrating the nail plate and destroys the fungus under the nail. There is no pain and no side effects. Best results and the best looking toenails occur with three laser sessions and the use of specific protocol.

Please understand, however, not all thick nails are caused by fungal infections and laser only works on nails with fungal infection. In addition, most studies show laser is not as effective as the oral medications for treating toenail fungus. It is likely more effective, however, than the topical medications. Information on other causes of thick nails is available here.

Read here how you can get the best results from laser treatment.

Laser Procedure for Nail Fungus

If we determine that laser treatment would likely be effective for you, we will schedule you for your first treatment. On that visit, the following will occur:

• Toenails are thinned using a special toenail grinder
• Toenails are treated with the laser. The big toenails require about two minutes and the small nails about one minute. Total procedure is less than 20 minutes and there is no pain.
• You will be given detailed instructions on preventing reinfection of the nails.
• For best outcomes, laser treatment will be repeated at 3 months and at 6 months.

Why is The Foot and Ankle Center the Best Seattle Clinic for Laser Treatment?

• We will confirm that you have a fungal infection before treating you. There are many causes of thick nails and the laser only works if a majority of the nail problem is caused by a fungal
  

  LEFT: Before ——- RIGHT: 3 months post treatment

  infection. About 30% of the patients that come in requesting laser treatment of fungal nails would not benefit from the procedure. If we don’t think the laser will work for your condition we will let you know so that you don’t waste money on ineffective treatment.

• Lowest cost per session in the Seattle area. Most patients have the best chance at clearing of nails with three laser sessions, each separated by three months. Our price of $590 includes all three sessions.
  • There is also a charge for an evaluation office visit for the first visit only. This visit is usually billed to your insurance. If you don’t have insurance or we are not contracted with your insurance you can find prices for office visits here.
  • We are often able to do the first laser session on this first visit, but that depends on time. The first visit is 30 minutes long. If we spend more than 15 minutes discussing discussing treatment options or other foot problems we probably will not have time to do the first laser on that visit.

• Better outcomes and better looking toenails. There is evidence that patients see better results when they have three treatments rather than one. We include the all three laser sessions in our treatment protocol.

• We treat all 10 toenails. A British study that came out a few years ago showed that in people with some thick toenails due to fungus, fungus was often found even in the normal looking toenails. Based on this study we suggest treating all 10 nails, even if some of them look normal. This helps prevent reinfection. Treatment of all 10 nails is included in the $590 cost.

• We will provide realistic expectations. This is probably the most important reason. We see a lot of people who have been told that laser treatment is their best option when in fact there is little chance laser treatment will help them. If we do not think laser is the best option for you we will let you know.  We will provide all of your options for treating the fungus and help you find the most effective and lowest cost option.

FAQs About Laser Treatment for Nail Fungus

• How effective is laser treatment for toenail fungus?

Laser seems to be about 30 – 40% effective for making nails look better, but newer studies may show different outcomes. This means about 40% of patients will have a better-looking toenail. Our estimate is less than 15% of patients have a completely clear nail after laser treatment.  This compares to studies that show about 38% of patients taking the oral medication terbinafine have a completely clear nail.

In general, we find that laser is less effective than oral medications and more effective than topical medications.

You may see some clinics advertising that laser treatment is more than 80% or 90% effective. Don’t believe them – this is misleading advertising and it is not true. There are currently no studies that support these claims.

• Can laser treatment enhance the outcomes of other treatments for nail fungus?

In this 2014 study, researchers found that “12 weeks of combined treatment with a long-pulsed Nd:YAG laser and oral terbinafine produce more rapid and effective mycological and clinical clearance in patients with onychomycosis than either treatment alone, without any obvious side effects”.

This is hte only study we have found that combines these treatments, so it’s healthy to be a little skeptical of it.  But currently it is the best evidence we have and this is where, based on the best available evidence, we feel that laser can be most valuable.  As noted above, laser is less than 50% effective when used as a standalone treatment.  But according to this study, there may be benefit in adding laser in combination with oral terbinafine.

Learn more about oral terbinafine on this page.

• Is the procedure painful?

Most patients feel no pain.  No anesthesia is needed.

• How many sessions are required, how long between them and how long does each laser treatment take?

Initial visit: This visit is for evaluation and to determine if you are a candidate for laser treatment. This visit is covered by most insurance carriers. We’ll take a complete history and evaluate your condition. If you are a good candidate for laser treatment you will be scheduled for your first treatment. This visit is critical because there are many causes of thick and yellowed nails, and the best treatment will depend on your diagnosis. Before we can determine if laser treatment would be effective for you we may need to take a sample of your nail to send for a lab test to determine if fungus is present.

Treatment #1: At this visit the nails are thinned and the first laser treatment is performed. You are given detailed instruction on preventing reinfection.

Treatment #2: This visit is performed 3 months after treatment #1. The nail is thinned again and laser treatment is performed again.

Treatment #3: This treatment is performed 6 months after treatment #1. This is the final laser treatment and review of preventing re-infection.

• Is it essential to treat all of the toenails or can I get laser for only one toe?

Studies have shown that if one toe is infected, even normal looking toenails often have fungus hiding in them. For optimal outcomes of laser treatment it has been found to be most effective to treat all 10 nails. If we only treat the one toe the odds of reinfection are much higher, so we do not offer treatment of only one nail.

• How does the laser work to treat nail fungus?

Studies are not completely clear on the exact mechanism of action, but it is thought that the laser is absorbed by the fungi causing damage before there is any pain or damage to human tissue. This occurs because of thermal damage to the fungus cells and/or photo-inactivation of the fungus cells.

• Will I be able to walk out, play sports, drive, etc. after the treatment?

Yes. You can do whatever you want immediately after treatment. There is no downtime.

• How soon will I see improvement to my toenails after treatment with a laser?

On average, the big toenails will regrow completely in about twelve months and the smaller nails in about six months. Healthy new growth is usually visible three to four months after the initial treatment.

 

Laser Cost and Insurance Information 

• How much does laser treatment cost?

Our philosophy is to keep the cost as low as possible and include all treatment in your initial fees so there are no surprises. The most effective outcomes are achieved with a total of three treatments and all three treatments are included in the total cost of $590. You may see treatment advertised for less, but these prices are for only one treatment, which has not been shown be to as effective as the three treatment protocol. If you do not have insurance coverage the evaluation visit cost is $109.

• Will my insurance cover laser treatment?

All insurance companies consider laser therapy a cosmetic procedure and do not cover the service. Most insurance carriers will, however, cover your initial visit for evaluation and diagnosis of your nail problem. But your initial visit, where we determine if you are a good candidate for laser therapy, can be billed to your insurance and normal co-pays will apply. As explained below, you may be able to use FSA funds for laser treatment.

• Can I be treated the same day I’m evaluated?

  

  LEFT: Before ——- RIGHT: 6 months post treatment

If a patient is traveling a long distance for treatment and they have previously been diagnosed with a fungal nail infection, we may schedule the first visit and laser treatment on the same day. In this case, a $150 deposit is required to hold the appointment. This is refundable if you give a 48 hour cancellation notification. It will also not be lost if you reschedule within 24 hours of your appointment. The remaining $440 for the laser treatment will be due before we administer the treatment.

• Can I get a payment plan?

We do not offer payment plans. One of the reasons we are able to offer such a low overall cost for the laser treatment is that we do not have to spend resources billing and collecting. You can pay with credit card, cash or debit card. We accept Visa, MasterCard and American Express cards.

• When is payment due?

Payment for the laser procedure in full is required before the treatment is administered. If it is determined you have a fungal infection at your evaluation visit, you will schedule an appointment for the laser procedure and pay a $150 deposit. This is refundable if you give a 48 hour cancellation notification. It will also not be lost if you reschedule within 24 hours of your appointment. The remaining $440 is due at the time of the first laser appointment, before the treatment is administered. If you fail to show for the appointment, the down payment is forfeited.

• Can I use my FSA/HSA to pay for Laser treatment for toenail fungus?

Most Heath Savings Accounts (HSAs) or Flexible Spending Accounts (FSA) may be used to pay for this treatment. Please contact your individual HSA or FSA regarding coverage.

Preventing Reinfection from Nail Fungus

People who get onychomycosis usually have inherited an immune system that does not fight this fungus very well. Thus, reinfection is not uncommon. You can read more here about preventing reinfection of nail fungus. Many patients return once per year for a preventative laser session. The cost of this session is currently $290 for one treatment session of all 10 toes. This is available only to patients who have undergone a full three treatment session with us in the previous 48 months. If the nails become infected again and a full course of treatment is required, then standard three-session treatment charges apply.

Get Started Now

Contact us today to make an appointment to find out if you are a good candidate for laser treatment for nail fungus.