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. 2019 Oct 1;12(10):29–34.

TABLE 4.

Energy-based onychomycosis treatments

TREATMENT MODALITY ARTICLE REFERENCE PARAMETERS NUMBER OF TREATMENTS (INTERVAL) ADDITIONAL TREATMENTS REPORTED CURE RATES
Nd:YAG Kalokasidis et al36 First pass: 1,064nm,14 J/cm2
Second pass: 532nm, 14 J/cm2 		2 (4 weeks) None At one month

  • Mycological: 95.4%

  • Clinical: 10.6% women, 5.4% of men

No long-term results
Hochman et al37 2 passes: 1,064nm, 223 J/cm2, no cooling 2–3 (3 weeks) Antifungal cream After last treatment:

  • Mycological: 87.5%

No long term results
Okan et al38 2 passes: 1,064nm, 40–60 J/cm2 4 (1 week) 40% urea cream under occlusion 1 week pretreatment At 6 months:

  • Mycological: 60%

  • Clinical: 47%
Carney et al39 1,064nm, 16 J/cm2 4 (1 week) + single additional session at Week 7 Topical antifungal At 15 weeks:

  • Mycological: 42.8%

At 24 weeks:

  • 33% recurrence
Fractional CO₂ Bhatta et al33 2–6 passes : E=9 mJ, 410 spot/cm2 3 (4 weeks) 1% terbinafine cream daily for 3 months At last treatment:

  • Mycological: 92%-94.6%

At 6 months:

  • Mycological: 80%-84%
Shi et al40 Multiple passes: E=15 mJ, 15% spot density 12 (2 weeks) 1% terbinafine cream daily, under occlusion overnight for 6 months At last treatment:

  • Clinical: 58.87%

At 3 months:

  • Mycological: 74.19%

  • Clinical: 68.55%
Nonthermal Zang et al42 635-/405-nm dual-diode laser 4 (1 week) None At 6 months:

  • Clinical: 67%
Near infrared light Landsman et al41 4,074 J/cm2, 870 and 930 nm Treatments at Days 1, 14, 42, and 120 None At 2 months:

  • Clinical: 65%
*

Clinical cure refers to >75% nail clearance or > 3mm of clear nail growth