8 March 2013 Treatment of toe nail fungus infection using an AO Q-switched eye-safe erbium glass laser at 1534nm
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Abstract
We report on “eye-safe” erbium glass laser operating at Short-Wave Infra-Red (SWIR) region at 1534nm, to treat Onychomycosis or toenail fungus. Infected toenails of 12 patients were treated over a 3 month period using both long pulse and Q-switched laser output pulses. Our results compared favorably to Neodymium Yittrium Aluminum Garnet (Nd:YAG) laser fungus treatment studies as reported in literature. Nd:YAG laser devices, operating in the Near Infra- Red, (NIR) region at 1064nm, have recently become an effective alternative treatment to traditional oral medications used to treat nail fungal infections. Conventional nail infection treatments employ medications such as allylamines, azoles and other classes of antifungal drugs that are unpopular due to numerous side-affects and drug interactions. Side effects of these drugs include headache, itching, loss of sense of taste, nausea, diarrhea, heart failure and even potential death from liver failure [1,2,3]. The effectiveness of conventional oral antifungal medications varies. In addition, antifungal prescription drugs are administered for long periods ranging from 6 weeks to 18 months. Nd:YAG antifungal laser treatment reports claim high success rates (65-95%) in eradicating toenail fungus and without adverse side-affects. Multiple laser treatments are administered over a 3 to 6 month period [4,5,6,7]. Our initial treatments performed with the Er:glass laser on toenail fungus patients required only 1 to 2 treatments for cure. This same SWIR laser was used in experiments to treat Athlete's Foot fungal infections. The 1534nm Er:glass laser emission has been found to be well optimized for dermatological treatments due high transmission properties of human skin in the SWIR region. Increased depth of tissue penetration is well-tolerated and provides for effective treatment of various skin conditions. [8,9,10,11] “Eye-safe” Class I lasers provide for practical skin and nail tissue treatment without the need for eye-protection goggles. Laser safety filters may inhibit a practitioner’s vision and ability to distinguish skin and nail regions exhibiting different colors and textures. The laser is “eye-safe” due to the fact that Megawatt peak power Q-switched lasers operating at 1.54um in the narrow spectral window between 1.4um and 1.6um are approximately 8000 times more eye-safe than other laser devices operating in the visible and near infrared. Long-pulse or free running lasers operating in this wavelength range are ~ 2000 times more eye-safe [12].
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Michael J. Myers, Jeffrey A. Myers, Franziska Roth, Baoping Guo, Christopher R. Hardy, Sean Myers, Angelo Carrabba, Carmen Trywick, Stewart Bryant, John Robert Griswold, Aggie Mazzochi, "Treatment of toe nail fungus infection using an AO Q-switched eye-safe erbium glass laser at 1534nm", Proc. SPIE 8565, Photonic Therapeutics and Diagnostics IX, 85650W (8 March 2013); doi: 10.1117/12.2000557; https://doi.org/10.1117/12.2000557
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