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Advertisements for Laser Treatment of Onychomycosis (Bryan C. Markinson, DPM)

04/08/2011      Kenneth Meisler, DPM


I read Dr. Markinson's comments and I agree that many podiatrists are giving patients false expectations regarding laser treatment for fungal toenails.

Just yesterday I had a patient who was very upset with another podiatrist who said Laser treatment will give a 90% chance of curing the fungus. The patient left the prior podiatrist because he felt he had been misled even though he had improvement.

I sit here writing this as I have a break between my first and second Laser patients of seven that I have scheduled for today to treat fungal toenails. The difference is that NONE of my patients are expecting a "cure."

All of the patients I see who present with onychomycosis are given the options of oral Lamisil, topical meds (Rx and OTC), and laser treatment. Many decide to take oral Lamisil because I feel it has the best documented chance of improving their condition. However many patients are adamant that they do not want to take Lamisil. Also some of the patients do not wish their patients to take oral Lamisil for various reasons such as my last patient who is on Coumadin.

I tell patients that I think there is a 60% chance that in one year they will be glad they had the laser done (that their nails will look better). I also tell them that they will have to continue to treat themselves with antifungal powders, perhaps topical antifungals and may require future laser treatments and possibly topical antifungals or Lamisil in the future. Even with these modest expectations many patients are willing to have the laser treatment.

I hope Dr. Markinson will agree that after giving patients a more realistic expectation that it is appropriate to use laser for fungus toenails.

Kenneth Meisler, DPM, NY, NY, Kenmeisler@aol.com