Treatments
Laser treatment for fungal nails: does it work?
Laser is the most heavily marketed option and the least well evidenced. It is worth understanding what the studies actually show before spending several hundred pounds.
Summary
Laser devices heat the nail plate to damage fungal cells. Regulatory clearance in some markets is for a temporary increase in clear nail, which is not the same as cure. UK guidance does not recommend laser as a first-line treatment, and it is not routinely available on the NHS.
What a course involves
Typical private practice in the UK.
- Three to four sessions spaced several weeks apart
- £150–£1,000 depending on clinic and number of nails
- A warm or hot sensation during treatment; no anaesthetic
- Usually combined with nail reduction and topical treatment
The evidence
Trials are small, short and often lack a control group. Reported mycological cure rates vary widely and are generally lower than oral terbinafine. Long-term recurrence data is limited.
How it compares
Cheaper, better-evidenced routes exist: removing the diseased nail with 40% urea, medicated lacquers for mild disease, or oral terbinafine for extensive infection. Laser is best considered when other options are unsuitable and cost is not a barrier.
When to seek medical advice
Ask any clinic for their own cure-rate data and what happens if it does not work before committing.
References
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Medical disclaimer. This article is general information written for a UK audience. It is not medical advice and does not replace assessment by a GP, pharmacist or podiatrist. Always read the patient information leaflet supplied with any product before use.