The fungus organism and its spores are very common in air and soil around the world. The pathogen most responsible for toenail fungus is called trichopyton rubrum fungus. Toenail fungus can be caused by trauma, poor foot hygiene, and diabetes and can affect people of any age. For unknown reasons, some people are more susceptible to contracting fungal infections. Fungus thrives in a dark, warm and moist environment, which is common in most shoes. Many people who suffer from toenail fungus are embarrassed to wear sandals or open shoes, and in some cases the infection can be painful.

Approximately 25 million Americans have some form of onychomycosis. Laser treatment is effective in approximately 90% of all cases. This revolutionary protocol is the most effective treatment for this very common and unsightly condition. Once the fungal infection has been resolved by the laser therapy and clear nail growth has begun, it's important to take several hygienic measures in order to maximize the long-term benefits.


After Laser

Before and After Laser Treatment

How do I know if I have toenail fungus?
You may suffer from onychomycosis of the toenails or finger nails if they appear thickened, brittle, crumbly, distorted, or darkened with underlying debris.


Can onychomycosis be treated by other methods?
Prescription antifungal medicines, such as Lamisil®, taken orally, may help clear the fungus in about 50% of patients. The oral medications need to be taken daily for three months. However, such medications require periodic blood tests, can cause side effects such as taste or stomach disturbance, allergic reactions or can interfere with other medications. Some of the oral medications used to treat fungal infections of the nail can impact the liver.

Before the introduction of laser therapy, in some cases, total removal of the toenail was the only way to effectively cure the disease.

How does the laser treatment work?
The laser therapy works by using a specific wavelength laser light that passes through the nail and the surrounding tissue. The laser light is absorbed by pigment in the fungi, which causes it to heat and kill or damage the fungal organism. This results in your nail growing out normally.

Is the laser treatment painful?
The laser treatment does not harm healthy tissue, and most patients do not experience any significant discomfort either during or after the procedure. You may, however, experience a mild warming sensation or periodic pin prick sensations that may last a fraction of a second. No anesthesia is needed.

After Laser

Laser Handpiece During Treatment




What can I expect during the laser treatment?
It is important that you do not have any polish, ornaments, creams or lotions on your toes. No medication, injections or sedation is required. You will be seated in a regular treatment chair, wearing special protective laser eye glasses. Depending upon the thickness of your nails due to the fungus, your nails may be thinned using an electric grinding instrument. Thinning is important so the laser will be most effective. The entire treatment lasts approximately 40 minutes.



How long will it take for healthy nails to grow?
A healthy toenail requires approximately one year to grow from the cuticle or eponichium to its full length. Toenails grow more slowly than fingernails. The first growth of clear nail that is free of onychomycosis is seen at about three to four months after the initial laser therapy. The clear nail growth will continue to push out the infected fungus nail.


Has the FDA evaluated the laser?
Yes; the Cutera® GenesisPlus treatment is FDA cleared for onychomycosis.

Are all lasers and laser treatments the same?

It is indeed unfortunate that on the internet and in the media, there are some medical claims that are either invalid or demonstrate exaggerated claims. There are advertisements for lasers that have not been clinically proven or that have not been cleared by the FDA. Just as you would with any treatment plan, be sure you clearly understand the claims and expectations of the treatment outcome.

The use of a laser for the treatment of onychomycosis is not simply “point and shoot.” There are numerous treatment methods that can vary considerably among doctors. In addition, there are different types of lasers that your doctor can choose.


Why choose Cutera® GenesisPlus laser?
· One of only two lasers FDA cleared for onychomycosis as of June 2011.
· Cutera is a worldwide leader in laser technology for medical purposes.
· Specialized heat sensor on hand piece provides accuracy and safety of treatment.
· Proven effectiveness


Will I be able to walk after the laser treatment?
Most people are able to simply put on their shoes and walk out of the office immediately after the procedure and resume their normal activities.

How long does the laser treatment take?
Each laser treatment takes about 15 minutes for all ten nails. The length of time depends upon the severity of the nail condition.

How many laser treatments are needed?
Up to a total of three laser treatments are provided during the first year. The number of treatments is dependent upon the severity of the fungal condition. Before the beginning of the laser treatment, the number of laser treatments will be fully discussed.

What are the after-care instructions for the laser procedure? What about re-infection?
A comprehensive plan to prevent reoccurrence is critical to long-term success. The feet should be bathed daily with warm water, soap and a wash cloth or nail brush. Using only soap and water and hand pressure is not effective. It is also important to use a nailbrush a few times each week with a mildly abrasive detergent such as Soft Scrub. Good foot hygiene is as important as good dental hygiene.

The average foot perspires about four ounces of sweat daily. This sweat provides the perfect breeding conditions for fungus. Even if you allow your shoes to partially dry out during the evening hours, they will likely still be damp in the morning and contain fungal organisms. Although there is no perfect solution to this problem, there are several options.



The SteriShoe® is an ultraviolet shoe sanitizer that effectively kills fungus and bacterial organisms using ultraviolet (UVC) light. UVC has been used for decades in hospital and municipal water treatment plants throughout the world. This chemical-free therapy is both effective and protective of the environment. We recommend the use of the SteriShoe® in conjunction with the laser nail treatment. It will not cure your infection, but it will provide a cleaner environment for your feet. Fungi are very resilient and can live in your shoe as spores, even if you don’t wear a shoe for months. Spores are similar to seeds. Once you start to wear your shoe again, the perspiration and heat from your foot will cause the spores to grow. The SteriShoe destroys the fungi and other microorganisms. A SteriShoe treatment takes approximately 40 minutes and one device be used on multiple shoes in your home. The cost of a SteriShoe is $120.00.


The fiber of your socks is also important. Cotton is the worst fiber because it absorbs the sweat of the foot and keeps it in continual contact. The synthetic fibers such as blends of acrylic, polyester and nylon are strong, but are minimally effective in keeping the foot dry. These plastic fiber socks are promoted as wicking sweat away from the skin, but those claims are poorly substantiated in clinical trials. In addition, they may cause increased foot odor. Socks that keep the foot very dry and do not cause foot odor are made of a high percentage blend of merino wool and small amount of nylon and spandex (for strength.) These socks are available at SmartWool® and at sporting goods stores such as REI. Some people believe that wool socks are either hot or itchy. Our patient's experiences disprove these ideas.


Can I use nail polish after the laser treatment?
Toenail polish can be reapplied the following day after the laser treatment. It is important to note that all nail paint and nail polish has to be removed prior to having the laser treatment performed.

What is the cost for the treatment?
The total cost of the laser treatment is dependent upon the degree of fungus in the toenails. Some people are much susceptible to fungus than others due to personal physiological differences such as foot perspiration. Additional treatments are often necessary. Therefore a consultation appointment is recommended. In general, the average cost of the complete laser treatment is between $500.00 and $1,000.00

How can I pay for the procedure?
We accept most major credit cards (VISA, Mastercard, American Express and Discover), debit cards, checks and cash. Payment plans are also available. For more information on financing and payment plans, please visit: CareCredit®


Is this procedure covered by my medical insurance?
Since toenail fungus is considered a cosmetic condition, health insurance companies and Medicare do not provide coverage for laser treatment. Patients with Heath Savings Accounts or Flexible Spending Accounts may be able to apply those funds toward the treatment, however we recommend that you check with your specific plan.


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