Combined oral terbinafine and long-pulsed 1,064-nm Nd: YAG laser treatment is more effective for onychomycosis than either treatment alone.

Abstract

Onychomycosis is difficult to cure. Systemic and topical treatments, including the 1,064-nm Nd:YAG laser, are not very effective when used individually. To compare the efficacy and safety of combined treatment with a long-pulsed 1,064-nm Nd:YAG laser and oral terbinafine with those of either treatment alone. We randomly divided 53 patients with a total of 90 infected nails into 3 treatment groups: the T group received oral terbinafine, the L group received long-pulsed Nd:YAG laser treatment, and the T + L group received both treatments. We evaluated the mycological clearance rate (MCR) and the clinical clearance rate (CCR) of the 3 groups at Weeks 4, 8, 12, 16, and 24. The MCR and CCR increased in all 3 groups in a time-dependent manner. The MCR and CCR of the T + L group were significantly higher than those of the T group and the L group at Weeks 8, 12, 16, and 24 (p < .05). These data indicate that 12 weeks of combined treatment with a long-pulsed Nd:YAG laser and oral terbinafine produce more rapid and effective mycological and clinical clearance in patients with onychomycosis than either treatment alone, without any obvious side effects.