Evolving role of lasers in nail therapeutics

Abstract

The diseases of nails are chronic disorders due to the slow rate of growth of nails. The slow rate of nail growth results in long treatment regimens, thus having the potential of causing side effects and posing a limitation of administration to many people. Patients who suffer from organ dysfunction, elderly patients, patients under polypharmacy, and the inability of many patients to adhere to the complete regimen can cause the treatment of nail diseases to be frustrating for both the treating dermatologists as well as patients. Most nail disorders have formed a set treatment protocol for the administration of oral and topical drugs over the years. The use of lasers has yet to make its mark in the treatment of nail diseases due to lack of a universally accepted protocol. This review article looks into various studies evaluating the efficacy of lasers in nail diseases. Largely, this review is based on an evaluation of the effectiveness of lasers in onychomycosis (22 studies and 1 meta-analysis) and nail psoriasis (seven studies). While there is sufficient proof that lasers are effective in the treatment of nails, there is no gold standard for the type of lasers to be used for a particular disease, the treatment parameters, and the follow-up protocol. Evaluation of larger sample sizes against a control group and longer follow-ups are the need of the hour for the formulation of much-needed protocols.