The two types of medical treatment are topical, medication applied directly to the affected nail or nails, or oral, taking medicine by mouth so it will get to the nail via the bloodstream. Oral medications usually have to be taken for 12 weeks, and achieve a “cure” from 60% to 75% of the time. However, these drugs have side effects including the potential for liver damage. Recurrence is common, from 10% to 50% of the time. Recurrence may be less likely if topical medicine is used on the nails; using both oral and topical medication may also improve the chance of eliminating the infection.

Oral medications are not able to actually kill all the fungus in infected nails, even if they can in the laboratory. The same thing can be said about topical medications. One idea is to combine the two to kill as many fungi as possible. For toenails, this must always be done along with cutting off as much infected nail as possible.

There are no FDA approved over-the-counter treatments available in the United States. There are creams made to treat athlete’s foot (a fungal infection of the skin) that can be used on toenails with varying success. These included Lamisil® (terbinafine), Nizoral® (ketoconazole), Mycelex® (clotrimazole), and Naftin® (naftifine), which are available without a prescription as well as with a prescription. The prescription medications are usually stronger. There are a couple of choices of topical medications FDA approved for fungal infection of the nails in the United States. These include ciclopirox lacquer (Penlac®) and tolnaftate 1% solution (called Formula 3).

A medicine used in many other parts of the world for the last 20 years is called amorolfine (trade name Loceryl®). It seems to be as safe and effective, if not more so, than the topical medications approved for use here. However, it is not FDA approved, and cannot be acquired in the United States or Canada. There are studies of its effectiveness and safety available because it is in use in Europe, the UK, and other places such as Australia. It can be ordered from other parts of the world.

Amorolfine is a different class of antifungal medication than the other topical drugs. It is active against essentially all the main classes of fungus that infect nails. Fungi called dermatophytes (meaning they like skin and skin structures like nails) are the most common causes of the infection. There are a few other fungi and mold that can cause onychomycosis and amorolfine can kill or stop these from growing in a laboratory setting. It works by damaging the membrane around the fungal cells. This kills dermatophytes like Trichophyton rubrum, the most common fungus involved. However, it does not always kill all the fungus in nails because it is very hard for it to reach every area of infection.

Amorolfine seems to be free of any serious side effects. At the beginning of treatment, some people (less than 1 in 10,000) develop some redness and/or burning that lasts only a few minutes. Usually this irritation stops happening after a number of applications. If the nail begins to separate from its base, it should be rechecked by the doctor. A tiny minority of people may develop an allergic reaction to the medication, which could cause itching and redness that do not go away quickly. Anyone with a true allergy to amorolfine cannot use it. But this is very unlikely. As of 2010, there had been so few allergic reactions that the company making Loceryl could not even estimate how often it happens.

Amorolfine comes as both a cream and a lacquer. A higher concentration of amorolfine (5%) works better than 2%. When used as a lacquer, the medication is applied to the entire nail. The lacquer does not dissolve in water, so it stays intact on the nail plate. It continues to release its medication over the site for a week at concentrations high enough to kill or damage the fungus. It does not seem to be absorbed into the system at those levels.

Amorolfine is able to get into the nails and areas under the nails. Sometimes, treatment with this alone has achieved clinical cures. A number of trials have yielded results for amorolfine that are as good or better than other topical treatment. In one such trial, after application of the 5% nail lacquer once or twice weekly for up to 6 months, 40–55% of patients with mild fungal nail infections were considered “cured” 3 months after treatment was stopped. Some experts believe amorolfine is the most effective topical agent.

In another study, testing the effect of amorolfine lacquer on infected big toenail material placed in humidified soil showed that the lacquer got rid of fungal growth in the majority of the nails. Experts believe that amorolfine may also be able to prevent fungi from attaching to the nail.

Combination therapy using amorolfine along with an oral medication has been found to be more successful than oral medication alone. Amorolfine attacks fungus in a synergistic way along with oral medications. This means that they work together to increase the cure rates because each attacks the fungal cell membrane in a different way. It should be possible to get better results more quickly, and lowering the amount of the oral agents should reduce their toxic side effects.

One study looked at using amorolfine with griseofulvin, one of the first oral medications for onychomycosis. Patients were either give griseofulvin for a year (standard treatment at the time) or 2 months of the oral medication along with amorolfine lacquer for 12 months. After 6 months, twice as many of the patients getting the combination were considered cured than those getting griseofulvin alone. Similar results have been obtained using amorolfine along with and after other oral medications, such as itraconazole.

Many experts believe the combination treatment is better, and that continuing the topical amorolfine after oral therapy can prevent recurrence.

Why is this medication not available in the USA or Canada? There is no obvious reason. A Swiss company applied to the FDA a number of years ago, but there is no evidence that any action was taken based on this application. All that can be found on the FDA website is that on 11/19/2002, SIEGFRIED LTD, was on a list of medications, which said, “AMOROLFINE HYDROCHLORIDE AS MANUFACTURED IN ZOFINGEN, SWITZERLAND.” Its status was listed as A II. The document containing this information is called “Development Approval Process /Forms, Submission Requirements/ DrugMasterFiles.” There is no other information available.

Amorolfine is safe and effective and used in many areas of the world. If you travel to another country, you may be able to get it there. It can also be ordered from online pharmacies, but not in Canada. Trade names include Curanail®, Locetar®, and Odenil®, in addition to Loceryl®. In most of Europe you need a prescription. In the UK and Australia it is now available over the counter. There does not appear to be any good reason not to use it.

References

Campbell, A.W., Anyanwu, E.C., Morad, M. Evaluation of the Drug Treatment and Persistence of Onychomycosis. TheScientificWorldJOURNAL 2004; 4: 760–777.

Choi, Sola. Manual of Dermatologic Therapeutics. Chapter 14. Dermatophyte Infections. Onychomycosis. Pages 87-90. 2007. Lippincott Williams & Wilkins. Philadelphia.

Flagothier, C., Piérard-Franchimont, C., Piérard G.E. New insights into the effect of amorolfine nail lacquer. Mycoses 2005; 48: 91–94.

Olafsson, J.H., Sigurgeirsson, B., Baran, R. Combination therapy for onychomycosis. British Journal of Dermatology 2003; 149 (Suppl. 65): 15–18.

Pittrof, F., Gerhards, J., Erni, W., and Klecak, G. Loceryl nail lacquer—realization of a new galenical approach to onychomycosis therapy. Clin. Exp. Dermatol 1992; 17(Suppl. 1): 26–28.

Roberts, D.T., Taylor, W.D., Boyle, J. Guidelines for treatment of onychomycosis. British Journal of Dermatology 2003; 148: 402–410.

The Merck Manual for Health Care Professionals. Onychomycosis. Last revision October 2009.

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Using PurNail Nail Fungus Remedy

The product is very simple to use. You simply wash the nail thoroughly with soap and water, and then dry the nail and surrounding skin to make sure there is no moisture to interfere with the topical solution. PurNail Nail Fungus Remedy comes with a brush applicator, and you simply brush the solution onto the nail and down into the cuticle. It is important that you leave your nail uncovered for at least 20 minutes to ensure that the solution is absorbed into the skin and not rubbed off by a sock. Although it can take up to six months for this remedy to heal a nail infection, the company offers a money back guarantee if you are unsatisfied with the product for any reason. Really, you have nothing to lose.

PurNail Nail Fungus Remedy is particularly effective because it combines a unique blend of all-natural ingredients to help rid your nail of the fungus. Here’s a look at each ingredient and how it helps you:

Undecylenic Acid

Undecylenic acid sounds like it will burn you, but it is actually just an anti-fungal derived from Castor oil. Yes, that stuff your mother used to make you take that tasted horrible can produce something that can help heal your nail fungus. Undecylenic acid is effective against all sorts of skin infections, such as Candida or yeast, Athlete’s foot, jock itch, and ring worm. If you use it on your nail, it will penetrate the skin and help to kill off the fungus that is causing the ugly discoloration to your nail bed. Even the Food and Drug Administration has recognized undecylenic acid as a powerful anti-fungal, so you can rest assured that this is an ingredient that pulls its weight in the PurNail blend. The only side effects known from this ingredient are allergic reactions, such as hives, swelling, and itching that can occur at the site of application. On the whole, it is a great, all-natural remedy to fighting nail fungus.

Melaleuca Alterifolia (Tea Tree Oil)

You can choose to use the long name of tea tree oil, Melaleuca Alterifolia, but really it is too much of a tongue twister for anyone but botanists and chemists. It is much easier to refer to this powerful, plant based anti-fungal as tea tree oil and make it easy on everyone involved. Tea tree oil is all-natural and comes from steam distillation of the leaves of the malaleuca alterifolia plant. Research has found that this topical solution is effective against all different types of fungus, including nail infections, athlete’s foot, vaginal infections, and acne. It can cause some irritation to the skin when it is applied, called contact dermatitis. This is redness, cracking, or peeling of the skin that comes in contact with the tea tree oil. If you start to feel any irritation from PurNail, discontinue use immediately and find some other solution for healing your nail fungus.

Helianthus Annuus (Sun Flower Seed Oil)

Sunflower seed oil has many uses in nutrition and in medicine. It is actually a great oil to use to cook with because it is low in saturated fat and high in vitamin E. However, do not attempt to cook with PurNail. The other ingredients, such as tea tree oil, are actually harmful if ingested. Sunflower seed oil is a great disinfectant, and it will kill off any bacteria that are lurking around on the skin under your fingernails or toenails. It’s best property, though, is that it retains moisture and creats a protective barrier around the skin that it is applied to. Sunflower seed oil serves a double purpose in fighting infection and protecting against future infection. It is a powerful, all-natural remedy that has even been used in the hospital on underdeveloped infants. Those who had the oil rubbed into their skin suffered less bouts of skin infections than those who did not. It can help to cure your nail of the fungus that is causing it to look so discolored. It can also cut down on the inflammation that erupts under your nail due to the infection.

Phenoxyethanol

Phenoxyethanol is a great word to whip out at parties to make yourself sound smart. It may not sound like it is an all-natural compound, but it is actually an organic compound that helps to preserve the ingredients in the topical solution and keep them stable. Apparently, the alternative is a compound that produces formaldehyde, so phenoxyethenol is a great solution to avoid that chemical reaction from taking place on your skin. To make this compound even more attractive, it also has antibacterial effects, although it usually has to be combined with a few other ingredients for those effects to be the most potent. On the whole, though, this ingredient is used as a preservative and fixative. It helps to keep the product together so that it can effectively absorb into your nail, while also providing a mild antiseptic effect.

Ethylhexylglycerin

Ethylhexylglycerin is a derivative of vegetable oil, and it is used to bind and preserve the ingredients in PurNail. Since it is from vegetable oil, it is all-natural, although it does go through quite a bit of chemical processing to get to the end product that you will find in the PurNail remedy. This ingredient is fairly new to the market, so not much is known about it. There is very little data on what it can do for you, and there have only been four scientific studies performed on it. It can cause contact dermatitis, or redness, itching, and skin irritation, in some people, so if you experience this, discontinue use of PurNail. Ethylhexylglycerin is often used instead of the chemical parabens, which is a controversial preservative that has come under fire. PurNail chooses to use this new, all-natural ingredient to complete its formula list because it is dedicated to the very best ingredients.

PurNail Nail Fungus Remedy: Should You Try It?

PurNail Nail Fungus Remedy is a great alternative or possible adjunct to conventional nail fungus treatment. It is applied topically, and all of the ingredients are safe and all-natural. They have a proven track record for dealing with fungus problems, and the topical application keeps you from needing to take a pill everyday. The one downside is that it does seem to take a long time for the treatment to work, but you can return the product at any time to get your money back. The company has a no questions asked policy about giving refunds. With that sort of customer service and the proven ingredients in the blend, you really have nothing to lose but your nail fungus.

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Lamisil is unable to kill other fungi that may be involved in onychomycosis like Candida albicans. Therefore Lamisil treatment is limited to dermatophytoses of the nail. For this reason it is important for doctors to accurately diagnose the organism that is causing the onychomycosis before starting treatment.

Lamisil is available as 250 mg tablets. The traditional way that Lamisil is administered is in a continuous regimen, once daily, for several weeks. If onychomycosis is affecting the fingernails, a single 250 mg dose is taken orally each day for six weeks. If onychomycosis is on the toenails, the treatment is prescribed for twelve weeks.

Recently, good results with Lamisil have been achieved using a pulse therapy regimen. In this approach, two 250 mg tablets (500 mg total) are taken each day for one week with three weeks of no drug. This one week on/three weeks off system is used for four weeks in fingernail onychomycosis and for eight weeks in toenail onychomycosis. This pulse regimen has not been approved by the Food and Drug Administration but is still used. While larger clinical trials are needed to determine if the pulse system is equally effective as continuous dosing, this approach would be less expensive overall and would minimize potential side effect risk.
The most commonly reported side effects are dyspepsia, which is also known as upset stomach or indigestion. There is also a slightly increased occurrence of headache in people taking Lamisil. People sometimes get a generalized rash when taking terbinafine (Lamisil).

Lamisil, as with all antifungal drugs, has the potential to cause liver problems. In fact, anyone with a history of liver disease will usually not receive one of these drugs to treat onychomycosis. To make sure that people do not experience liver problems while they are taking the drug, a liver function test will be done prior to starting the medication. This is a blood test that measures enzymes from the liver, among other things. The test will be repeated at four weeks to make sure no problems have occurred. If they have, Lamisil is stopped and the problem usually goes away on its own. In some rare cases Lamisil has caused liver failure.
Another rare but potentially serious Lamisil side effect is that it can cause a drop in the number of white blood cells in the blood. Because of this, doctors routinely take a blood sample before treatment called a complete blood count or CBC. This can be done at the same time as the liver function test. Then, after four weeks, the CBC is repeated to check for a drop. If there is a drop, the drug is stopped. Stopping the drug is usually enough to see this white blood cell number return to normal.
The onychomycosis drug has been linked to very severe skin reactions called Stevens-Johnson syndrome and toxic epidermal necrolysis. These are very rare Lamisil side effects, but if they occur, they can cause the skin to blister and come away from the body. Stevens-Johnson syndrome and toxic epidermal necrolysis require hospitalization and close supportive care.
Compared to other antifungal and onychomycosis treatments, Lamisil interacts with relatively few drugs. It may cause cyclosporine (immunosuppressant) to be less effective. Alternatively, the toxicity of cimetidine (acid-reducing pill) and rifampin (antibiotic) may increase.
While the drug may be safe it is not always possible to know for sure, therefore Lamisil should not be started in pregnant women or nursing mothers. Onychomycosis treatment can be postponed until after pregnancy and nursing is complete.

The occurrence of onychomycosis in children is very rare compared to the rate of occurrence in adults. However, should it occur, Lamisil could potentially be used to treat the disease. While it has not been approved by the FDA for use in children, a Lamisil treatment dose can be prescribed based on the weight of the child. Children weighing less than 25 pounds or younger than 12 years old should not be treated with Lamisil.
Lamisil treatment of onychomycosis is faster than it was with older agents like griseofulvin. While Lamisil can cure onychomycosis in a majority of patients taking the medication within several months, the nail itself is not normal for some time, even after the dermatophytosis has been eliminated.
After Lamisil treatment is complete, the drug can be detected in the nails for up to three months after the drug is stopped. It can be detected in the blood for up to six weeks after treatment cessation.
Lamisil 250 mg tablets costs the National Health Service in Great Britain £3.44. Canadian retailers charge $80 to $160 for a one month supply. In the United States the cost of Lamisil varies, but the unsubsidized cost could be as high as $400 a month or more.

References
Terbinafine (Lamisil) prescribing information
Gupta AK, Lynch LE, Kogan N, Cooper EA. The use of an intermittent terbinafine regimen for the treatment of dermatophyte toenail onychomycosis. J Eur Acad Dermatol Venereol 2009;23:256-262.
Takahata Y, Hiruma M, Shiraki Y, Tokuhisa Y, Sugita T, Muto M. Treatment of dermatophyte onychomycosis with three pulses of terbinafine (500 mg day for a week). Mycoses 2009;52:72-76.

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You may have heard that lasers are now being used to treat fungal nail infections. This is a relatively new nail fungus treatment which has definite potential. This article should give you enough information to know whether or not you might want to seek laser therapy for your nail infection.

There are a number of ways to deal with onychomycosis. They almost always include cutting away as much of the affected nails first.
These include:

• Topical medicines – creams, ointments or lacquers applied to the toenails.
• Oral medicines – systemic therapy where the medication gets into the bloodstream and then to the nails.
• Removing most or all of the toenail, then using local therapy as the new nail grows out.
• Removing the toenail permanently by killing the toenail root.
• Using some other technique along with topical medicines to try and force the medication into the nail. This has included drilling holes and using heat.
• Alternative and complementary medications, like tea tree oil.
• Laser therapy, which is used to try and kill all the fungus, often along with removing as much of the thickened toenail as possible beforehand.

Each new treatment has been hailed as a potential cure, only to prove less effective than hoped, or in the case of oral medicines, potentially dangerous because of the medications’ side effects.

Many people wonder if whatever treatment they use is going to kill the fungus or just slow it down. Killing fungus is called fungicidal. Slowing it down is fungistatic. While many medications as well as lasers can kill fungus in a laboratory setting, essentially all therapy fails to kill all fungus in infected nails. That is why the infection comes back after treatment, or only improves the appearance of the nail without eliminating all traces of fungus.

Laser (Light Amplification by Stimulated Emission of Radiation) treatment

Laser is a form of light energy. The energy of the light is strengthened and sharply focused, so it can hit a narrow and specific target. When a laser beam of sufficient energy hits a target, it causes damage. Temperatures may rise at the site. This can kill funguses, and other organisms that cause disease. However, lasers do not have to produce heat to be used to treat disease. Their energy may have other specific effects.

Lasers have been in use medicine for decades. What was once thought of as a science fiction weapon or a national defense system is now used every day to treat patients. Lasers can do fine, delicate work as well as being used when a lot of energy is needed.

Some uses include:

• Surgery – cautery of blood vessels, cutting of tissues.
• Ophthalmology (eye) – treatment of retinal problems including damage from diabetes, aging, and problems due to vascular disease. Reshaping of the cornea to correct vision (LASIK surgery). This type of laser therapy must be exactly targeted and cannot cause excessive heat or anything that would damage the eye. It is very successful.
• Dermatology – Removal of many types of skin bumps and lumps, from moles and scars to tattoos. Face peels and deeper layer laser therapy to erase wrinkles and treat acne. This is an area where many different kinds of lasers are used for different problems.
• Podiatry – Used in surgery to cut through bone to fix deformities like bunions.
• Other – Lasers can “pulverize” kidney stones and gallstones.

This is by no means a comprehensive list.

Lasers and onychomycosis

To penetrate into nails, lasers need to be within a certain wavelength. The longer the laser is used, the more power reaches the tissue. The power is the amount of light energy in a period of time, delivered to a specific spot. A laser has to be powerful enough to reach the tissues needing treatment.

Most of the lasers for toenail treatment generate heat. The heat does not instantly kill fungus but causes damage that leads eventually to its death. Heat in the surrounding area is monitored and cooling systems are employed to protect adjacent tissues.

Many lasers already used in medical practice are in various stages of testing and FDA approval for treatment of onychomycosis. Lasers already in use by dermatologists or podiatrists for other procedures can be used in what is called “off-label” treatments. These devices have been determined to be safe for other conditions, and it is not illegal to use them to try and clear up nail fungus. The best laser or lasers to use have not been determined.

The Type of Lasers Used to Treat Nail Fungus

• Pin Pointe Laser
• Q Clear Laser
• Cool Touch Laser
• Cutera Genesis Plus™ Laser

Podiatrists are the main medical professionals who take care of toenail onychomycosis because they take care of feet. They have already been using lasers to treat plantar warts and ingrown toenails, among other problems.

As recently as 2009, there were questions about the amount of research needed to know if lasers are effective for onychomycosis and whether or not enough has been done.

Doctors who already had lasers were ready to use them to treat onychomycosis even without studies proving effectiveness. Researchers investigated the results from lasers already on the market, as well as testing lasers made specifically to treat nail fungus.

Certain lasers have been shown to inhibit the growth of a number of the funguses that causes nail infection, or even kill them in the laboratory, although they have not been proven to kill all the fungus in an infected nail.

One study done with what is called a long-pulse 1064 Nd:YAG laser was published in 2010. The research doctors examined and pared down toenails suspected to have fungus, but only the patients (72) with positive fungal cultures were treated with the laser. They also pretreated the nails to make them softer. They directed the laser in a circular pattern around each affected toe, for three passes. They did a treatment every week for four weeks.

Patients were rechecked after three, six, nine and twelve months. Follow up included re-culturing for fungus. Almost 96% were negative for fungus at three months. The three patients who were positive had repeat procedures, and all patients had no fungus on culture at six and twelve months.

Most of the patients treated this way had no pain or mild pain directly after the procedure. 38% had moderate pain briefly, and none had more than that. Most of the patients experienced less pain after the subsequent treatments compared with the first treatment. The patients were satisfied with their treatment.

These researchers also applied laser energy to the fungus they grew from the patients’ nails after the first session. Significantly less fungus grew after laser treatment. However, there was still some growth in the lab after laser.

There have been a number of other studies looking at how well other types of lasers treat onychomycosis. One used a Noveon laser. This device uses different frequencies than most of the other lasers. The two wavelengths are 870 nm and 930 nm, wavelengths that are reportedly lethal to fungi and safe for the tissues of the toe.

The authors of this study, which was published in the Journal of the American Podiatric Medical Association in 2010, say that the wavelengths studied have been shown to kill toenail fungus in a laboratory setting. They also mention a concern that other wavelengths like the 1064 nm wavelength have the potential to cause mutations in adjacent cells.

This study included people with toenails that either grew fungus on culture or appeared to have fungus on a stained preparation viewed under a microscope. There were 34 patients, 25 in the treated group and 9 in a control group.

There were four treatments of each affected toe. The first was given on day one, followed by days 14, 42 and 120. There were checkups at 60 days and 180 days when samples of the nails were taken for culture and/or microscopic staining and examination. Each treatment had two parts. The first was four minutes with application of both wavelengths. The second was with the 930 nm alone for another two minutes. Treatment was interrupted if a toe got too hot.

In between treatments, patients got a topical medication called terbenafine, and were still allowed to have the nails trimmed as necessary. Control patients got the same thing except that the lasers were set at zero power.

Cultures of toes treated with lasers were negative in 75% of toenails on day 60, after three treatments. Toenail samples appeared clear on microscopic examination in 64% of cases on day 120. On day 180, 39% of toenails were negative on culture and had at least three mm of clear nail growth. There was also improvement of the appearance of the onychomycosis in the treated nails. Pictures included with the study show significant improvement in the appearance of many treated nails. As determined by examiners, the difference in clear nail growth between the treated and control nails was statistically significant.

There were no serious adverse events. Patients experienced slight tingling or heat.

These investigators concluded that the treatment was safe, at normal physiologic temperatures, and like in the laboratory, toenails could be cleared of fungus with negative cultures in 75% of the nails after three treatments. The Nomir Noveon was approved for other uses in 2007, but has not yet been FDA-approved for onychomycosis.

Long-term follow up has not been published or reported in regards to any of the lasers used on nails.

Some studies have been published in journals or online. Others have not been published, but their findings were given to the FDA to get approval. The approved lasers operate at the 1064 wavelength. Differences between devices can include timing of pulses, and whether or not cooling is simultaneously applied.

While there are these other lasers in various stages of approval for treatment of nail fungus, the following four have been approved as of 2012 for “the temporary increase of clear nail in patients with onychomycosis.”

All of the following lasers are 1064 nm Nd:YAG systems:

• PinPointe™ FootLaser™
• Q-Clear™ laser system
• CoolTouch VariaBreeze™ laser
• Cutera Genesis Plus™ laser (also has a 532nm option)

They have not proved that they can kill or eradicate onychomycosis, but the FDA is satisfied that they do improve the appearance of fungus in the nails, at least temporarily.
The 1064 nm laser passes through the nail to kill the fungus in the nail bed. There is little pain, no serious side effects, and no long-term danger such as that caused by continual oral therapy. However, none has been proven to eradicate or cure the fungal infection completely or permanently.
While doctors and investigators who prefer the Noveon laser with its lower wavelengths, citing the higher wavelengths as possible causes for mutations (thus possibly causing damage to a developing fetus or cancer), there is no evidence that this has happened.

PinPointe™ FootLaser™

According to its manufacturers, the PinPointe FootLaser received FDA clearance for the temporary increase of clear nail in patients with onychomycosis on October 15, 2010, making it the earliest laser so designated.

The press release announcing the FDA clearance included a statement from Harvard University’s Chief of the Division of Podiatric Surgery, Dr. Adam Landsman. He said, “Toenail fungus is an incredibly embarrassing chronic condition affecting millions of people worldwide that genuinely impacts a person’s quality of life. For some with diabetes or immune disorders nail fungus can lead to serious health problems. With the clearance of the PinPointe FootLaser, patients finally have a pain-​​free treatment option that is more successful than topically-​​applied antifungal drugs, safer than oral medication, and less painful than surgical removal of the nail.”

A treatment lasts about 20 to 30 minutes. According to the manufacturer, the fungus may be killed after one treatment. The need for retreatment may occur because of reinfection from the environment. The treatment causes slight warmth, or possibly in a few patients, the sensation of a slight pinprick.

Treatment with the PinPointe FootLaser usually costs about $1,000.
Many podiatrists have given testimonials about this laser, and there have been case reports of its success. In one early trial, 87% of patients treated with this laser showed improvement.

According to an article in Podiatry Today, May 2010, early studies with the PinPointe FootLaser showed great promise.
One of the podiatrists writing this article described his own experience with the PinPointe FootLaser, which he said improved his onychomycosis, especially in the big toenail. He had no problems and believes it poses no health risks. He did this after locally applied therapy failed. While oral medicine helped, the fungus reoccurred, and he had side effects he attributed to liver or gall bladder problems.

To find a doctor in your area who uses the PinPointe FootLaser, go to this website:

https://nuvolase.com/patients/find-a-provider.

By entering your zip code you can find a local podiatrist who has this device.

Not all podiatrists or other healthcare providers list the cost of laser treatment on their website. You may have to call and ask. It is not covered by insurance. However, even when three treatments are needed, this may cost less than oral medication.

On the PinPointe FootLaser website, it is clear that this laser represents big business. A company called Cynosure has acquired the rights to distribute the laser all over the world. As of October 2011, they estimated that 100,000 treatments had already taken place. It can be used in the European Union countries, Australia and Canada.

The company’s press release says that a 12-month trial of 250 patients showed that 71.4% of the patients had continued clear nail growth after only one treatment. If clear nails can be growing for as long as twelve months, this treatment is much more successful than anything before.

Q-Clear™ Laser

The Q-Clear™ has been used in surgery and dermatology since 2003. It received FDA approval for treatment of onychomycosis in September of 2011. At that time, the FDA approval was for “the temporary increase of clear nail in patients with onychomycosis.”

While it may be able to kill fungus in the laboratory, there is frequently fungus remaining after treatment. All it takes is some remaining fungus to eventually cause the nail to return to its pretreated state over time.

The Q-Clear is an Nd-YAG laser that delivers high pulses of energy at 1064 nanometers. It can also deliver a 532 nanometer beam which is in the visible light spectrum and green in color, but this is not what is used for onychomycosis.

The Q-clear is not as large or expensive as older lasers used for other problems. It is compact and lightweight. It is also less expensive than older lasers. It is made by Light Age Inc., a company that has been making lasers for many medical applications as well as lasers used in other fields since it was founded in 1986.

The press release at that time stated: “September 28, 2011 – Light Age Inc., a Somerset, NJ based private developer and manufacturer of laser products, has received US FDA marketing approval for its Q-Clear™ laser systems for the treatment of onychomycosis. With it, fast, effective, low cost treatments can now become commonly available through dermatologists, podiatrists, and other professional healthcare providers.”

The main points are that the treatment is fast and low cost.

The company did their own study, which lasted 12 months and included patients of multiple ethnicities and both sexes. It was reported that 97% of the patients saw some clearing of their infection, with between 55% and 65% of the areas appearing clear. Light Age said that there was little to no reported pain and that all of the patients were satisfied. They also said, “…Q-Clear™ laser system has proven to be substantially effective in clearance of dystrophic nails having a clinically apparent diagnosis of onychomycosis.”

In this study, patients were treated once. No anesthesia was needed, taking less than five minutes per affected foot.

The Q-Clear has a red beam that allows the treating physician to precisely target the nails. The handpiece delivers the laser energy; the doctor moves the handpiece over the nails and circular beams hit the targeted area. Onychomycosis caused by all the normal fungi can be treated this way.

CoolTouch Inc. VARIABreeze ™ Laser

CoolTouch Inc. makes a laser called the VARIABreeze ™ which was approved for use on nails in November of 2011. The FDA clearance, the other 1064nm lasers, is for the temporary increase of clear nail in patients with onychomycosis. The company has been making lasers for medical uses since 1994, and has devices for treatment of skin wrinkles, varicose vein treatment, laser lipolysis (to reduce fat) and skin tightening.

According to the company, the CoolBreeze laser procedure takes twenty minutes. Patients treated with the laser can expect to see improvement in a few weeks. The company notes that it is safer than oral medication. The company also says that it is easier to have one treatment than to apply medication every day. CoolTouch describes their laser treatment as “…fast, safe, effective and painless…”

CoolTouch did studies on a 1320 nm, pulsed, CoolBreeze Nd:YAG laser to treat onychomycosis before their VARIABreeze laser was approved. This device is adjustable in terms of size of treated area, energy delivered, and a hand device allowing a cooling agent to be used. There may also have been studies of the VARIABreeze delivered to the FDA.

Using the older device, fifty-four toes (38 patients) that had culture-positive toenail fungal infections were treated with the laser. Toenails were treated at least two times in separate sessions with four weeks in between.

The patients in this study reported mild pain immediately after treatments. Patients were rechecked at four, twelve and twenty-six weeks after treatment. Patient satisfaction at week four was 3.4 (out of 5), at twelve weeks this number was 3.6, which is statistically significant. There was an increase in clear nail plate in 80% of the treated nails.

Only one patient reported significant pain in a big toenail; this pain was gone in two months.

The researchers for this study suggested that this laser could be used for two or three treatments, and that each treatment, even including all toenails and fingernails takes only 15 minutes. They could not determine whether or not the funguses, dermatophytes in this case, were inhibited or destroyed.

However, other researchers looked at the effects of fungus that was first wet under a vacuum or slowly cooled before being irradiated. The laser used was a CoolTouch, Q-switched, Nd:YAG laser, 1320 nm. This research showed that cooling, putting in a vacuum and using lasers can slow down the growth of the fungus. Slow cooling followed by rapid laser treatment reduced the rate of fungal growth the most. It is not entirely clear how this information can be helpful to the practicing doctor, but these kinds of studies helped companies like CoolTouch design their lasers to treat nail fungus.

One podiatrist in Sacramento, California who had been using the similar CoolBreeze laser before the CoolTouch was approved said the laser treatment was effective in 80% of cases that he treated. He says that the system monitors the temperature to make sure the tissues do not get too hot.

This doctor noted that the toenail does not become clear at the time of treatment. Once a significant amount of the fungus is killed, the new nail must grow out. Each person’s nails grow at a different rate, so that results will not become completely visible for six to twelve months. However, clear nail growing out can be visible as early as eight weeks after the procedure.

This particular doctor offers three treatments beginning at $275, which is not covered by insurance. The cost varies depending on how much nail needs to be cut back before the laser treatment. He will give patients 75% off if they need re-treatment in the future.

He also states that results are much better if you use topical treatment on the nails afterwards and make sure that there is not a good place for the fungus to regrow. For example, diabetics with high blood sugars are making a good home for fungus in the nails and need to control their blood sugar to keep nail fungus away. Topical preparations should be continued and shoes sprayed with antifungal medication.

This general advice can be applied to all laser treatments of onychomycosis.

Cutera Genesis Plus™ laser

This company received FDA approval in March 2012 for its Harmony (XL) multi-application, multi-technology platform laser system. While it is a 1064 nm Nd:YAG laser, it also has a tip (called a KTP tip) which uses a shorter wavelength of 532 nm. The company that makes this device, Alma Lasers, Inc., says that the shorter wavelengths cause tiny cavities in the nail which may help the 1064 nm laser get into the fungal colonies under the nail. The company also says that the 532 nm wavelengths are absorbed by red and brown pigment in the nail. These discolorations can be caused by fungus, and treating them with the laser may improve the appearance of the nails.

They suggest that the lower wavelengths be used first to help eliminate the discoloration of the nails and cause mechanical damage to the nail, so that the 1064 nm laser can get more effectively under the nail to the nail plate, where they say the fungus is “deactivated.”

The Genesis Plus is a free-standing, light and portable machine that can be moved from room to room.

This laser has already been approved for many skin conditions, including removing deep pigmented spots and tattoos. The two different wavelengths mean that it can remove more colors in tattoos. Black, blue and green can be removed with the 1064 nm wavelength, while red, orange and yellow can be removed with the 532 nm wavelength.

One small study was done by a podiatrist using the Cutera Genesis Plus on all the toenails of seven patients, who had culture-proven fungal nail infections. The handpiece of the device can be set to deliver as many as 100 pulses each time it is passed up and down and side to side over the nails. Each nail received four passes. The big toenail received 100 pulses. The other 4 nails received about 100 pulses together.

There were two treatments done for each patient, six weeks apart. Each session lasted about 15 to 30 minutes, again treating all the nails on each foot. No anesthetic was necessary, and there were no observed side effects.

Success was documented by the use of digital photography, high resolution, with photos taken before treatment, at week six and twelve post first treatment.

70% of the treated nails showed improvement after the two treatments. 71% of the significantly to severely affected nails showed improvement while 67% of the mild to moderately affected nails showed improvement.

This small study looked at cosmetic results only. 70% of their patients showed improvement after two laser treatments with no side effects.

The podiatrist who reported these cases charges a different amount, depending on how many nails are involved. Including evaluation, this can be $800 for five toes and $1,000 for ten toes. $100 of these charges can be billed to insurance as podiatric examinations. Follow-ups can also be charged at $50 to insurance. But the laser therapy is essentially never covered by insurance.
A second laser treatment, if needed, would only cost $100. This is at a Southern California podiatry clinic outside of Los Angeles County.

Cost of laser treatment of onychomycosis

Cost to treat nails depends on many factors including:

• How many nails are involved.
• How thick they are and how much surgical paring has to be done first.
  What type of laser is used.
• The area of the country you live in and the cost of medical care there in general.
• Whether or not the goal is to completely clear nails, if this is possible, as opposed to improving their appearance.

Quotes range from treatment starting at $275 to $1,100. Most people with affected toenails that have not been satisfied with conventional treatments should expect to pay around $1,000 for anywhere from one to three treatments depending on which system is used. Most podiatrists charge significantly less if there is a need for re-treatment with the laser.

Research

There is ongoing research, trying to prove the efficacy of many different lasers. Researchers want to find the best ways to use lasers to cure nail fungus. They also want results to obtain FDA approval for “the temporary increase of clear nail in patients with onychomycosis” if their system has not been approved, or to indicate it can do more than that. Ultimately laser manufacturers and doctors treating onychomycosis want to try and cure the fungal infection.

To look for clinical trials, go to this site:
Clinicaltrials.gov

and select “Basic Search.”

You then search for a trial by putting “laser and fungus” into the search engine, or “laser and onychomycosis.” The results frequently contain trials that are not exactly what you want, so you need to read through them. A search on March 22, 2012 yielded nine results. Two were not about lasers. One was completed but had no results reported. Two had status listed as “unknown” which can mean a variety of things but is not helpful. One trial was active but not recruiting.

A specific CoolTouch laser trial was listed, open by invitation only, and will use 15 people for a randomized, placebo-controlled study.

One recruiting trial called “Study of the V-Raser Diode Laser System in the Treatment of Onychomycosis” is recruiting participants in Connecticut. This trial is trying to establish that the particular laser works, and all the participants will be treated. If you live in Connecticut and you want to see if you meet the criteria for this study, look at the information here:

https://clinicaltrials.gov/ct2/show/NCT01452490?term=lasers+and+fungus&rank=4

One other trial was listed that will be recruiting participants but is in Brazil.

If you would like to try laser therapy for your nails but cannot afford it, you can check from time to time to see if there are any new trials in your area.

Conclusion

Laser treatment of onychomycosis is safe, causes minimal discomfort and no long-term side effects or problems. The systems have only been FDA approved for cosmetic improvement of the nails. What trials have been done support the claim that they improve the nails’ appearance and can clear areas of fungus.

No laser has been proven to eradicate fungal nail infection. Long-term effectiveness is not known. The ideal number of treatments depends on the laser system and is not definitive. One to three initial treatments are usually suggested.

It is very likely that success also depends on who is using the laser. A very experienced podiatrist who knows how to cut back as much affected nail as possible beforehand and how to use the laser system will probably get the best results.

Treatment will probably cost around $1,000 and will not be covered by insurance in most cases. Many treating doctors offer re-treatment at significantly discounted prices if it is needed.

If you can afford it, laser treatment is a very reasonable way to improve the appearance of your nails without having to apply products daily and without the danger of taking oral medication. However, it is no more likely to completely cure onychomycosis than any of the other choices currently available.

This type of laser cannot be used by cosmeticians or anyone without a medical degree. A doctor of medicine specializing in dermatology or a doctor of podiatry should have the most experience.

Research may discover a better way to use lasers in the future. At the current time, there is very little difference between the FDA-approved lasers for onychomycosis. Choosing a podiatrist that has a lot of experience may be more important than which laser is used.

Other lasers that are not FDA approved for onychomycosis can still be used to treat it, and if your podiatrist is comfortable with his or her existing laser system, it is reasonable to try it if the podiatrist has had success treating fungal infections.

References
Cynosure Acquires Worldwide Exclusive Rights to Distribute PinPointe™ FootLaser™ for Treatment of Onychomycosis. https://nuvolase.com/news-and-events/press-releases/cynosure-worldwide-distribution-rights
Light Age Inc. receives FDA approval for the treatment of onychomycosis. 10/13/2011 Light Age Inc.

https://www.medica.de/cipp/md_medica/custom/pub/content,oid,34955/lang,2/ticket,g_u_e_s_t/~/Light_Age_Inc._receives_FDA_approval_for_the_treatment_of_onychomycosis.html

https://www.podiatristsacramento.com/laser_treatment.html

Kozarev, J., Vižintin, Z. Novel Laser Therapy in Treatment of Onychomycosis. Journal of the Laser and Health Academy Vol. 2010, No.1; www.laserandhealth.com Vol. 2010, No.1;pp. 1-8.
Singer, N. False Start on a Laser Remedy for Fungus. New York Times. March 20, 2009.
501(k) Summary for the LightAge, Inc. Q-Clear™ Nd:YAG Laser from the FDA, September 15, 2011.

https://www.prnewswire.com/news-releases/new-nail-fungus-approach-receives-fda-clearance-142781615.html

Aguilar, G., Sun, F., Carlier, P., et al. Effect of vacuum and thermal shock on laser treatment of Trichophyton rubrum (toenail fungus). Photonic Therapeutics and Diagnostics VI (Proceedings Volume). February 8, 2010. https://spie.org/x648.html?product_id=841056 (abstract).

Mosena, J., Haverstock, B. Laser Care For Onychomycosis: Can It Be Effective? Podiatry Today. Volume 23; Issue 5: May 2010. https://www.podiatrytoday.com/laser-care-for-onychomycosis-can-it-be-effective

Weiss, David. 3 Month Clinical Results using Sub-millisecond 1064 nm Nd:YAG Laser for the Treatment of Onychomycosis. https://conejofeet.com/wp-content/uploads/2011/06/David-Weiss-DPM-report.pdf
Van Dyck, N. Onychomycosis Trial Preliminary Results using a 1320 nm Mid-Infrared Laser. March, 2010.

https://www.podiatristsacramento.com/cooltouch_studies.pdf

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But ciclopirox doesn’t seem to work as well as itraconazole pills or terbinafine pills. Ciclopirox is a chemical that you paint onto your infected nails like nail polish.

The brand name is Penlac Nail Lacquer. You can get it only with a prescription from your doctor.It may take a while before you see any results. Sometimes it takes as long as six months. If your infection is very bad, you may have to keep using ciclopirox for up to a year.

You may also need to see a health care professional every month or so to have the infected part of your nail removed.

Ciclopirox stops the fungus from making the chemicals it needs to grow. This may eventually get rid of the fungus, so your infection goes away. Then the dry or split skin and other symptoms of infection may be able to heal.

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Terbinafine is an antifungal drug (a drug that kills fungi). It’s used to treat infections that are caused by fungi, including those that affect fingernails and toenails. It doesn’t change the way that damaged nails look. But, by stopping the fungus, it allows new nails to grow normally. The brand name for terbinafine pills is Lamisil.

You’ll need to take terbinafine pills every day for at least three months.

Studies show that terbinafine is safe to take for most people. This includes people who have diabetes or HIV, and people who’ve had a transplant. If you take terbinafine pills every day for 12 weeks, there’s a 6 in 10 chance you’ll get rid of your fungal nail infection. If you take the drug for 24 weeks, you’re even more likely to get rid of your fungal nail infection. Nearly 9 in 10 people who take terbinafine for 24 weeks got rid of their fungal nail infection.Terbinafine pills appear to work better than itraconazole pills and griseofulvin pills.

All antifungal pills can cause diarrhea, a rash or breathing problems. But not many people get these problems. They are usually mild and go away when you stop taking the pills.

Terbinafine can also cause taste, smell or vision problems. These effects are often mild and not many people get them. They should go away when you stop taking the pills.

You may be slightly more likely to get side effects if you’re older (over 60). One study found that among 30 people over 60 years old, 18 had side effects from the drug. These side effects were classed as mild or moderate. And no one in the study stopped their treatment because of these reactions.

Sometimes people get more serious side effects. These are rare but it is important to know about them. Terbinafine can cause liver problems and heart problems. Terbinafine can cause liver problems, so you’ll need to have regular tests to make sure your liver is working normally. Also Terbinafine may cause heart failure.

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Itraconazole is an antifungal drug (a drug that kills fungi). It’s used to treat infections that are caused by fungi, including those that affect fingernails and toenails. It doesn’t change the way that damaged nails look. But, by stopping the fungus, it allows new nails to grow normally. The brand name for itraconazole pills is Sporanox.

You’ll need to take itraconazole pills for at least three months. There are two ways you can take itraconazole pills:

• You can take them every day. This is called continuous treatment
• Or you can take them for one week in every four weeks. This is called pulsed treatment or intermittent treatment.

Sometimes people get more serious side effects. These are rare but it is important to know about them. Itraconazole can cause liver problems and heart problems. Itraconazole should not be used by people with certain heart problems, especially heart failure. Talk to your doctor if you’re unsure whether you should be taking these pills.

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Funginix (formerly known as Fungisil) is a topical nail fungus treatment that contains anti-fungal agents, essential oils and fungus-fighting extracts.  Its has been shown that users have seen results with mild to moderate cases of nail fungus infestation. Also it should be noted that Funginix is a topical treatment therefore users will see more effective results if they file down the nail fungus to allow the treatment to reach the nail bed.

How to Use Funginix

Your first tip to keeping your nails fungus free is to keep them clean and dry throughout the day. If your feet tend to sweat, try changing your socks and shoes twice per day to keep the moisture away from the nails. Fungus thrives in moisture, and it will help rid you of this embarrassing problem by always wearing dry socks. Next, you want to apply the Funginix solution twice per day, usually after a shower, but before putting on socks. Allow 20 minutes to let the solution penetrate into the nail bed before putting on socks. Use the applicator that comes with the product to work it into the cuticle of the nail and underneath the nail bed. Apply generously so these helpful ingredients can get to work on your nail fungus.

Active Ingredient: Undecylenic Acid, USP 10%, Incactive Ingredients: Water, Prunus Amygdalus Dulcis, (Sweet Almond) Oil, Oleth-10 Phosphate, Triethanolamine, Polysorbate 20, Acrylates Copolymer, lycerin, Propylene Glycol, Uva Ursi (Bearberry) Extract, Beta-Glucan, Propolis Extract, Aloe Barbadensis Juice

Undecylenic Acid

The active ingredient in Funginix is undecylenic acid, which is a derivative of castor oil. This all-natural ingredient is often prescribed by doctors for different types of fungal infections, such as athlete’s foot, ringworm, and jock itch. It is a powerful antiseptic and is sure to clear up your nail fungus because it has a proven scientific track record that it works.

Prunus Amygdalus Dulcis (Sweet Almond) Oil

Sweet almond oil is a great ingredient to promote skin health. It acts as a natural moisturizer, and massage therapists actually use it to help lubricate their hands for massage. This keeps the skin around the nail soft and supple, and counteracts the actions of the fungus that dry out the skin. Studies have also shown that it is useful against black marks on the skin and can help with the discoloration from the nail fungus.

Uva Ursi (Bearberry) Extract

Bearberry extract is another powerful skin medication that is used in the Funginix solution. It is most commonly taken internally to combat urinary tract infections, but when used as a topical solution, Bearberry extract is great against contact dermatitis. Some of the ingredients in Funginix can cause this itchy, redness when used in high dosages. This ingredient helps to cut down on this side effect.

Aloe Barbadensis Juice

You may be familiar with using aloe on your sunburned skin, but it is also very effective against skin complaints, such as eczema and ringworm. Aloe has been used in healing slow healing wounds for centuries. With all of these powerful skin fighting properties, aloe is a natural to be included in the Funginix proprietary blend. It can help heal your fungal infection and keep your skin moist.

Tocopheryl Acetate (Vitamin E)

Vitamin E is an antioxidant, which means it is capable of cleaning toxins from anything it comes in contact with. In addition, it is helpful in reducing the appearance of scars and blemishes on the skin. For this reason and other powerful skin assisting properties, it is included in Funginix to clear up the fungus and reduce the appearance of any marks the condition causes on your hands or feet.

Camphor

Camphor, when applied topically, gives the skin a cooling sensation and makes it tingle. However, the real reason camphor is important to Funginix is that it can lessen the pain of a fungal infection, and it also has antiseptic properties. It can help with any topical itching you may feel, but the best action of camphor is its ability to kill off the fungus that is causing your nail problem.

Menthol

Menthol is often combined with camphor to give the cooling, easing sensation to the skin. Menthol on its own, however, can cut down on the pain you feel from fungal infections. It is great as an antimicrobial, and it can help to defeat the fungus that stubbornly refuses to go away. Menthol is very commonly used for aches and pains from muscle strains and cramps.

Melaleuca Alternifolia (Tea Tree) Leaf Oil

Tea tree leaf oil is stellar for taking care of many different types of bacteria. It has shown promise in scientific studies in use against viruses, many types of bacteria, and fungus. Including this ingredient in the Funginix blend is just another step towards killing off the fungus that is causing your unsightly nail fungus. It is a powerful ingredient to have in the arsenal against this condition.

Lavandula Angustifolia (Lavender) Oil

Lavender oil is often used for relaxation. By combining it with the other ingredients in Funginix, it helps to penetrate the nail bed, bring a cooling feeling to the area, and help with some of the pain from the condition. Massage therapists use it to relax their clients and to aid in bringing the soothing power of the lotions to the muscles. In Funginix, it helps to deliver the fungicidal ingredients to the nail bed.

Jasminum Officinale (Jasmine) Oil

Jasmine oil, in addition to smelling great and producing relaxation, has some antiseptic properties that make it important in the Funginix blend. It is also known for reducing the sight of stretch marks and generally making the skin supple and healthy. It goes a long way towards reversing the effects of the dry skin that is often caused by nail fungus.

Eugenia Caryophyllus (Clove) Flower Oil

Clove flower oil is commonly used for toothaches, but many do not know that it also has antiseptic properties. Clove flower oil can cut the pain from fungal infections that are growing in your nails, in addition to killing off the fungus that is actually causing the pain and discoloration. It is also known for warming the skin and helping induce blood flow to the area.

Theobroma Cacao (Cocoa) Seed Butter

Cocoa seed butter might remind you of chocolate, but it is actually a very strong moisturizer. It is absorbed readily into the skin and has also been used to fight off stretch marks. Like vitamin E, it has antioxidant properties that help it to combat the toxins produced by the fungus in your nail. As with many other ingredients, Funginix uses cocoa seed butter to reduce the action of the fungus and to keep the skin soft and supple.

Rosa Canina (Rose Hip) Flower Oil

The final active ingredient in Funginix is rose hip flower oil. Rose hips are known for their high vitamin C content, but the oil from their flowers is often used to fight off skin conditions. It has a history of being effective against acne, dermatitis, and eczema. People have also used rose hip flower oil to diminish the appearance of scars and blemishes, such as stretch marks. It works in Funginix to fight off the fungus and help reduce the ugly side effects on your nails.

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If you have fungus on you toenails or fingernails, you likely would do just about anything to get rid of it. Treating nail fungus can be a long-term project that requires patience, adherence to a treatment plan, and sometimes doctor intervention. Luckily, Zetaclear Nail Solution makes it easier to treat this common condition with a topical application. It is also an all natural treatment, which means it is generally safe to use. If you are the type who hates taking prescription medications, using a topical, all natural solution like Zetaclear is just the option you need to control your nail fungus. Before you run off to the doctor for a prescription drug, try this unique blend of oils to penetrate your nail bed and heal your nail fungus.

How to Use Zetaclear Nail Solution

You take three drops of the gel solution and apply it directly to the top of the nail. Spread the solution around with the applicator and try to get some of it underneath the nail to ensure adequate penetration. Immediately place a waterproof or regular bandage over the gel-coated nail. Make sure that the bandage does not slip around on the nail. If it does, replace gel and bandage as necessary. Every other day, clear out the keratin debris that will accumulate under the nail. Twice per week, gently abrade the the top of the nail with a file to help the solution penetrate into the nail bed. You should start to see results within four weeks.

ZetaClear contains a proprietary formulation of natural oils each of which has been demonstrated to contribute to the promotion of healthy looking nails.  Zetaclear also contains Tea Tree Oil which has been shown through studies done by Mayo Clinic to be effective in treatment of fungus on the fingernail and toenail.

The following ingredients are what helps to clear up your nail fungus.

Tea Tree Oil

Tea tree oil is a popular ingredient in nail fungus treatments – and for good reason. It is a potent antiseptic and well known for promoting skin health. Tea tree oil contains a powerful chemical called terpenoids that also help penetrate the nail and cure the nail bed of any fungal contaminants. Australian aborigines have used it for thousands of years for just this reason. Recent scientific studies have supported this ancient use of tea tree oil and shown that it is effective against skin infections. The oil is drawn out of the tea tree constituents by steam distillation of the leaves. This ingredient is generally considered safe, but it can occasionally cause skin irritation on contact. Zetaclear dilutes the tea tree oil with other oils to prevent this side effect. You can read more about Tea Tree Oil Benefits here.

Almond Oil

Almond oil is a powerful moisturizing agent that helps keep the skin supple and works to keep the nail bed moist so the medication can penetrate further down. This oil has been used since Egyptian times to keep the skin and nails soft and moisturized. It does not cause any skin irritation or allergic reactions on contact, making this a safe, effective ingredient in Zetaclear. It is also non-greasy, so the likelihood that the oil will slide around on the nail is decreased with almond oil. The skin absorbs it very quickly, and this helps it penetrate into the nail bed for optimal fungicidal effect. Almond oil has also been used to remove black marks on the skin, which is another reason it is great to use for discolored nails.

Jojoba Oil

Jojoba oil is native to the American southwest, and native American tribes have long used it to promote skin health. The oil is primarily taken from the jojoba seeds, since this part of the plant is roughly half oil. This ingredient is helpful because it is chemically very like human sebum, which is the oil that your skin naturally produces. It, therefore, helps to keep the skin and nails moist when the fungus tries to dry out the nail bed. The oil helps to break down the keratin, or nail matrix, and allow the other ingredients to seep into the nail bed.

Vitamin E Oil

Antioxidants are powerful chemicals that roam the body and scrub it free of toxins. Vitamin E is one of the most powerful antioxidants known to science, and by making it an oil and using it topically, you can get the same antioxidant effects. This means that the toxins caused by the fungus residing in your nail is neutralized and cleaned out by the power of the vitamin E in this oil. Furthermore, vitamin E oil is often used to help reduce the appearance of scars and any blemishes that appear on the skin. It is a powerful skin moisturizer and can help to defeat the toxins that a resident fungus produces in your nail. By removing these toxins, your nail slowly starts to return to a normal, healthy color.

Lemongrass Oil

Lemongrass is native to Asia and India, and if you have ever eaten cuisine from countries in these reasons, you may have tasted it before. It has a slightly citrus flavor to it, and that is also why it is known as citronella. Lemongrass as citronella is used in candles and sprays to help ward away nuisance bugs, such as mosquitos. Research has shown that lemongrass oil is also a powerful anti-fungal, and this is why the creators of Zetaclear include it in this topical medication. When applied topically, this ingredient kills off the fungus growing under your nail and causing discoloration. It is one of the powerful ingredients that works directly on the fungus itself in the Zetaclear solution blend.

Undecylenic Acid

Undecylenic acid is the most powerful anti-fungal ingredient in the Zetaclear solution. It is a fatty acid originally derived from Castor oil, and many studies have shown great results when using this oil against nail fungus. This ingredient is also effective against many types of skin infections, such as Athlete’s foot, yeast infections, jock itch, and ringworm. All the other moisturizing and carrying oils are to deliver this ingredient to the nail bed. It is often prescribed by doctors in prescription strength, but it is more than effective at the strength in Zetaclear. Occasionally, this ingredient can cause skin irritation when it comes into contact with sensitive skin, but the other oils in Zetaclear are effective in diluting it enough to prevent this possible side effect. If you do experience irritation, discontinue use and consult your doctor for a different nail fungus treatment.

Clove Oil

You may know clove oil from its use in dentistry. Your grandmother may have used it on your teeth and gums to help relieve toothaches. This is because clove oil is a powerful anesthetic and can help take some of the pain of nail fungus away. It also has a great antiseptic effect, and it helps to kill off bacteria and fungus that reside in your nail bed. Clove oil mainly comes from Madagascar and Indonesia, and the oil can come from the bud, leaf, or stem if the plant. The most powerful oil comes from the stem, and this is most often used in nail fungus treatments, such as Zetaclear. However, the Food and Drug Administration recently withdrew its opinion that it is helpful for toothaches. Its current stance is that there is not enough information for that claim. However, the FDA has no stance regarding clove oil’s antiseptic properties.

Our Findings have been shown that Topical Treatments such as Zetaclear are more effective when the user files down the infected nail so that treatment can penetrate further into the nail and nail bed.  There is a guarantee with this treatment and we recommend Zetaclear as an alternative to prescription medications to treat nail fungus infections.

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