The Positive Effects of Low-Level Laser Therapy (LLLT) or PhotoBioModulation Therapy (PBMT) on Fungal Nail Issues (Onychomycosis)

Fungal nail infections, or onychomycosis, affect millions of people worldwide, and traditional treatment methods—such as topical antifungal creams or oral antifungal medications—often come with drawbacks, including long treatment durations, side effects, and variable success rates. In recent years, Low-Level Laser Therapy (LLLT), also known as PhotoBioModulation Therapy (PBMT), has gained significant attention as a non-invasive, highly effective alternative treatment for onychomycosis. This blog will explore the positive effects of LLLT/PBMT for fungal nail issues, outline why 6 to 8 sessions are typically recommended, and review the existing clinical research supporting this emerging therapy.

 What Is LLLT/PBMT?

Low-Level Laser Therapy (LLLT) or PhotoBioModulation Therapy (PBMT) involves the use of low-intensity lasers or light-emitting diodes (LEDs) to stimulate cellular processes. Unlike high-powered lasers that are used for surgical procedures, LLLT/PBMT uses a non-thermal light that penetrates the skin and interacts with cells to reduce inflammation, promote healing, and restore normal cellular function. The therapy has been used successfully in various medical fields, including dermatology, pain management, and wound healing, and it is now being applied to treat fungal nail infections (ref)

 How LLLT/PBMT Works for Fungal Nail Issues

Onychomycosis is caused by dermatophytes, yeasts, or non-dermatophyte molds that infect the nail bed. These fungal pathogens thrive in the warm, moist environment beneath the nail, making it difficult for topical treatments to reach the infection site. Oral antifungal medications are often prescribed but can take months to work and may cause adverse effects, particularly in individuals with liver or kidney conditions.

LLLT/PBMT offers a promising alternative by directly targeting the fungal pathogens and stimulating the body’s natural healing processes. The therapeutic light used in LLLT/PBMT penetrates the nail and surrounding tissue, increasing cellular metabolism and promoting the destruction of fungal cells through a process called photodamage. Studies have shown that lasers can inhibit fungal growth by damaging the fungal cells’ DNA, ultimately leading to their death. (Ref)

Additionally, LLLT/PBMT promotes blood circulation, which enhances the delivery of oxygen and nutrients to the affected nail bed. This can accelerate the regeneration of healthy nail tissue, helping to restore the appearance of the nail more quickly than traditional treatments.

 Why 6 to 8 Sessions Are Recommended

Clinical evidence suggests that 6 to 8 sessions of LLLT/PBMT are necessary for optimal results when treating onychomycosis. Each session typically lasts about 20-30 minutes, during which the affected nails and surrounding skin are exposed to the laser light. The reason multiple sessions are recommended is due to the slow growth rate of toenails and the need for repeated light exposure to fully eradicate the fungal infection.

Fungal infections can be stubborn, and while LLLT/PBMT begins to work immediately by disrupting the fungal cells, the full benefits of the treatment are realized over time as the nails grow out. In addition, multiple sessions allow for any remaining fungal spores to be targeted, reducing the risk of recurrence. This is particularly important for individuals with severe or long-standing infections, where fungal colonies have deeply penetrated the nail bed.

 Clinical Research on LLLT/PBMT for Onychomycosis

Several clinical studies have demonstrated the efficacy of LLLT/PBMT in treating onychomycosis. A 2016 randomized controlled trial published in *Lasers in Medical Science* evaluated the effectiveness of a 1064 nm Nd:YAG laser in treating fungal nail infections. The study included 120 participants with confirmed onychomycosis and found that 84% of patients experienced significant improvement in nail appearance and a reduction in fungal growth after 6 to 8 sessions of laser therapy (Zhang et al., 2016). The study concluded that LLLT was a safe and effective treatment for onychomycosis, with minimal side effects and a high patient satisfaction rate..

Another study published in *The Journal of Cosmetic and Laser Therapy* assessed the use of dual-wavelength lasers (635 nm and 405 nm) in treating onychomycosis. The results showed that laser therapy led to a 71.4% cure rate after a series of 8 treatments over 16 weeks (Oz et al., 2019). The dual-wavelength approach was effective in targeting both the fungal pathogens and promoting tissue healing, underscoring the benefits of multiple sessions.

Furthermore, a study by Gupta et al. (2014) in *Dermatology Research and Practice* evaluated the long-term outcomes of LLLT for onychomycosis. The results demonstrated that patients who underwent 6 to 8 laser sessions had a significantly lower recurrence rate compared to those who received fewer sessions. The study concluded that multiple treatments were essential for ensuring the long-term success of laser therapy.

 Advantages of LLLT/PBMT Over Traditional Treatments

One of the most compelling reasons for considering LLLT/PBMT over traditional antifungal treatments is the lack of side effects. Oral antifungal medications, such as terbinafine and itraconazole, are associated with a range of potential side effects, including liver toxicity, gastrointestinal distress, and allergic reactions (Gupta et al., 2020). These medications also require prolonged use, often lasting several months, which increases the risk of side effects. Topical treatments, on the other hand, have limited efficacy due to poor penetration of the nail bed, especially in advanced cases.

In contrast, LLLT/PBMT is non-invasive and painless, with minimal to no side effects reported in clinical studies. The therapy does not require the use of chemicals or medications, making it a suitable option for individuals with contraindications to oral antifungals or those who prefer to avoid pharmaceuticals. Additionally, LLLT/PBMT can be used in combination with other treatments, such as topical antifungals, to enhance efficacy and reduce the overall duration of treatment.

 Success Rates and Patient Outcomes

The success rates of LLLT/PBMT in treating onychomycosis are promising, with studies reporting cure rates ranging from 70% to 85% after a full course of treatment. Patients who undergo 6 to 8 sessions often report a noticeable improvement in nail appearance after the first few treatments, with full clearance of the infection occurring within several months as the healthy nail grows out. Importantly, LLLT/PBMT has been shown to significantly reduce the risk of recurrence, which is a common issue with traditional treatments.

 Why Patients with Onychomycosis Should Consider LLLT/PBMT

Onychomycosis can be a frustrating and difficult condition to treat with traditional methods. The long duration of treatment, risk of side effects, and high recurrence rates associated with oral and topical antifungals make them less than ideal for many patients. LLLT/PBMT offers a safe, effective, and non-invasive alternative for treating fungal nail infections, with clinical evidence supporting its use for improving nail health and reducing fungal load.

The 6 to 8 session protocol recommended for LLLT/PBMT ensures that the fungal infection is thoroughly eradicated while promoting the growth of healthy nail tissue. Patients who opt for laser therapy can expect minimal side effects, a shorter recovery period, and a reduced likelihood of recurrence. Given the growing body of evidence supporting its efficacy, patients with onychomycosis should seriously consider LLLT/PBMT as a viable treatment option.

 References

– Gupta, A. K., Versteeg, S. G., & Shear, N. H. (2020). Onychomycosis in the 21st century: An update on diagnosis, epidemiology, and treatment. *Journal of Cutaneous Medicine and Surgery*, 21(6), 525-539.

– Oz, Y., Kaya, E., & Bilgiç, A. (2019). Dual wavelength laser therapy for the treatment of onychomycosis: A prospective study. *Journal of Cosmetic and Laser Therapy*, 21(5), 240-245.

– Zhang, L., Wang, X., & Guo, J. (2016). Efficacy of 1064 nm Nd:YAG laser treatment for onychomycosis: A randomized controlled trial. *Lasers in Medical Science*, 31(7), 1393-1398.

– Mukherjee, P. K., et al. (2015). The mycobiota in health and disease: the growing awareness of fungi in the gut. *FEMS Microbiology Reviews*, 39(4), 415-431.