The Newest and Safest Treatment in the Fight against Toenail Fungus: The PinPointe™ FootLaser™

Have you ever suffered from toenail fungus? Are you embarrassed to go to the nail salon or go to the beach with friends or family because of the appearance of your nails? Have you tried medications, only to be frustrated when nothing works? If so, laser therapy could be your answer.
Onychomycosis, most commonly known as a chronic toenail fungal infection, can be very difficult to treat as it grows extremely slowly. The fungal organism that is the source of the problem can only be killed during its growth phase. That is why it can be very frustrating for many dermatologists and podiatrists to treat toenail fungus.

Signs and Symptoms:
Fungal infections can go unnoticed for long periods of time because there may be no initial discoloration or pain. The infection is a mold that typically occurs when the toenail is exposed to a dark, warm moist environment. A fungal nail infection that is persistent or becomes painful should be treated. Otherwise, it can cause problems and potentially impact the function of the entire foot. The fungus breeds underneath the growing portion of the nail and can occasionally penetrate through the surface of the nail. Studies have shown health-related quality-of-life issues associated with onychomycosis and it is clear that patient treatment is both necessary and desirable.

A fungal infection is diagnosed by its appearance - a thickening and discoloration of the nail plate as well as a possible foul odor. As the nail thickens, it may lift from the nail bed (onycholysis). Other symptoms include brittleness, chronic in-grown toenails and debris under the nails. In some forms of fungal nail infections, a black or white, powdery discoloration may appear on the surface of the nail plate.

Toenail fungus can become debilitating, interfering with both walking and with shoe pressure. If the infected toenail is left untreated, further complications may occur. In some cases, the nail can break away from the underlying skin (the nail bed), allowing the fungus to spread to other parts of the foot. Although the degree to which the infection spreads varies from person to person, it is best to identify and treat the problem as quickly as possible.

Many treatment methods have been used over the years. First isolated in 1939, griseofulvin was commonly used in the 1960s and 1970s as a first-line treatment for fungal infections. However, due to a significant liver toxicity, it quickly fell out of favor. In the 1980s, topical antifungal medications were frequently used, though these had limited success (less than 10%). In the mid-1990s, oral medications such as terbinafine and itraconazole were used. These newer agents had the advantage (over griseofulvin) of reduced toxicity and a shorter duration of therapy. However, results were moderate (approximately 55-65% improvement) and liver toxicity was still an issue. Similar to griseofulvin, terbinafine and itraconazole are still in use today, despite the risk of liver problems.

Today, there is a new treatment that has been extremely beneficial in the fight against fungus - The PinPointe™ FootLaser™. This breakthrough technology was introduced nearly 2 years ago and has shown significant success in the treatment of chronic fungal infections. PinPointe,the company that developed this light-based procedure, claims an 88% success rate. The laser, which is now FDA-cleared for the treatment of nail fungus, is a specially designed, patented device that shines through the toenail and vaporizes the pathogens embedded in the nail bed and nail plate.

Upon first hearing of this technology at the 2008 American Podiatric Medical Association Annual Conference, I was immediately interested, especially because there were no other effective treatments available at the time. I was, to say the least, a little skeptical of its efficacy as none of the other treatment modalities have worked well thus far. A close colleague of mine first began using the laser in September 2008. He advised me that the procedure worked well. I asked to see the results after 3-4 months, as it takes several months for the nail to completely grow out. In December 2008, he informed me that the procedure was very successful in treating some of the worst cases of fungal nail infections he had ever seen.

In early 2009, we brought the laser to the Long Island area as well as to our Connecticut offices and have performed the procedure on over 875 patients. We have seen a significant number of happy and very satisfied patients; patients that have been frustrated throughout the years. They found this modality the only effective means in the treatment of their debilitating and cosmetically unappealing condition.

This PinPointe™ FootLaser™ is safe, pain-free and is performed in one treatment with no need for drugs or anesthesia. This state-of-the-art, premiere treatment therapy, uses a laser that passes directly through the nail to target the precise infection site. As the laser passes through the nail, it identifies and destroys the pathogens that cause the fungus. The laser does not harm the nail or surrounding skin in any way. Following this procedure, the toenail will eventually grow back new; clear, healthy and free of any fungus.

The entire procedure takes approximately 30-45 minutes and is performed in the comfort of our office. Approximately 85% of my patients that I have performed the procedure on have been extremely satisfied after one treatment. Only a small percentage of the patients have needed a second treatment in an attempt to get rid of a stubborn fungal infection. In my experience, overall this is the best treatment to date for this unsightly and painful foot problem.
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Summer’s here—time for sandals and flip-flops and peek-a-boo toes. But what’s showing on your feet? Painted nails and pretty toe rings…or ugly foot fungus? Nail fungus affects about 38 million people in America. Many people wonder how they got this disease, which can be difficult to eradicate and is certainly unsightly. Here are some commonly asked questions…with answers.

Q: How did I get this fungus?

A: As a practicing board-certified podiatric surgeon, I am asked this question several times a day. Unfortunately, it’s difficult to ascertain the exact cause of a fungus. Some patients may recall a dirty nail salon or a summer trip to the Hamptons with a roommate who may have had toe fungus. The truth is, fungus is everywhere, and some people are more susceptible to it than are others. Fungus can be found in gym locker rooms, hotel rooms, and nail salons. It would be difficult not to be exposed to it, but if you limit your exposure, you can minimize the chance of getting a bad infection.

Q: What does it look like?

A: Fungal infections can cause the nails to become discolored, thick, yellow, incurvated, and can possibly cause the nail to break away from the nail bed, leading to a gap between the nail plate and the nail bed. This allows for dirt, bacteria, germs, and fungus to live under the toenail and breed. Occasionally this can lead to odor as well.

Q: Is fungus contagious?

A: Yes. Studies have shown spouses generally can infect each other. If you or a loved one have fungus, it is better to treat it early to prevent the spread to others in your household.

Q: Is it more common in women?

A: We see a greater number of women with the infection, likely due to the fact that most women paint their toenails. This allows for a dark area under the nail and allows the fungus to breed. Women also take more trips to the nail salon, so they are exposed to fungus more often.

Q: Why are fingernails less likely to develop fungus?

A: Fungus thrives in a dark, moist environment. Fingernails are exposed to light, and there is less moisture on the fingernails. In fact, many people have dry skin on their fingers.

Q: How can I avoid getting this infection?

A: Consider using a nail salon that uses sterile instruments and either bring your own nail file or make sure that a new one is used. The nail file is porous and can act as a breeding ground for fungus. Always use flip-flops at the gym or in hotel rooms. Also consider an antifungal powder in your shoes to decrease moisture. Since fungus breeds in a dark, moist environment, you should leave damp or wet shoes near a window to dry properly. Do not put them in your dark closet.

Q: How bad can the fungus get?

A: Fungus can affect the nails to different degrees. You can have a very mild or superficial infection that can usually be treated by topical medications and debridement. This usually starts with white spots on the surface of the nail. Moderate infections may penetrate the nail plate and may affect up to 50% of it. Other, more severe infections can affect over 50% of the nail plate and can get down to the matrix/root of the nail.

Q: How can I effectively treat this?

A: For mild infections, topical medications and mechanical debridement can be quite effective. Occasionally, we may try oral medications or laser procedures to cure the infection quickly. Moderate to severely infected nails may not get better with topical medications but usually respond well to oral medications or a new type of laser treatment called PinPointe Foot-Laser.

Q: How safe is the laser?

A: The PinPointe FootLaser is completely safe. It is a YAG laser that has been around for many years. YAG lasers have been used for hair removal, aging spots, and sunspots.

Q: How long has the laser been used

for nail fungus?

A: The laser was introduced in California early last year and has been used in New Jersey for about a year already. It became available in New York in January of this year.

Q: What are the benefits of the


A: Usually the laser treats patients in a single session, with no drugs and no anesthesia. Laser light passes through the toenail without causing damage to the nail or surrounding

skin. During the procedure, the pathogens that cause toenail fungus are targeted, allowing the new nail to grow in healthy and clear. Unlike some medication-driven treatments for toenail fungus, the laser presents minimal risk of side effects, and it is a great alternative for many patients who can’t or don’t want to take oral meds.

Q: What are the side effects of the

oral medications?

A: Generally speaking, oral Lamasil is relatively safe. A blood test is done prior to initiating therapy and other tests may be performed to ensure the medication is not having ill effects on your blood or liver enzymes. There have been some patients who have experienced rashes and a taste disturbance; however, most of the side effects are resolved once you come off the medication.

Q: Can I use nail polish during treatment?

A: You can use nail polish while on oral medication and immediately after the laser treatment. If a patient is on topical therapy, she cannot use nail polish as the topical medications will not penetrate through the polish.

Q: Is the laser treatment covered by

my insurance?

A. At this time there is no insurance company that covers the laser procedure.

It is considered to be aesthetic and too new a modality. Time will tell if insurance companies will adopt this treatment modality into the patients’ plans. Many patients use their HSAs (Health Savings Accounts) or FSAs (Flexible Spending Accounts) to cover the cost for the laser treatment.

Q: What is the cost of the laser?

A: The laser procedure costs from about $975 on Long Island to upward of $1500 in Manhattan.

Keep in mind, this infection never goes away on its own and usually gets worse with time. Many times it spreads to surrounding toenails, skin, and even to your loved ones. For more information on the laser and other treatment options, make an appointment with your local podiatrist to discuss which option is best for you. Consider visiting the following websites for more information: www.PinpointeFoot

For more information on the newest and safest toenail fungus treatment, please contact our Long Island foot doctors at Advanced Podiatry today at either our Huntington, NYManhasset, NY or Roslyn, NY practice! Or fill out our site request form today!

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Advanced Podiatry of Manhasset at the Americana

(516) 844-0039 - Manhasset, NY
(631) 400-3085 - Huntington, NY
(646) 741-7714 - Manhattan, NY 
(516) 869-3300 - Great Neck, NY
(718) 639-0499 - Maspeth, NY

Manhasset, NY Podiatrist
Advanced Podiatry
2110 Northern Blvd
Suite 208
Manhasset, NY 11030
(516) 844-0039

Huntington, NY Podiatrist
Advanced Podiatry
181 Main Street,
Suite 207
Huntington, NY 11743
(631) 400-3085

Manhattan, NY Podiatrist
Advanced Podiatry
110 E 40th St #201, 
New York, NY 10016.
(corner of Park Ave & 40th)
(646) 741-7714

Maspeth, NY  Podiatrist
Advanced Podiatry
5531 69th St
Maspeth, NY, 11378
(718) 639- 0499

Great Neck, NY  Podiatrist
Advanced Podiatry
488 Great Neck Road,
Great Neck, NY, 11021
(516) 869- 3300

Roslyn, NY
1514 Old Northern Blvd.
Roslyn, NY 11576
(516) 484-1420
*Moved to Manhasset