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Nd-YAG Laser 90% Effective Eradicating Toenail Fungus

PMNews Letters

By: Bryan C. Markinson, DPM

The Podiatrist in the News Part 2 – PM News 4-13- 2012 highlights Dr. Kevin Gavin and attributes the following quotes regarding onychomycosis therapy to him: “Topical medications require application twice daily and work less than half of the time. Oral medications can be toxic to the liver and are no more effective.” Really?

Oral medications are no more effective than topicals? The article continues with this quote: “The Nd-YAG Laser at the Foot & Ankle Institute requires no anesthetic, no medications, and has proven itself to be 90% effective in eradicating toenail fungus for many patients in my practice over the last year.” WOW! 90% effective for MANY patients? Does anyone know what that means?

This information should not have been published in PM News, even if it quotes an irresponsible journalist (Aishwarya Sharma, Trib-local Huntley ) who obviously did not do his or her homework in checking out the information provided by Dr. Gavin. I hope Dr. Gavin has a chance to write in PM News that he did not have the opportunity to edit the article, as both bits of information cited above are very problematic. They are both contradictory to any and all existing data, and I doubt that beyond the patient “happiness factor” he has no evidence of “effectiveness” for laser therapy that defines the 90% figure in any meaningful, appreciable, or clinically significant way.

Laser therapy for onychomycosis is obviously effective, but the best protocols are yet to be defined. Most likely the continued use of laser therapy will prove itself valuable in the ongoing long-term management of the infection along with adjunctive therapy. If present trends continue, the rampant slick marketing touting numbers that are meaningless will result in the demise of this therapy before the best ethical use and maximum recurring revenue generation for your practice is determined.

Disclaimer: I am an advisor to Nomir Medical, the makers of the Noveon Dual Wavelength laser

Bryan C. Markinson, DPM, NY, NY

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