The future of lasers in onychomycosis.

INTRODUCTION: Laser therapy is one of the most promising device-based therapies for onychomycosis. To date, reported clinical efficacies, as well as anecdotal clinical results, have varied greatly, and the specific mechanism of action has not been well-elucidated. METHODS: Here, we provide an overview of the mechanisms of action and detailed analysis of the technical parameters involved in creating a laser that will be successfully fungicidal in onychomycosis. RESULTS: This review provides important insight into why the efficacies of laser studies reported to date vary so greatly and what is critical in order to obtain high efficacy in the clinical treatment of onychomycosis. CONCLUSIONS: There is substantial opportunity to improve the targeting and anti-targeting properties of lasers to address the specific considerations required to treat onychomycosis and, more generally, other dermal pathogens.