Zapping Away Foot Infections -- In-Depth Doctor's Interview

What is the technical name for the fungus that people get on their feet, and where does it come from?

Dr. Gabriel Maislos: It’s called onychomycosis, and essentially, it’s everywhere. People can grab fungal infections from the floor, from the carpet, their house – it’s everywhere.

What are some of the challenges with treating it?

Dr. Maislos: It’s very difficult to treat because it is highly resistant. Historically we have treated fungus with topicals that are only eight percent effective, and then with Lamisil, oral medication, which can have an adverse effect on your liver, and is only 70 percent effective. Now, we have the laser, which is 80-87 percent effective.

What’s so great about this laser?

Dr. Maislos: It’s great because it’s painless, it’s safe – you don’t have to worry about checking your liver enzymes before or after – and it’s effective. One treatment usually knocks it out.

How does the laser work?

Dr. Maislos: Essentially, the patient comes to my office and I do an evaluation. I determine if they have a fungal infection. The actual treatment itself is about 45 minutes. It involves debriding the nail, which is where we shave the nail down so it gets nice and thin, and then the treatment takes about 25, 30 minutes. We treat all 10 nails and we do a grid-like pattern; basically, we start off in vertical and then horizontal.

What is the laser actually doing?

Dr. Maislos: The laser is an infrared Yag laser and it eradicates the fungus, virus, the bacteria at it's source. The reason I think it’s so highly effective is because we are able to treat the nail matrix. The nail matrix is the immature nail or the root of the nail that is not visible. The nail starts of thin and as it grows out and matures it becomes hard and known a the actual nail plate. By killing the fungus at the root of the infection we are able to allow a healthy nail to grow out

Is this a permanent treatment?

Dr. Maislos: This is a permanent treatment. We’ve been doing this over a year now, and we’ve seen from beginning to the end, complete resolution.

Is it just one treatment, or do the patients have to return? 

Dr. Maislos: The patients come back in 4-6 months for a follow up appointment. We take before and after pictures that allow the patient to see the difference. The patients love it because they can see it as clear as night and day. You won’t see resolution in four months because the nail takes anywhere from nine months to a year to grow out, but at four months, they’ll see what they call subungual clearing, which is a big stark difference between the fungal nail that’s growing out and the new nail which is free of fungus.

What kind of a difference has the laser made in treating the fungus?

Dr. Maislos: It’s totally changed it. I exclusively treat it now with the laser. Before, I didn’t feel that comfortable knowing that I could give a treatment like a topical, whether it’s a nail lacquer or whether it’s a cream or gel, and I knew there was only eight percent success. That’s not something that I feel comfortable with – having the patient come back and knowing that I really didn’t effectively treat it. At first I was skeptical, because like any new treatment out there, I was very skeptical until I started seeing the patients come back which were just loving it, and they start telling their friends and the next thing I know, I’ve done a ton of these. It’s how I exclusively treat nail fungus.

Why do some people get the fungus while others don’t?

Dr. Maislos: If your immune system is compromised – so let’s say, you’re elderly or diabetic – then you’re more susceptible to an infection, so you’re going to see a lot of nail fungus in that patient population. Some people, like you’ll see a husband and a wife who live in the same house – one has it; the other one doesn’t. It’s just that one is susceptible to it and the other one is not, and unfortunately, it’s bad luck.

Is it contagious, and is it possible to get it at a nail salon?

Dr. Maislos: It is. It’s not contagious like if the person is right across from me, it’s going to jump from my toenails to the next person, but if you’re in a nail salon and they’re not auto-claving or sterilizing their instruments, there is a good chance you can get it. They’ve done numerous studies where they show that there are all kinds of things beyond fungus, like all kinds of viruses that they’ve been known to culture. If you go to the nail salon, you want to make sure you bring your own instruments and that they’re sterilized. I have countless patients that come in angry because they say, ‘I got it from my nail salon. I knew it,’ and it’s something that you have to be concerned about.

Can you get the fungus from almost anywhere?

Dr. Maislos: You can get it almost anywhere, but if you’re taking an instrument that’s not cleaned and it has fungus on it and you’re introducing it under the nail, there’s a high chance you’re going to get it.

END OF INTERVIEW

This information is intended for additional research purposes only. It is not to be used as a prescription or advice from Ivanhoe Broadcast News, Inc. or any medical professional interviewed. Ivanhoe Broadcast News, Inc. assumes no responsibility for the depth or accuracy of physician statements. Procedures or medicines apply to different people and medical factors; always consult your physician on medical matters.