Laser Toe Fungus Removal
Laser Toe Fungus Removal

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What is Laser Toe Fungus Removal?

Toes are ones of our many exterior signs of beauty and aesthetic accessorization. Pedicures are often very elaborate and designed to match the clothing and/or foot wear.  Laser toe fungus removal and treatment can help your toes and feet look their very best.

Well-maintained feet

Figure 1.  Toe nail beauty is a big part of aesthetic presentation and attraction. Attractive toe nails have assumed a Haute Coutre in western culture. To have attractive, well-manicured and painted nails has become the norm.

Toe fungus (also known medically as onychomycosis) is an extremely common occurrence.  Approximately 4 million Canadians suffer from toe fungus.  Toe fungus is easy to acquire.  Some of the most common causes and means of contamination include pedicures performed in less than sterile conditions, minor trauma to the nail plate and immunocompromised conditions, such as diabetes or decreased blood supply to the legs.  Most commonly, there is no obvious cause for the toe fungus and toe fungus is a painless, yet extremely unsightly, socially unacceptable stigma of uncleanliness and makes people extremely embarrassed, especially during open-toe season’s/summer’s thongs and high heels, where the toe fungus is exposed.

Being by the pool is one of the times where your feet will be exposed

Figure 2.  Toe Nail Fungus can be very socially embarrassing in open shoe environments, especially evening shoes, the summer flip flops or by the pool.  Toe Fungus causes the sufferer to cover up the offense condition.

Toe fungus is caused by specific fungi that are able to penetrate under the nail plate.  This environment is relatively avascular, with a poor blood supply and poor immune system access.  Once the toe fungus gets hold, it begins to replicate and forms unattractive white opacification under the nail.  If allowed to progress and live without interruption, the toe fungus will spread to involve the entire plate and the nail plate itself can become distorted, thick and very scaly; almost like bird talons. The Toe Fungus often spreads to infect other toes on the same and other foot. Nail plate irregularities, indents and grooves occur as the toe fungus invades the germinal matrix or the area at the base of the toe where the nail plate actually forms.

Fungus appears under the nail plate

Figure 3.  The Fungus gets under the Nail plate in the sterile matrix where it grows slowly and distorts the color and then texture of the nail itself.

Even though the toe fungus is asymptomatic and usually not painful, it is aesthetically unacceptable and has become the focus of a high-tech laser treatment that replaces some of the older, more deforming treatments.

Examples of early and advanced toe fungus

Left: Early Toe Fungus Right: Advanced Toe Fungus

Figure 4.  Examples of early to advanced Toe Fungus disease

How is Laser Toe fungus Removal performed?

Toronto Toe Fungus patients are treated with a specific laser called the PinPointe™ Foot laser.  The PinPointe™ Foot laser is specifically designed and engineered only for the laser treatment and removal of toe fungus.  There are many other lasers that attempt to treat toe fungus, but their major application has been hair removal or skin rejuvenation. These laser devices are then also used to treat toe fungus and are not as successful; they are not FDA cleared; and they are not validated with long-term clinical trials.  As always, Dr. Mulholland, a Toronto plastic surgeon, brings to his SpaMedica patients the very best in laser treatment and the PinPointe™ Foot laser is the industry gold standard for the treatment and removal of Toe Fungus.

The PinPointe™ laser, owned by Cynosure Laser Systems, is specifically designed only for the treatment of toe fungus.  Once a history and physical assessment have been made by Dr. Mulholland or one of his SpaMedica consultants, and a diagnosis of Toe Fungus has been made, contraindications and indications will be discussed, as well as treatment and recovery.

The PinPointe machine to treat toe fungus

Figure 5.  The PinPointe™ Foot Laser is the Industry gold standard and leader in the laser treatment and laser removal of Toe Fungus.

The PinPointe™ Laser Toe Fungus treatment and removal itself is relatively simple and painless.  The nail plate is first debrided with a delicate toe plate burr, which is similar to a microdermabrasion performed on the skin, but for reduction of the thick, hyperkeratotic parts of the nail plate, to facilitate better penetration of the Laser.  Small little rotating nail plate and biologic sanding instruments are used to thin the thickened hyperkeratotic scaly nail plate, that allows better penetration for the laser and topical fungus products.  Once the nail micro-debridement has been performed by your highly-trained SpaMedica medical aesthetician, the actual PinPointe™ laser is then deployed to treat and remove the toe fungus.  The PinPointe™ is a 1,064-nm Nd:YAG Toe Fungus laser with a very small spot size.  The 1 mm spot size combined with the gated release of the laser, which is brief periods of time when the laser is on and then periods of time when it is off, allows heating of the fungus under the nail plate, but not heating of the nail plate itself.  This is important, as once the fungus is heated to 79°C, it undergoes a nonspecific death.  By keeping the pulse profile gated, with on time and off time with the laser pulsing, the sensory nerves and pain nerves of the nail plate are not stimulated and the treatment is a warm, comfortable feeling, but not painful.

PinPointe Device

Figure 6.  One of the secrets to the PinPointe Laser Toe Fungus treatment and removal success is the pulse profile, which has been specifically engineered to treat the nail plate and Toe Fungus.  The PULSE SEQUENCING calls for a micro-pulse of laser “on time”, when the fungus is selectively heated, then a short period of “off time” allowing the sterile matrix nail tissue around the fungus to cool. This is then followed by another cycle of on-off times, allowing the fungus to heat up, but the surrounding nail tissue, nerves and vessels to stay cooler, thus reducing the risk of nail plate burns and keeping the TREATMENT PAINLESS. Other lasers do not do this.

Toronto Toe Fungus patients will have each toe affected by the toe fungus treated for approximately two minutes.  Two passes are made, one horizontally and one vertically, and the skin around the nail plate as well as the lunula, or white germinal matrix of the base of the toe, is also treated. During your SpaMedica toe fungus treatment, laser toe fungus reduction and laser toe fungus treatment, the entire nail plate of each affected nail is treated twice.  The entire treatment option takes no more than 10 to 15 minutes, in addition to the 10 to 15 minutes of nail plate debridement.

Laser Toe Fungus Treatments

Figure 7.  Toronto Toe Fungus patients have each affected toe treated. The Toe Fungus and nail plate are treated with 2 painless passes, the second pass is 180 degrees to the first pass to ensure all areas of Toe Fungus have been treated. The PinPointe™ Foot fungus pulse configuration ensures no pain but the highest degree of toe fungus death and reduction in the medical industry.

Following treatment, post-laser toe fungus treatment nail care is outlined, which includes a topical antifungal, Clotrimazole, which is applied several times a day for the first three to four weeks following your laser nail plate treatment.  Footwear hygiene is discussed as well and following the first three weeks of topical fungal treatment, in the next three weeks, Formula 3® is used on the nail plate itself.  These products are prescribed or provided at the time of your treatment, none of which would be curative on their own, but help support and enhance the Laser Toe Fungus treatment and removal.  In addition, ultraviolet light inserts are available for sale to ensure that recontamination doesn’t occur from your footwear.  Old footwear that has not been recycled in some time you are advised to discard and purchase new footwear.

In general, patients are seen back six weeks after the first treatment and a second treatment is also performed.  The cost of the laser toe fungus removal/laser toe fungus reduction covers the cost of the second treatment.

Fungus cream and treatments for toe fungus

Left: Clotrimazole Fungal Cream Right: Formula 3 Fungal Treatment

Ultraviolet Light Shoe Inserts

Figure 8.  Post Laser Toe Fungus Treatment and removal, Toronto Toe Fungus patients are prescribed: A. Clotrimazole cream to be applied to the affected toes. B. Formula 3 is applied following this for approximately one month.  C. Ultraviolet light inserts are recommended to prevent any further fungal build up in your new shoes.

What are the causes of toe fungus?

The most common kind of toe fungus that invades the nail plate is Trichophyton Rubrum.  Occasionally the Toe Nail Fungus is caused by Candida Albicans and then a number of other fungi and non-fungiform organisms that can cause the infection, but over 90% of Toe Fungus infections are Trichophyton Rubrum and respond extremely well to Laser Toe fungus Removal and Laser Toe Fungus treatment.

What are my other options for treatment of my unattractive, aesthetically displeasing toe fungus?

Toronto toe fungus patients have numerous treatment options, but none as simple, painless and effective as Laser Toe Fungus removal.  Historically, traditional surgical treatment called for nail plate removal performed under local anaesthesia and then topical antifungal agents for approximately one year.  Control rates were approximately 75%, but the unsightly, unattractive deformity of having the nail plate removed for up to one year, made this a very unattractive option except for the most ill of patients, such as hospitalized diabetics or patients with peripheral vascular disease who have undergone amputations of other toes.

Oral antifungal agents can also be prescribed; however, these must be taken for over a year.  The oral antifungals have risks of liver insufficiency or failure, bone pain and muscle aches and, after one year of oral antifungal treatments covered by healthcare have a control or cure rate is only approximately 75%. Often the oral anti fungal medications are not covered by drug plans.

Who is a candidate for Laser Toe Fungus removal and Laser Toe Fungus Treatment?

Candidates for laser toe fungus treatment include any Toronto toe fungus patients who have unsightly, aesthetically displeasing toe fungus and do not have any serious underlying conditions, such as uncontrolled diabetes, uncontrolled cancer or arthrosclerotic disease with poor circulation to the toes.  Laser toe fungus patients also cannot be pregnant at the time of treatment.

Is Laser Toe Fungus removal and Laser Toe Fungus treatment painful?

The PinPointe™ toe fungus laser is essentially painless.  The entire process feels like a warm, comforting treatment to the toe and this is because of the gated nature of the pulse sequencing of the PinPointe™ foot laser.  The laser itself fires for a brief period of time and then there is a break, followed by another exposure duration and then another break.  This continues for 20 sequential pulses.  It is during the breaks that the actual nail matrix is allowed to cool down.  Then indiscriminate heat is specifically attracted to the fungi itself and the toe fungus is heated to 79° which results in this nonspecific thermal death.  Because of the comfortable nature of the treatment there is no anaesthetic required – no topical and no injection local anaesthesia or toe blocks.

How long does the Laser Toe Fungus removal treatment take?

The treatment is relatively quick.  Each toe takes approximately two to four minutes to treat and each infected toe can be treated on the same visit.  The most common toes affected are the big toe, followed by the second toe; although toes number five, four and three can also be affected.  Your treatment price includes treatment of all toes affected with the toe fungus.

How long is the recovery from my laser toe fungus treatment and laser toe fungus removal?

There is relatively little to no recovery required.  Patients are encouraged to return to activities of daily living and normal activities immediately.  High-impact aerobic activity can be continued and only the postoperative Clotrimazole and then Formula 3® is required.  Good toe hygiene, discarding old, moist, fungi-riddled shoes is advised and ultraviolet light inserts are also advised for any new foot wear.

What kind of results can I expect from my PinPointe™ Laser Toe Fungus removal and Laser Toe fungus Treatment?

Toronto Toe Fungus patients can expect excellent cure rates with Laser Toe Fungus treatment. Two PinPointe™ laser toe fungus treatments, separated by six weeks, result in over 90% control and cure.  The PinPointe™ Foot laser is the most studied and specific laser developed for toe fungus and several large, multi-center trials have shown excellent cure rates of well over 90%.  Dr. Mulholland has worked with Cynosure since the beginning of launching this laser toe fungus treatment and is one of the pioneers in the area of non-surgical, laser treatment of unwanted, aesthetically displeasing toe fungus.  Although other lasers have been promoted for the treatment of toe fungus, they are not specific, do not have gated pulse durations and are quite painful and do not achieve that critical 79° temperature within the fungus itself that facilitates its death and resolution of your aesthetically displeasing nail plate toe fungus deformity.

Before and after photos of toe fungus

Figure 9.  Two cases of Toe Fungus 12 months after the Laser Toe Fungus treatment removal.

For those individuals that do not have 100% clearance, a third treatment can be instituted.  This is usually obvious by about the fourth to the sixth month.  There will be a charge for this third treatment; the first two treatments are covered by the initial cost.

What are Toronto Toe Fungus patients saying about their laser toe fungus treatment and toe fungus removal?

Most patients are extremely happy with their Laser Toe Fungus treatment.  Not only is it affordable, painless and relatively simple to perform with no recovery, but there is a high success rate.  Four million Canadians suffer from toe fungus infections and it is extremely unattractive and aesthetically displeasing.  Toe Fungus infections make wearing toe nail polish virtually impossible and look quite unattractive when nail polish is not camouflaging the unsightly discolouration.  If toe fungus is allowed to progress too long, actual physical deformity of the toe occurs and this cannot be camouflaged at all.  In Canada, the summer season is short enough, with flip-flops, sandals and thongs, that ensuring attractive toes and well-manicured toenails is paramount.  Laser toe fungus treatment and laser toe fungus removal can help achieve that.

How long will my results last following my laser toe fungus treatment and laser toe fungus removal?

Toronto toe fungus patients who undergo PinPointe™ laser toe fungus removal can expect their results to be permanent.  It is important, however, that the underlying causality and etiology of the toe fungus – that is, having pedicures in unsanitary nail salons and wearing unhygienic, chronically moist footwear – must be reversed in order to ensure that your curative laser toe fungus procedure will be ultimately successful for the rest of your life.

Are there any maintenance treatments required following my Laser Toe Fungus PinPointe™ laser treatment?

Following the first two treatments, and once successful resolution of the toe fungus is achieved, there is no maintenance requirement.  However, if you get a recurrent infection or under-the nail-plate toe fungus, a whole new round of treatment will be required.  The only maintenance is nail hygiene, the use of ultraviolet light inserts into your shoes, is recommended ensuring that the environment of your shoe and under your sock is healthy and dry.

What are the side effects and complications of Laser Toe Fungus removal?

One of the most appealing things about the PinPointe™ laser toe fungus removal procedure is its extreme safety as well as efficacy.  With its gated release of energy, with pulse sequencing and rest periods between each laser burst, excessive heating of the nail matrix does not occur and the risk of a nail plate burn, pain or complication is almost zero.  There are virtually no side effects and the post-treatment care is relatively simple.

How much does a PinPointe™ Laser Toe Fungus removal treatment cost?

The cost for laser toe fungus removal treatment is $750.00 for all affected toes. The treatment itself includes the second visit in six weeks to treat the affected toe or toes.  The $750.00 includes all affected toes with toe fungus, including the micro-debridement.

If your toe fungus includes onychogryphosis, which is a massive deformity of the nail plate with extremely large, talonesque, scaly deformities of the nail plates, this will not be subject to the aesthetic treatment covered by the $750.00.  In fact, these nails do not respond to the toe fungus lasers as readily and often surgical treatment, including nail plate excision and oral antifungals, will be required.

Chronic toe fungus leads to Onychogryphosis

Figure 10.  Chronic Toe Fungus can lead to Onychogryphosis

Why choose SpaMedica for my laser toe fungus treatment and laser toe fungus reduction?

Dr. Mulholland and SpaMedica have been pioneers and leaders in non-invasive aesthetic enhancement using lasers.  Dr. Mulholland has worked with Cynosure Lasers for seven years, the exclusive distributor and manufacturer of the PinPointe™ laser.  Dr. Mulholland has been at the forefront of non-invasive laser treatment of toe fungus.  When he trained in the 1980s, Dr. Mulholland performed many nail plate excisions.  Realizing that this was not the most aesthetically pleasing way to deal with toe fungus, his involvement in the non-invasive treatment of the toe fungus pathology now allows Dr. Mulholland to offer his patients now a non-surgical option, with a high degree of success, without the risks, expense and prolonged use of oral antifungals. The SpaMedica Medical aesthetician team are experts in nail plate debridement and application of the PinPointe™ laser toe fungus laser.  You will be visiting one of the most experienced laser centres in Canada.

How can I show Dr. Mulholland my concerns and see if I am a candidate?

Toronto laser toe fungus removal patients should simply fill out the appointment request form or “ask a question” form and upload up to 3 photos for Dr. Mulholland to review.

How do I schedule a consultation for my Laser Toe fungus treatment removal?

Toronto toe fungus patients who want to undergo a consultation for PinPointe™ toe fungus laser treatment and laser toe fungus removal should simply call 1-877-712-8367 or fill out the e-mail consultation appointment request form. A SpaMedica client service representative will respond promptly to your call or to your e-mail and schedule your consultation at your convenience.  Schedule now to begin a beautiful, fungus-free, sandal, thong open-toed summer.


Cosmetic Surgery and Laser Skin Care Spa:
66 Avenue Road Suite 4
Toronto, Ontario M5R 3N8
Tel: 1-877-712-8367