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Clinical Solutions in Practice

Laser Offers Improved Results For Onychomycosis

Danielle Chicano, Editorial Associate
July 2013

Are you looking for a fast, effective and drug-free way to increase clear nails in patients with onychomycosis?

   Then you may want to consider GenesisPlus, the only podiatric laser with FDA clearance for large 5 mm spot size treatments, according to the manufacturer Cutera. The company adds that the laser’s 5 mm spot size allows for a greater depth of penetration and uniform coverage, and that real-time temperature monitoring and self-calibration provide safety for patients and podiatrists.

   The company says GenesisPlus is faster, more efficient and safer than similar products available to podiatrists. Cutera notes that GenesisPlus is 25 times faster than 1 mm spot size lasers.

   Jodi Schoenhaus, DPM, FACFAS, has been using GenesisPlus since 2010 and notes that she uses the laser to treat onychomycosis in more than half of her patients. GenesisPlus not only treats onychomycosis but podiatrists can also use the versatile laser to treat warts and scars, adds Dr. Schoenhaus, who is board-certified in foot surgery and reconstructive rearfoot and ankle surgery by the American Board of Podiatric Surgery.

   Similarly, Bruce Werber, DPM, FACFAS, uses GenesisPlus in about 80 percent of his patients with onychomycosis. Dr. Werber has also found GenesisPlus beneficial for treating spider veins and neuromas, reducing bacterial load in wounds and for musculoskeletal issues such as plantar fasciosis and Achilles tendinopathy.

   Dr. Schoenhaus notes many advantages to using GenesisPlus over other lasers available for podiatric use.

   “There is real-time calibration with every pulse. That means you are getting the same energy delivered with every pulse,” explains Dr. Schoenhaus. “There are no disposables or materials that you have to purchase and discard after a use. The handpiece has a temperature sensor so you get feedback as to how much energy you are building up and what temperatures you are generating in a nail.”

   Not only is GenesisPlus a reliable product but Cutera’s customer service, training and online resources make their laser ideal and beneficial to one’s patients and practice, explains Dr. Werber, who is in private practice in Scottsdale, Ariz.

   Dr. Schoenhaus notes that laser therapy is her first line of treatment for mild or moderate onychomycosis, and when providing clinical improvement for severe involvement.

   “I use the laser treatment in conjunction with topical and sometimes oral treatments, and I put patients on a nail treatment program,” adds Dr. Schoenhaus, who is in private practice in Boca Raton, Fla.

   Dr. Werber also uses the laser in conjunction with oral treatments, noting that GenesisPlus has been very useful in his treatment armamentarium.

   “We occasionally (use GenesisPlus in combination with oral therapy), especially in the patients who have had fungal infections for over three years. We find that it improves our outcomes,” explains Dr. Werber, an Associate Professor at the Midwestern University School of Podiatric Medicine.

   With any laser treatment, both Dr. Schoenhaus and Dr. Werber say it is important to know your guidelines and ensure patients have realistic expectations.Having patients maintain treatment and understand the need for appropriate home care is required, explains Dr. Schoenhaus.

   “The only limitation (to GenesisPlus) is that you cannot clear and treat everything with the laser. Some pathology is too severe and the laser will not give you a mycological cure,” adds Dr. Schoenhaus. “It will, however, provide clinical improvement.”

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