Treatment Guide

Toenail Fungus & Laser Therapy

Why Class 4 lasers are the most effective solution for onychomycosis—and why cold lasers don't work for this application.

23M
Americans Affected
<50%
Pill Effectiveness
Class 4
Laser Solution

Understanding Toenail Fungus

Toenail fungus (onychomycosis) affects up to 10% of American adults. The condition causes thick, yellow, sometimes foul-smelling toenails. People spread it by shedding invisible spores when walking barefoot in locker rooms or across carpets.

The root problem: toenail fungus is extremely hard to kill. The fungi are so hardy that popular anti-fungal pills work less than 50% of the time—and carry risk of liver damage. Prescription lacquers painted on toenails are effective less than 10% of the time and require daily treatment for 48 weeks.

Current Treatment Options

Pharmaceuticals

Anti-fungal pills effective <50% of the time. Risk of liver damage. Pharma giants continue developing new products, but side effects remain a concern.

Lacquers & Ointments

Prescription lacquers effective <10% of the time. Requires daily application for 48 weeks. Getting solution under the nail is difficult.

Home Remedies

Tea tree oil, Listerine, Vicks VapoRub, Clorox. Known for anti-bacterial properties but no regulated efficacy data. Penetration under the nail is the issue.

Class 4 Laser

Heat-based treatment that passes through the nail to kill fungus underneath. Promotes healing of surrounding tissue. Best current option.

Why Class 4 Lasers Work

This is the opposite of most therapeutic laser applications. Instead of promoting natural healing with lower power levels, toenail fungus treatment uses a Class 4 laser to generate heat that kills the fungus under the nail.

Penetration

Light energy passes through the toenail to reach the fungus underneath—something topical treatments can't do.

Targeted Heat

Delivers just enough heat under the nail to kill fungus without being too painful. It's the heat that kills the fungus, not the wavelength.

Tissue Healing

The same laser that kills fungus also promotes healing of surrounding tissue through photobiomodulation.

Key Point: By using a pinpoint probe with a Class 4 system (10+ watts), you can focus energy through the toenail and kill fungus while simultaneously promoting healing. This is why Class 4 lasers are perfect for this application—they're dual-purpose systems.

Why Cold Lasers Don't Work

Although some low-power cold laser manufacturers claim their healing lasers can treat toenail fungus, the efficacy is very low. If you already own a cold laser, it's worth trying—but don't buy a cold laser for this application and don't expect great results.

Cold lasers (Class 3B and lower) don't generate enough heat to kill fungus. They're not the right tool for this job. Maybe there's some improvement if the cold laser boosts the immune system, but a cold system will never match the results of a hot system.

Typical Treatment Pricing

Average costs (Colorado market—other areas may vary). Includes 3 treatments + 1 follow-up appointment (~12 weeks after treatment).

$300–$400
One Toe
$600–$800
One Foot
$1,200
Both Feet

Most clinics bill packages based on number of toes. If you already have patients seeking safer alternatives for toenail fungus, the payback on a Class 4 therapy/toenail laser can be just a few months.

The Bottom Line

Treating toenail fungus is a hot laser process where the fungus is burned out from under the toenail. An 810nm–1040nm Class 4 laser is the optimal solution because:

  • The wavelength passes through the nail effectively
  • It heats the area under the nail sufficiently to kill fungus
  • It promotes healing after treatment
  • It's a dual-purpose system you can also use for standard therapy applications

Cold lasers (Class 3B and lower) don't generate enough heat and aren't effective for this application—regardless of manufacturer claims.

Ready to add toenail fungus treatment to your practice?

Class 4 lasers give you a dual-purpose system—toenail fungus treatment plus full therapeutic capability.