Frequently Asked Questions (FAQ)

Is the Lunula Laser treatment covered by insurance?

Laser nail management is a non-insurance covered medical service. To help as many patients as possible to receive this service, we strive to keep our fees as reasonable and affordable as possible. Once you compare alternative costs, we are confident that you will find our fees to be fair and reasonable. In fact, the cost of treatment is often less than half the cost of alternative pin-point laser treatment, and about that of one bottle of the prescription topical Jublia or Kerydin, which has less than 18% effectiveness.

How many treatment sessions are necessary?

The initial Lunula Laser treatment is four sessions at one week intervals. Assessment for additional treatment sessions will be made after 3-4 months, with ongoing evaluations thereafter.

The Lunula Laser is in the regenerative class of lasers; this class is thought to boost and augment your own immune system to attack and kill the fungus. The Lunula Laser also improves blood flow to the nail bed and is thought to help your body grow and regenerate a more clear and healthy nail. This process takes time. You may see improvement beginning to occur at the base of your nail after 3-4 months. Toenails grow slowly, however, and it will take 12-18 months maximum for clear nails to develop. Please be patient.

Is the treatment painful?

The Lunula Laser (www.lunula.com) is the newest, safest, and most effective clear nail management available for onychomycosis. This is the first and only non-thermal (non-heat producing) laser to receive FDA clearance for the clear nail management of onychomycosis. Because this is a non-thermal laser, the treatment is completely painless.

What are the risks of treatment?

The Lunula Laser has no reported serious or adverse incidents (skin discomfort or irritation is possible but not likely).

Is this a guaranteed cure?

This problem is managed, not cured. The goal is to end up with clearer, more normal appearing nails.

The fungus is very resistant to treatment. This organism is able to block your immune-mediated white blood cells from attacking and killing it. It invades deep into the bed and root of the nail which causes damage to these structures.

Some individuals are less immune, or more sensitive, to the organism invading and infecting their nails, making them more prone to developing this condition. Further factors which influence this are: various underlying medical conditions; chronic pressure on the nail from shoes; injury to the nail; certain medications such as chemotherapy; and moist/dark environmental conditions, such as the high humidity in Florida combined with your foot in a shoe all day.

Fungal infected nails are extremely difficult to cure. The Lunular Laser treatment is provided as an integral part of a comprehensive management program to increase clear nail production. Clinical studies and reports have demonstrated an improvement rate greater than 80%; but all patients are different, and no guarantees can be provided. Maximum improvement could take as long as 18 months.

Can this come back?

Treatment of onychomycosis is challenging. Recurrence (re-infection) rates are high. Treatment does not necessarily cure the fungal nail infection, but effective clear nail management is possible.

You likely developed the fungal nail infection because your body’s local immune system was unable to fight off the environmentally acquired fungus. Further complicating factors include a number of medical conditions, such as diabetes and psoriasis. Trauma (injury) to the nail can also expose you to the fungus. This injury could be a very definite impact-type injury or could be repetitive, mild impact from shoes or certain activities.

The point to remember is that you are prone to this problem: either by nature or by lifestyle. So, you are also prone to reinfection. The Lunula Laser is believed to activate your local immune system to attack the fungus, while improving blood flow to help your body grow and regenerate a clearer nail. Comprehensive management recommendations should become a regular part of your lifestyle to maximize your clinical response and minimize reinfection.

Periodic repeat Lunula Laser sessions may be necessary to help maintain your clearer nails. These are painless and are always provided at a discounted rate.

How did I get this?

This fungus is a micro-organism which is present widely throughout the environment including: shoes; clothing; carpets & floors.

Is this contagious?

Everyone is exposed to the fungus, although some individuals are more susceptible. For this reason, precautions should be used to sanitize floors and clothing. It is recommended that family members and significant others also be treated if infected.

How can I prevent this from coming back?

A very important part of your comprehensive management is managing re-infection and minimizing repeat exposure to the fungus. Our recommendations are as follows:

• Family members and those close to you should be treated if also infected.
• The skin of your foot is likely to also be infected by the fungus. We will give you a prescription for an antifungal skin cream which should be used daily.
• You should obtain chlorhexidine soap, and wash your feet with this while bathing. This is a very powerful anti-microbial soap which can be purchased from Amazon or most pharmacies.
• You should keep your feet as dry as possible. Fungus thrives in moist, dark environments. Using moisture wicking socks instead of cotton will help.
• If you frequent nail salons, choose wisely. The fungus is contagious. If you are selecting a nail polish color at the salon, you are likely to also be “selecting a fungus”. Consider bringing your own nail polish.
• The fungus is in your local environment including floors, carpet, bathtubs, showers, socks and shoes. These items should be regularly disinfected, sanitized or discarded if necessary.
• Although topical antifungal medication is minimally effective as a primary treatment, they are useful as a part of comprehensive management and prevention. There are many options, and some “natural” products have been reported to be as effective as or more effective than prescription medications. Some to consider are: honey bee propolis, tea tree oil, and Vick’s vapor rub. You should research these online.
• There are a number of vitamin supplements which have been reported to improve the health of your nail. One commonly recommended supplement is biotin. You should purchase a high quality product from a trusted supplier.

Remember that you likely developed the fungal nail infection because your body’s local immune system was unable to fight off the environmentally acquired fungus. If there are lifestyle- or environmental-impacting factors in play, it is always helpful to modify or eliminate these.

Are there other antifungal treatment/management options?

The available antifungal management options are:

1. Oral antifungal medication is available, but in my opinion is not a medically or ethically reasonable option due to the multiple potential side effects of the medication including liver failure and death. This is no longer an option which I have utilized in my practice for the last several years.

2. Surgical removal of the nail can be done. This is usually reserved for extreme cases.

3. There are numerous topical medications, both prescription and “natural”. The effectiveness of topical medications is reported to be 5% to 18%. The prescription medications are seldom covered by insurance and are quite expensive (both Jublia and Kerydin cost $500 to $800 per small bottle). In my opinion, these are best used for long term maintenance and prevention of recurrence. Some of the natural options seem to be as effective as the prescription medications, at a much more reasonable cost.

4. The “pin-point” laser has been used for a number of years. This is a heat generating laser which attempts to kill the nail fungus. This procedure tends to be relatively expensive ($1500 to $2000) and uncomfortable. It is also potentially risky for patients with certain medical conditions. The heat generated will cause a laser plume, which is a sort of vapor that is potentially toxic.

5. The newest, safest, and most effective management for increase in clear nail is the Lunula Laser (www.lunula.com). This is the first and only non-thermal (non-heat producing) laser to receive FDA clearance for the clear nail improvement of onychomycosis. Because this is a non-thermal laser, the treatment is completely painless.