FAQ (Frequently Asked Questions)

  1. Is this procedure Health Canada Approved and FDA cleared?

The Lunula LASER treatment is FDA cleared for Onychomycosis (fungal nails).  Health Canada has licensed this unit to temporarily increase the clarity of the nail in patients with a fungal nail infection.  It is important to note that no treatment can permanently cure fungal toenails including surgical removal of the toenail, oral and topical anti-fungals.  This is because reinfection is possible if you are immunologically prone to fungal infections or if your toenails come in contact with fungus in the future.  The importance of preventative measures cannot be overemphasized both during and after treatment.  This involves a program to reduce the fungal load in your footwear, socks and other places where fungus thrive such as your shower, etc. 

Our clinic is the first in the Niagara region to offer the Lunula LASER.  Laser treatment is not a stand-alone procedure and does requires the use of anti-fungal paint-on or oral anti-fungal medication.  Some other clinics advertise laser toenail treatments with units that are not approved by Health Canada.

  1. How does the Laser Toenail Treatment work?

The Lunula Laser® by Erchonia is a dual-diode low-level laser device that administers two therapeutic wavelengths: 405 nm (violet) and 635 nm (red) as a line-generated beam to maximize the treatment surface area. The device targets fungus that lives in and under the toenail without causing damage to it or the surrounding skin. This photochemical mechanism enables Lunula Laser to give a direct, non-contact treatment using photonic energy to modulate secondary cellular reactions without the patient feeling the device working.

The 405nm wavelength causes breakdown of the fungal cell wall/membrane which can cause fungal cell death and increased fungal susceptibility to the body’s immune attack.

The 635nm wavelength can stimulate the production of reactive oxygen species and nitric oxide in the body which promotes increased blood flow, increased nutrient delivery and infiltration of immunological cells which help destroy the fungus and increase clear nail growth.

Your toenail will not fall off as a result of this treatment.  You will not notice a clear nail immediately since it can take at least 3 months for your clear nail to begin to emerge and 6 to 12 months for the entire nail to grow out. 

  1. What is the process I go through to receive this treatment?

Call our office to schedule a consultation.  If you are a candidate for Lunula laser toenail treatment the foot specialist will review the treatment and answer any questions you may have.  On the day of treatment, we ask that you remove your toenail polish before your laser session.  We will discuss aftercare to prevent re-infection. We will then schedule your subsequent appointments spaced about a week apart.  Your comfort, safety and convenience are our priority.   You will be required to wear Laser-protective eye goggles/glasses for patient safety to prevent damage to your eyes. 

  1. How long does the Lunula laser toenail treatment take?

The laser toenail fungus treatment usually takes only 12 minutes per foot.  If you have fungal toenails on both feet, then 24 minutes. 

  1. How many Lunula Laser treatments are required and what is the timing between sessions?

Typically, we schedule 4 Lunula laser sessions spaced about a week apart for mild infections, then we allow the nail to grow for 1 month before evaluation.   

Possibly 2 additional sessions spaced about a week apart may be needed for mild to moderate infections. 

If the infection is severe, we allow the nails to grow an additional month followed by additional treatments if required. 

So somewhere between 4 to 6 or more sessions may be required depending on the severity of your infection and your individual response to Lunula Laser therapy. 

  1. Is the treatment painful and will I be able to walk after the Lunula Laser Nail Treatment?

The laser nail treatment does not harm living tissue. Patients can simply walk in, have the procedure done, and then walk right out and go back to their normal activities including work or sports as they usually would. Because this is a non-thermal Laser, you will not experience any pain or burning though some patients may feel a slight tingling sensation.  Your comfort and safety are our priority.

  1. Are there any after care instructions for the laser nail procedure?

Yes; it is important to know that a comprehensive plan to prevent reoccurrence is critical to long term success and each patient will leave the office with those preventive measures for home care.  We simultaneously treat the infection with topical or oral anti-fungal medication in addition to the Laser for optimal results. 

  1. Who should not have laser toenail treatment?

If you are pregnant or have active cancer or have been in remission for less than 6 months then you are not a candidate for this treatment.

The Lunula Laser treatments are safe if you have a pacemaker, are on blood thinners, have diabetes, peripheral neuropathy, peripheral arterial disease, or have been in cancer remission for greater than 6 months. 

  1. What is the cost for the Lunula Laser Treatment? Is it covered by my insurance?

OHIP does not cover the cost of this treatment.

Costs for this procedure are discussed during your consultation.  We offer one of the most competitively priced laser fungal toenail treatments in Ontario. 

This procedure may be covered by your Extended Health Insurance Plan. Patients with flexible spending accounts can often use these funds towards procedures such as the laser nail treatment.  We cannot directly bill your insurance for this treatment and payment is due on the day of your treatment.   

If we determine you are a candidate for Lunula Laser treatments, we can provide you with a pre-authorization letter for you to submit to your insurer to determine your level of coverage.  Alternately, you may wish to inquire about your coverage directly with your insurer prior to your consultation so you will be ready for treatment if appropriate.   

  1. If I know I want the laser toenail treatment, why do I need a consultation?

Not all yellow toenails are fungal infections.  Other conditions such as nail trauma and several dermatological conditions can mimic fungal infections and will not respond to this treatment.  It is important to have your yellow toenails assessed by our qualified Doctor of Podiatric Medicine to determine if this treatment is appropriate for your particular condition.  Also, if fungal and thickened, the nail will be trimmed and thinned out to aid the Laser beams’ penetration through the entire nail to optimize your chances of growing out a clear nail. This service, known as a “medical pedicure”, is performed using sterile instruments and a rotary filing device which may be performed at the time of your initial consultation and at your one month follow-up after your 4th treatment (at an additional cost).   

  1. When can I paint my nails after the toenail laser treatment?

Toenail polish can be re-applied 24 hours after the laser toenail treatment, however you will likely be using a topical anti-fungal medication which cannot penetrate through the coloured nail polish. It is important to note that all nail polish and decorations must be thoroughly removed with acetone prior to having the laser nail treatment. 

  1. How do I pay for the Lunula Laser nail fungus procedure?

We accept cash, debit, VISA and Mastercard. 

  1. Is this Laser procedure guaranteed to cure my yellow toenails?

Unfortunately due to the nature of medicine, the Canadian Foot Clinic & Orthotic Centre cannot guarantee a cure for your fungal toenails.  It is important to note that no treatment can permanently cure fungal toenails including surgical removal of the toenail, oral and topical anti-fungal medications.  This is because reinfection is possible if you are immunologically prone to fungal infections or if your toenails come in contact with fungus in the future.  Fungus is everywhere in our environment and the risk of re-infection is ever present.  In order to control fungus, you must practice daily foot hygiene.

Based on several studies, the reported improvement rate is about 67% after 3 months and 89% after 6 months in producing clear nail growth.  Thus, there is a chance it may not work due to factors such as severity, length of infection, re-infection, etc. However, it is often effective for many patients. 

  1. What are the advantages of Lunula Laser treatments for the treatment of fungal toenails?
  • No chance of developing microbial resistance to this form of treatment
  • Does not interfere nor interact with any systemic medicine
  • No chance for liver toxicity
  • Treatment protocol is painless, ensuring good patient compliance
  • The Lunula laser treats the entire nail complex: nail plate, nail bed and germinal/matrix complex. The Lunula leaves no area untreated
  • It increases the vascular supply to the toe. With repeated treatments such as once a week for four weeks the results remain for the long-term and an increase in vascularity promotes more rapid nail growth and growth of healthier nail tissue
  • FDA cleared for fungal nails/Onychomycosis & approved for use by Health Canada to increase the clarity of nails in patients with fungal nail infections

 

  1. What are the risks of Lunula Laser treatment?

When utilizing true cold laser therapy, such as the Lunula device, there is virtually no risk, either to the patient or the treating foot specialist. Although rare, some of the possible risks include: redness, tingling, warmth and swelling.  These are generally short lived and mild in nature.  There is no down time after the treatment.