The Four-Step Nailcur process defined:

Step One - The Laser

Our special laser treats each infected nail independently and automatically. For mild to moderate fungal nails the laser is used for one cycle. For severe infections it is used for two cycles. Using two cycles for the mild to moderate fungus will accelerate and shorten the duration of treatment. The general rule of thumb is that it requires eight treatments for significant improvement to clear fungal nails. In older patients and where there has been nail trauma either by acute trauma or constant irritation like playing a sport where the nails rub the shoes, additional laser treatments may be necessary.  Prolonged treatment can also occur with patients who are swimmers or have sweaty feet, for which we also can provide treatment. Treatment for fungal nails usually occurs every other week but under certain circumstances can be provided weekly. The laser portion of the treatments take 20-25 minutes for a single pass and an additional 20 minutes for the second pass.

Step Two - Nail Cutting and Nail Bed Cleaning

Meticulous Nail Care {MNC} -

This technique starts after the second laser treatment. The thicker the nails the more they absorb the laser energy, and therefore we start this AFTER the second laser treatment. Meticulous nail care is where the portion of infected nail is physically removed by nail trimming with nail clippers and other specially designed tools and electric burrs. We also remove callus and debris from under the nail and within the nail bed. This special technique was developed to reduce the fungal load as much as possible. The less infection, fungus of the nail and nail bed we need to treat the better. With MNC we can take nails that resemble hooves and or severely deformed nails and transform them back to their normal appearance. Almost all nails (about 98%) can become normal with our protocol. MNC will be used periodically throughout the treatment, sometimes as often as each visit. Generally speaking, this is a bloodless procedure that is normally not painful but may sometimes be uncomfortable. Meticulous nail care is necessary and required to achieve the desired results.

Step Three - Daily Maintenance Kit and Topical Products

Use of the Nailcur Nighttime Foot Rejuvenation Kit {NFRK} –

This kit was developed to specifically be used with the Nailcur Laser Treatment. This kit is similar to brushing your teeth. By brushing one’s teeth regularly, daily you can eat and drink whatever you like and essentially you will not develop cavities. The kit consists of the large foot brush which needs to be soaped up and lathered before use in the shower. Depending on the severity of your athletics foot infection determines how many scrubs you need to perform at least once daily. See details on this aspect under the skin care section. The same protocol will apply to your nails. You will need to scrub nails daily with the separate small brush provided. If you go on vacation it is recommended to take just the small brush and bend your knee to use it as your foot scrubber as well.

After scrubbing, you must dry your feet thoroughly with a towel. Drying the bottom and top of the foot is not enough. You must also dry between each toe with the towel and each nail. After this, use of a hairdryer is necessary, again dry the top, bottom, and sides of each foot, then the area between each toe is blow dried. Use your index finger while drying to disperse the water and confirm the area is dry before moving on to the next toe web. Lastly, use your index finger and thumb to disperse and confirm each nail is dry.

Use the NFR Gel at bedtime or during the day if not able to use at night. The gel is applied to the feet moccasin style. Imagine a moccasin on your foot. Wherever the moccasin is touching the foot you apply the gel, meaning everywhere except the top of the foot and the ankle. You will apply to the entire bottom and sides of the foot, heel, between the toes, and on the toes and nails at bedtime followed with covering the foot with the provided bag and a sock. Cover overnight and remove in the morning. This will take place nightly until the dry scaly skin is gone. Typically, this will be from 1 to 3 weeks with 2 weeks as an average.

Once the skin is cleared, only apply the NFR Gel to the nails and skin around the nails nightly, covering with the provided small bags for the duration of the laser treatment and beyond if instructed to do so. Basically, use this gel until the nails appear normal.

Once the skin has been cleared of all fungus, use the maintenance medicated coconut gel once or twice weekly applied to the entire foot, but NOT the nails (see nail care above). Use of a sock is recommended. After the nails are completely cleared, apply the maintenance gel to the entire foot including the nails once or twice weekly thereon.

Additional topicals may be recommended to use at the same time or independently depending on the fungal nail condition and patient compliance issues.

These other nail products are Renewed Nail Sealant and Tolcylen.

Nail polish should NOT be used during the active treatment. If necessary, polish nails for a day or two and remove as soon as possible.

Step Four - Nail Growth Vitamins and Anti-fungal and Anti-mold Medications

One of the key factors to quickly treating your nail fungus condition is to grow out the nails as fast as possible. During your active treatment and until your nails are completely fungal free you should take one nail vitamin daily until the first bottle in finished. Using a second bottle may be necessary.  The special low dose meds that will be dispensed should be taken as directed. If the nails are not completely free of fungus after the initial laser treatment you may be asked to take a repeated dose of these medications. The dose is approximately ¼ the normal dose and therefor NO blood tests are required, and alcohol may be consumed. If you have a history of kidney or liver disease, please let the office know as a consultation with your primary physician may be required to determine if these meds are appropriate. It is recommended to take these medications as it will cut down the time for complete clearing. If you decide to not take the medicines additional laser treatments may be required.

A no charge follow up visit will be provided to check your nails at the appropriate time, usually 1-3 months after laser treatment is complete. If further treatment is recommended this treatment would be at an additional charge.

If you should have any questions, please ask during your treatments. We are here to make your nails as perfect as possible, and this requires your participation to accomplish.

Thank you,

 Dr. Roth