{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T10:19:22Z","timestamp":1784110762760,"version":"3.55.0"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,1,19]],"date-time":"2024-01-19T00:00:00Z","timestamp":1705622400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,1,19]],"date-time":"2024-01-19T00:00:00Z","timestamp":1705622400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Lasers Med Sci"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>The purpose of this review is to consolidate and summarize laser-assisted drug delivery (LADD) for nail diseases, particularly onychomycosis and psoriasis. A PubMed search was conducted in June 2023 using search terms (1) \u201claser assisted drug delivery\u201d AND \u201cnail,\u201d (2) \u201claser\u201d AND \u201cnail,\u201d and (3) \u201cnail disorder\u201d AND \u201claser treatment.\u201d References of papers were also reviewed, yielding 15 papers for this review. Fractional ablative CO<jats:sub>2<\/jats:sub> laser (FACL) and Er:YAG laser can be used for LADD of topical medications such as amorolfine, terbinafine, and tioconazole to treat onychomycosis. A fungal culture should be performed to determine the type of dermatophyte, which will help determine which topical will be most effective. Laser settings varied between studies, but overall LADD tended to be more effective than topical treatments alone. Laser-assisted photodynamic therapy (PDT) was also found to be effective in treating onychomycosis. For psoriatic nails, LADD was used to deliver calcipotriol-betamethasone dipropionate foam, tazarotene, triamcinolone, or methotrexate into the nail. Again, LADD was found to be significantly more effective than topical treatment alone. FACL was the only laser noted for use for LADD in both diseases. Laser-assisted drug delivery for nail disease is a newer approach for onychomycosis and nail psoriasis with several benefits and drawbacks. Dermatologists should discuss the option of LADD with their patients who have recalcitrant onychomycosis or nail psoriasis.<\/jats:p>","DOI":"10.1007\/s10103-024-03992-6","type":"journal-article","created":{"date-parts":[[2024,1,19]],"date-time":"2024-01-19T05:02:19Z","timestamp":1705640539000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["A focused review on laser- and energy-assisted drug delivery for nail disorders"],"prefix":"10.1007","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5189-6677","authenticated-orcid":false,"given":"Hailey","family":"Konisky","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raquel","family":"Klinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lesley","family":"Coe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose A.","family":"Jaller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel L.","family":"Cohen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kseniya","family":"Kobets","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,1,19]]},"reference":[{"issue":"4","key":"3992_CR1","doi-asserted-by":"publisher","first-page":"192","DOI":"10.12788\/j.sder.2017.046","volume":"36","author":"E Wenande","year":"2017","unstructured":"Wenande E, Erlendsson AM, Haedersdal M (2017) Opportunities for laser-assisted drug delivery in the treatment of cutaneous disorders. Semin Cutan Med Surg 36(4):192\u2013201. https:\/\/doi.org\/10.12788\/j.sder.2017.046","journal-title":"Semin Cutan Med Surg"},{"issue":"1","key":"3992_CR2","doi-asserted-by":"publisher","first-page":"694","DOI":"10.1080\/07853890.2022.2044511","volume":"54","author":"DK Lee","year":"2022","unstructured":"Lee DK, Lipner SR (2022) Optimal diagnosis and management of common nail disorders. Ann Med 54(1):694\u2013712. https:\/\/doi.org\/10.1080\/07853890.2022.2044511","journal-title":"Ann Med"},{"key":"3992_CR3","unstructured":"Bodman MA, Krishnamurthy K (2023) Onychomycosis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK441853\/"},{"issue":"3","key":"3992_CR4","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1111\/j.1468-3083.2011.04373.x","volume":"27","author":"BE Elewski","year":"2013","unstructured":"Elewski BE, Ghannoum MA, Mayser P, Gupta AK, Korting HC, Shouey RJ, Baker DR, Rich PA, Ling M, Hugot S, Damaj B, Nyirady J, Thangavelu K, Notter M, Parneix-Spake A, Sigurgeirsson B (2013) Efficacy, safety and tolerability of topical terbinafine nail solution in patients with mild-to-moderate toenail onychomycosis: results from three randomized studies using double-blind vehicle-controlled and open-label active-controlled designs. J Eur Acad Dermatol Venereol 27(3):287\u2013294. https:\/\/doi.org\/10.1111\/j.1468-3083.2011.04373.x","journal-title":"J Eur Acad Dermatol Venereol"},{"issue":"12","key":"3992_CR5","doi-asserted-by":"publisher","first-page":"2111","DOI":"10.3390\/s16122111","volume":"16","author":"MT Tsai","year":"2016","unstructured":"Tsai MT, Tsai TY, Shen SC, Ng CY, Lee YJ, Lee JD, Yang CH (2016) Evaluation of laser-assisted trans-nail drug delivery with optical coherence tomography. Sensors (Basel, Switzerland) 16(12):2111. https:\/\/doi.org\/10.3390\/s16122111","journal-title":"Sensors (Basel, Switzerland)"},{"issue":"48","key":"3992_CR6","doi-asserted-by":"publisher","first-page":"e17948","DOI":"10.1097\/MD.0000000000017948","volume":"98","author":"W Ma","year":"2019","unstructured":"Ma W, Si C, Kasyanju Carrero LM, Liu HF, Yin XF, Liu J, Xu Y, Zhou B (2019) Laser treatment for onychomycosis: a systematic review and meta-analysis. Medicine 98(48):e17948. https:\/\/doi.org\/10.1097\/MD.0000000000017948","journal-title":"Medicine"},{"issue":"1","key":"3992_CR7","doi-asserted-by":"publisher","first-page":"47","DOI":"10.25259\/IJDVL_98_2021","volume":"89","author":"E Ranjan","year":"2023","unstructured":"Ranjan E, Arora S, Sharma N (2023) Fractional CO2 laser with topical 1% terbinafine cream versus oral itraconazole in the management of onychomycosis: a randomized controlled trial. Indian J Dermatol Venereol Leprol 89(1):47\u201353. https:\/\/doi.org\/10.25259\/IJDVL_98_2021 dermato-venereologica, 98(4), 467\u2013468. 10.2340\/00015555-2874","journal-title":"Indian J Dermatol Venereol Leprol"},{"issue":"6","key":"3992_CR8","doi-asserted-by":"publisher","first-page":"575","DOI":"10.1007\/s40261-020-00914-6","volume":"40","author":"B Rajbanshi","year":"2020","unstructured":"Rajbanshi B, Shen L, Jiang M, Gao Q, Huang X, Ma J, Wang J, Hu Y, Lv H, Wu X, Zhao J (2020) Comparative study of traditional ablative CO2 laser-assisted topical antifungal with only topical antifungal for treating onychomycosis: a multicenter study. Clin Drug Investig 40(6):575\u2013582. https:\/\/doi.org\/10.1007\/s40261-020-00914-6","journal-title":"Clin Drug Investig"},{"issue":"1","key":"3992_CR9","doi-asserted-by":"publisher","first-page":"e13155","DOI":"10.1111\/dth.13155","volume":"33","author":"AM Zaki","year":"2020","unstructured":"Zaki AM, Abdo HM, Ebadah MA, Ibrahim SM (2020) Fractional CO2 laser plus topical antifungal versus fractional CO2 laser versus topical antifungal in the treatment of onychomycosis. Dermatol Ther 33(1):e13155. https:\/\/doi.org\/10.1111\/dth.13155","journal-title":"Dermatol Ther"},{"issue":"4","key":"3992_CR10","doi-asserted-by":"publisher","first-page":"467","DOI":"10.2340\/00015555-2874","volume":"98","author":"A Koren","year":"2018","unstructured":"Koren A, Salameh F, Sprecher E, Artzi O (2018) Laser-assisted photodynamic therapy or laser-assisted amorolfine lacquer delivery for treatment of toenail onychomycosis: an open-label comparative study. Acta dermato-venereologica 98(4):467\u2013468. https:\/\/doi.org\/10.2340\/00015555-2874","journal-title":"Acta dermato-venereologica"},{"key":"3992_CR11","doi-asserted-by":"publisher","first-page":"103149","DOI":"10.1016\/j.pdpdt.2022.103149","volume":"40","author":"N Sobhy","year":"2022","unstructured":"Sobhy N, Talla Eweed H, Omar SS (2022) Fractional CO2 laser - assisted methylene blue photodynamic therapy is a potential alternative therapy for onychomycosis in the era of antifungal resistance. Photodiagnosis Photodyn Ther 40:103149. https:\/\/doi.org\/10.1016\/j.pdpdt.2022.103149","journal-title":"Photodiagnosis Photodyn Ther"},{"issue":"1","key":"3992_CR12","doi-asserted-by":"publisher","first-page":"542","DOI":"10.1080\/09546634.2020.1771252","volume":"33","author":"M Abdallah","year":"2022","unstructured":"Abdallah M, Abu-Ghali MM, El-Sayed MT, Soltan MY (2022) Fractional CO2-assisted photodynamic therapy improves the clinical outcome and patient\u2019s satisfaction in toenail onychomycosis treatment: an intra-patient comparative single-center study. J Dermatolog Treat 33(1):542\u2013549. https:\/\/doi.org\/10.1080\/09546634.2020.1771252","journal-title":"J Dermatolog Treat"},{"issue":"5","key":"3992_CR13","doi-asserted-by":"publisher","first-page":"918","DOI":"10.1016\/j.jaad.2014.01.893","volume":"70","author":"EH Lim","year":"2014","unstructured":"Lim EH, Kim HR, Park YO, Lee Y, Seo YJ, Kim CD, Lee JH, Im M (2014) Toenail onychomycosis treated with a fractional carbon-dioxide laser and topical antifungal cream. J Am Acad Dermatol 70(5):918\u2013923. https:\/\/doi.org\/10.1016\/j.jaad.2014.01.893","journal-title":"J Am Acad Dermatol"},{"issue":"5","key":"3992_CR14","doi-asserted-by":"publisher","first-page":"916","DOI":"10.1016\/j.jaad.2015.12.002","volume":"74","author":"AK Bhatta","year":"2016","unstructured":"Bhatta AK, Keyal U, Huang X, Zhao JJ (2016) Fractional carbon-dioxide (CO2) laser-assisted topical therapy for the treatment of onychomycosis. J Am Acad Dermatol 74(5):916\u2013923. https:\/\/doi.org\/10.1016\/j.jaad.2015.12.002","journal-title":"J Am Acad Dermatol"},{"issue":"6","key":"3992_CR15","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1080\/14764172.2017.1334925","volume":"19","author":"J Shi","year":"2017","unstructured":"Shi J, Li J, Huang H, Permatasari F, Liu J, Xu Y, Wu D, Zhou BR, Luo D (2017) The efficacy of fractional carbon dioxide (CO2) laser combined with terbinafine hydrochloride 1% cream for the treatment of onychomycosis. J Cosmet Laser Ther: official public Eur Soc Laser Dermatol 19(6):353\u2013359. https:\/\/doi.org\/10.1080\/14764172.2017.1334925","journal-title":"J Cosmet Laser Ther: official public Eur Soc Laser Dermatol"},{"issue":"3","key":"3992_CR16","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1080\/09546634.2018.1509046","volume":"30","author":"EB Abd El-Aal","year":"2019","unstructured":"Abd El-Aal EB, Abdo HM, Ibrahim SM, Eldestawy MT (2019) Fractional carbon dioxide laser assisted delivery of topical tazarotene versus topical tioconazole in the treatment of onychomycosis. J Dermatolog Treat 30(3):277\u2013282. https:\/\/doi.org\/10.1080\/09546634.2018.1509046","journal-title":"J Dermatolog Treat"},{"issue":"2","key":"3992_CR17","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1002\/(sici)1096-9101(1997)21:2<186::aid-lsm10>3.0.co;2-d","volume":"21","author":"J Neev","year":"1997","unstructured":"Neev J, Nelson JS, Critelli M, McCullough JL, Cheung E, Carrasco WA, Rubenchik AM, Da Silva LB, Perry MD, Stuart BC (1997) Ablation of human nail by pulsed lasers. Lasers Surg Med 21(2):186\u2013192. https:\/\/doi.org\/10.1002\/(sici)1096-9101(1997)21:2<186::aid-lsm10>3.0.co;2-d","journal-title":"Lasers Surg Med"},{"issue":"7","key":"3992_CR18","doi-asserted-by":"publisher","first-page":"1391","DOI":"10.1007\/s10103-016-1990-z17","volume":"31","author":"J Zhang","year":"2016","unstructured":"Zhang J, Lu S, Huang H, Li X, Cai W, Ma J, Xi L (2016) Combination therapy for onychomycosis using a fractional 2940-nm Er:YAG laser and 5 % amorolfine lacquer. Lasers Med Sci 31(7):1391\u20131396. https:\/\/doi.org\/10.1007\/s10103-016-1990-z17","journal-title":"Lasers Med Sci"},{"issue":"1","key":"3992_CR19","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1007\/s10103-020-03054-7","volume":"36","author":"J Zhang","year":"2021","unstructured":"Zhang J, Zhang Y, Qin J, Lu S, Cai W, Li J, Huang H, Yang S, Xi L (2021) Comparison of a fractional 2940-nm Er:YAG laser and 5% amorolfine lacquer combination therapy versus a 5% amorolfine lacquer monotherapy for the treatment of onychomycosis: a randomized controlled trial. Lasers Med Sci 36(1):147\u2013152. https:\/\/doi.org\/10.1007\/s10103-020-03054-7","journal-title":"Lasers Med Sci"},{"issue":"3","key":"3992_CR20","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1080\/14764172.2018.1502451","volume":"21","author":"K Bonhert","year":"2019","unstructured":"Bonhert K, Dorizas A, Sadick NS (2019) Efficacy of combination therapy with efinaconazole 10% solution and 1064 nm Nd:YAG laser for treatment of toenail onychomycosis. J Cosmet Laser Ther: official public Eur Soc Laser Dermatol 21(3):179\u2013183. https:\/\/doi.org\/10.1080\/14764172.2018.1502451","journal-title":"J Cosmet Laser Ther: official public Eur Soc Laser Dermatol"},{"issue":"1","key":"3992_CR21","doi-asserted-by":"publisher","first-page":"5329","DOI":"10.1038\/s41598-023-32440-8","volume":"13","author":"L Folle","year":"2023","unstructured":"Folle L, Fenzl P, Fagni F, Thies M, Christlein V, Meder C, Simon D, Minopoulou I, Sticherling M, Schett G, Maier A, Kleyer A (2023) DeepNAPSI multi-reader nail psoriasis prediction using deep learning. Sci Rep 13(1):5329. https:\/\/doi.org\/10.1038\/s41598-023-32440-8","journal-title":"Sci Rep"},{"issue":"5","key":"3992_CR22","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1016\/j.ad.2022.01.006","volume":"113","author":"E Canal-Garc\u00eda","year":"2022","unstructured":"Canal-Garc\u00eda E, Bosch-Amate X, Belinch\u00f3n I, Puig L (2022) Nail psoriasis. Psoriasis ungueal. Actas Dermosifiliogr 113(5):481\u2013490. https:\/\/doi.org\/10.1016\/j.ad.2022.01.006","journal-title":"Actas Dermosifiliogr"},{"issue":"12","key":"3992_CR23","doi-asserted-by":"publisher","first-page":"e15965","DOI":"10.1111\/dth.15965","volume":"35","author":"VK Ortner","year":"2022","unstructured":"Ortner VK, Mandel VD, Skak K, Zibert JR, Bourlioux M, Nissen CV, Fuchs CSK, Philipsen PA, Haedersdal M (2022) Investigating the efficacy and safety of calcipotriol\/betamethasone dipropionate foam and laser microporation for psoriatic nail disease-a hybrid trial using a smartphone application, optical coherence tomography, and patient-reported outcome measures. Dermatol Ther 35(12):e15965. https:\/\/doi.org\/10.1111\/dth.15965","journal-title":"Dermatol Ther"},{"issue":"5","key":"3992_CR24","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1097\/DSS.0000000000003418","volume":"48","author":"R Alakad","year":"2022","unstructured":"Alakad R, Nassar A, Atef H, Eldeeb F (2022) Fractional CO2 laser-assisted delivery versus intralesional injection of methotrexate in psoriatic nails. Dermatol Surg: official public Am Soc Dermatol Surg 48(5):539\u2013544. https:\/\/doi.org\/10.1097\/DSS.0000000000003418","journal-title":"Dermatol Surg: official public Am Soc Dermatol Surg"},{"issue":"6","key":"3992_CR25","doi-asserted-by":"publisher","first-page":"788","DOI":"10.1111\/ddg.14731","volume":"20","author":"A Nassar","year":"2022","unstructured":"Nassar A, Atef H, Eldeeb F, Alakad R (2022) Comparison of fractional laser-assisted drug delivery and intralesional injection of triamcinolone acetonide in nail psoriasis. Journal der Deutschen Dermatologischen Gesellschaft =. J German Soc Dermatol: JDDG 20(6):788\u2013796. https:\/\/doi.org\/10.1111\/ddg.14731","journal-title":"J German Soc Dermatol: JDDG"},{"issue":"7","key":"3992_CR26","doi-asserted-by":"publisher","first-page":"2808","DOI":"10.1111\/jocd.14536","volume":"21","author":"N Essa Abd Elazim","year":"2022","unstructured":"Essa Abd Elazim N, Mahmoud Abdelsalam A, Mohamed Awad S (2022) Efficacy of combined fractional carbon dioxide laser and topical tazarotene in nail psoriasis treatment: a randomized intrapatient left-to-right study. J Cosmet Dermatol 21(7):2808\u20132816. https:\/\/doi.org\/10.1111\/jocd.14536","journal-title":"J Cosmet Dermatol"},{"issue":"2","key":"3992_CR27","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1016\/j.jaad.2020.04.172","volume":"84","author":"Y Wang","year":"2021","unstructured":"Wang Y, Geizhals S, Lipner SR (2021) Retrospective analysis of laboratory abnormalities in patients prescribed terbinafine for onychomycosis. J Am Acad Dermatol 84(2):497\u2013499. https:\/\/doi.org\/10.1016\/j.jaad.2020.04.172","journal-title":"J Am Acad Dermatol"},{"issue":"8","key":"3992_CR28","doi-asserted-by":"publisher","first-page":"1513","DOI":"10.1007\/s10103-019-02802-8","volume":"34","author":"K Yeung","year":"2019","unstructured":"Yeung K, Ortner VK, Martinussen T, Paasch U, Haedersdal M (2019) Efficacy of laser treatment for onychomycotic nails: a systematic review and meta-analysis of prospective clinical trials. Lasers Med Sci 34(8):1513\u20131525. https:\/\/doi.org\/10.1007\/s10103-019-02802-8","journal-title":"Lasers Med Sci"}],"container-title":["Lasers in Medical Science"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10103-024-03992-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10103-024-03992-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10103-024-03992-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T15:42:49Z","timestamp":1738338169000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10103-024-03992-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,19]]},"references-count":28,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["3992"],"URL":"https:\/\/doi.org\/10.1007\/s10103-024-03992-6","relation":{},"ISSN":["1435-604X"],"issn-type":[{"value":"1435-604X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,19]]},"assertion":[{"value":"22 September 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 January 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 January 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"N\/A.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"39"}}