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Cool Touch Laser Treatment for Fungal Nails

About the Cool Touch Laser Treatment for Fungal Nails

Onychomycosis is a common infection of the nail, and it may affect approximately 6.5% to 8.7% of the North American population. Visual description includes: yellowed, discolored, thickened and flakey nail / nail debris. The fungus causes a breakdown of the keratin within your nail plate. The byproduct is termed subungal debris which harbors both keratin and fungal elements. The same fungus that is responsible for toenail fungus is also responsible for athletes feet aka tinea pedis. An infected nail can act as a breeding ground for recurrent athlete’s feet and mold.

  • Are you embarrassed to show off your nails in sandals?
  • Are you not a candidate or do not want to take the oral medications?
  • Do you want the latest technology without the complications?
  • Do you want the most cost effective and efficient laser treatment?
  • The cool touch nail laser treatment treatment is here for you!

The Family Foot & Leg Center is now proud to present the custom , gentle cool touch laser treatment for your fungal nails in addition to Keryflex total nail resurfacing technology.

Why the cool touch laser treatment vs others? The cool touch uses a 1320 nm beam, a much safer and cooler beam than the 1064 nm of the competition. For additional safety and comfort, a cryogen spray is used when the nail is heated to the optimal treating temperature. A large 10mm beam diameter, controlled depth provides a reproducible safe procedure while treating the offending pathogen. More in the FAQ.

The laser treatment is not new to the medical profession, but the use in treating fungal nails has picked up steam recently as additional research is being done. laser treatments have been used for vein removal, wart distruction, removal of fine lines / wrinkles, hair, acne and tatoo removal. We at the Family Foot and Leg Center (FFLC) have done our research into various laser treatment modalities currently on the market and has found the 1320 nm laser treatment by cool touch to be the most effective and gentle on the nail bed but tough on fungal cells. We also have a 1064 nm laser treatment (similar to the competition) but we reserve such for spider veins and less sensitive areas.

The studies for this cool touch laser treatment has been impressive, please see the data page for the summary of findings and articles.


Below is an Article Written by Dr. Mark Katz
Monday, March 22, 2010
CoolTouch Laser Treatment Zaps Toenail Fungus

Do you have discolored thick toenails? Do you want to avoid strong medications that can cause liver damage? Are you tired of liquids and creams that are time consuming to apply with poor results?

Finally you can get rid of your discolored, cracked fungal toenails or onychomycosis with the latest laser treatment advances. While laser treatments may seem scary to some, they are used daily for cosmetic procedures using safe laser energy.

While there are several laser treatment technologies available, Dr. Marc Katz, a Tampa podiatrist, has done his homework. Before jumping into various technologies, he wanted to research each treatment and find the best, most effective solution for his patients, not the most popular and best marketed treatment.

He said no to the Pinpointe laser treatment immediately for several reasons. The Pinpointe is essentially a laser treatment designed for dental procedures with modifications to capture a new market, toenails. So the design and treatment is less than optimal. The Pinpointe has a small spot size that can produce a problem known as stacking. Stacking comes from overlapping of the laser treatment beam in the same area possibly leading to burns and damage. Small spot size can also lead to missed areas of treatment. Dr. Katz also did not like the fact that the laser treatment treatment is performed with no control of the beam distance or desired temperature for fungal death and this leads to inconsistent treatments with poorly controlled outcomes. Additionally, the beam was not accompanied by cooling to avoid surrounding tissue damage. The current single treatment with Pinpointe has also become controversial. There is increasing evidence that to be effective, two or even three treatments are necessary and best for the patient. The single treatment protocol resulted from the fact that the doctor was charged each time the laser treatment was turned on, hardly in the best interest of the patient.

Initially, a comparison was made between the Noveon and Pinpointe laser treatments. With more research,different promising options became clear that combined superior treatment and safety features. While the Noveon was promising, it failed its initial FDA approval for onychomycosis and ran into financial problems. Additionally, some of the lower wavelengths had questionable results and the safety features with the Noveon added additional costs to the procedure. As of this writing, the Noveon is not available but may be in the future. It should also be noted that the laser treatment also was initially developed for dental procedures. All of the laser treatments mentioned here have been FDA cleared for podiatry, dermatology and general surgery use. So they are appropriate for toenail treatments if proven worthy by your doctor.

As research proceeded, Dr. Katz liked the Cooltouch CT3 Plus Zoom laser treatment, one of the most proven laser treatments on the market today with a track record. The Cooltouch allows for various types of skin treatments for many issues. Dr. Katz points out that toenails are simply modified skin, so the Cooltouch laser treatment makes sense. He also liked the higher wavelength of the beam and feels that the hard thick nail can be more safely penetrated and treated with this different wavelength. In addition there are added features that improve the appearance of the nail by resurfacing, similar to skin resurfacing and rejuvenation. This is only a Cooltouch feature.

The CoolTouch CT3Plus CoolBreeze produces 1320nm laser treatment energy that is specifically absorbed by water and water associated with collagen in the tissues of the nail matrix. The laser treatment is so sophisticated that it can detect and reach the proper target temperature set by the doctor leading to death of the fungus. The treatment then stops immediately and then the nail is cooled with a spray. This allows for fungal death without damaging the skin or the nail growth plate. Cooltouch’s impeccable safety emanates from its incorporating pulsed cooling and real-time temperature feedback into its treatments. In addition, the CoolBreeze Handpiece features an adjustable spot size from 3 mm to 10 mm allowing for adjustments based on nail size for most effectiveness. Other laser treatments currently being used do not incorporate these advanced features for patients leading to less desirable outcomes and minimal safety features. The Cooltouch laser treatment can be completely controlled. The treatment temperature to kill the fungus can occur automatically while incorporating safety. Each patient can receive a customized treatment leading to the best possible outcome. This is truly unique.

There are different growth phases of the nail and fungus and the best results occur when the patient receives at least 2 treatments. The cost of 2 treatments with the Cooltouch is usually the same or less compared to only one treatment with the Pinpointe laser treatment. This certainly benefits the patient.

Dr. Katz feels that the laser treatment is superior to all other remedies for fungal toenails. However, patients need to follow a comprehensive maintenance regimen to prevent recurrence of the toenail infection.

Excerpt from paper submitted to the FDA

In this paper, we present preliminary results using the CoolTouch 1320 nm mid-infrared CoolBreeze laser treatment on patients to treat toenails that have demonstrated dermatophyte infections resulting in onychomycosis. Fungal infection was determined by the investigator pre-treatment. Toes were treated a minimum of two times at separate sessions. There were 38 patients with a total of 54 toes treated. All subjects tolerated the treatments without anesthesia with one subject reporting an adverse event complaining of a localized, sharp pain like sensation that resolved within two months. Forty-three out of 54 (79.6%) toes treated showed a measurable increase in clear nail area. Improvement in the areas of clear nail growth was measured from 30 to 180 days post the final treatment.

Please note the investigator above did not use the Keryflex resurfacing technology ( after the laser treatment treatment. Here at the Gentle Nail laser treatment Center, we apply these two state of the art treatment modalities to increase the healing effects. In fact, the application of Keryflex alone has been shown to significantly improve the discoloration of nails caused by fungus.

Frequently Asked Questions

  • What should I expect?   The protocol is about 15 minute consultation followed by, 15 minute treatment with the laser treatment, then another 15 minutes for the application of the keryflex.  Followup second treatment at around 1 to 6 months depending on the severity of your nail disorder.  Total treatment time of about 30 minutes with 45 minutes at the most.
  • Other laser treatments are claiming just one treatment why do you recommend two?   Majority of the time one treatment is all that is needed with the gentle laser treatment also, but we do another treatment to “clean up” to ensure success.  We also bundle the two laser treatment treatments into one price so that we can ensure that you will be happy with your results.
  • What does it cost?  The consultation is $50, if you decide on the procedure the cost is ($1500 for both feet-$50 = $1450) for all 10 nails. You will get TWO laser treatment sessions (1 to 6 months apart) and TWO Keryflex nail resurfacing  procedures, NOT ONE Session that is offered by the competition.
    • Competitor’s Laser Treatment Charge? $900 for one  laser treatment session  despite studys and clinical feedback of needing two treatments to be effective.   In reality with the other laser treatment you WILL  spend a lot more if you need second treatment.  We don’t charge for a second procedure as it is included in the pricing.
    •  If  you only have 4-5 nail involvement , why do we treat all 10 nails?   Infected nails can act as a breeding ground and can spread to other nails in the adjacent area, not to mention invade the skin around the nail causing athlete’s feet (Tinea Pedis).   It is safer to treat all the nails in order to kill all the fungal elements as fungal cells can not be seen with the naked eye.  
  • Difference between the CoolTouch Laser Treatment Technology vs the other Laser Treatment on the Market?
    • The cooltouch uses 1320 nm (cooler) energy laser treatment versus the competitor’s 1064 nm for gentle / safe operation
    • Cryogen spray to avoid damage to the nail bed or healthy skin when the temperature reaches a predetermined safe setting
    • Controlled depth for predictable and safe results
    • Larger spot size of up to 10mm vs the 1mm of the competitor.  This is done to prevent stacking (reheating) the previous treated area to avoid unnecessary trauma to the nail bed.    Larger spot size equals more uniformed / safe  / gentler fungus killing beam.
    • Customized care for the patient’s condition  and severity with variable spot size treatment and highly adjustable parameters of this versatile laser treatment.
    • Optimal wavelength absorbed by water, nail and fungal cells on the skin / nail allowing uniform absorption in all skin types with no effect to melanin or hemoglobin 
    • Temperature gauge to assess the temperature of the nail surface to stop the treatment if the temperature gets dangerously high.   The other laser treatment does not have this important safety feature at all.
    • Heat sensor video shows complete and more uniformed laser treatment/heat penetration with the CoolTouch laser treatment. 
  • What should I expect from the consultation?   Your podiatric laser treatment physician will examine your nails and go over post procedure instructions.      Please remove nail polish prior to your consultation.    Consultations  and treatments are done at the Main office on Goodlette Road, with any doctor of the Family Foot & Leg Center.
  • How do I schedule to get this done? First you must get a physician consultation by calling our scheduling service at 239 430 3668   and asked to be scheduled for a laser treatment nail consultation / treatment
  • Will it hurt?  NO,   You will feel a warming sensation, not pain.  When the optimal temperature is reached a cryogen (cold mist) will be sprayed  on the treating surface, quickly cooling down the nail.  The nail never gets heated beyond the safe zone predetermined in the settings. NO local anesthetic required for this gentle procedure. 
  • Will this harm my liver?   No, unlike oral medications that are moved around the body and then metabolized in the liver with potential harm to the liver the laser treatment treatment stays local where the infection is.
  • How does this compare to the oral medications and other modalities out there?    Oral medications with all its complications has an improvement rate aroung 70%, with the laser treatment Therapy it is about 85+% but without the Side Effects.    At the Gentle Nail laser treatment Center we also use the Keryflex procedure to further improve on this 85+% number.  

  • Will this fungus return?   No matter how you treat your fungal nails, and even if fully resolved, the fungal infection may return if you do not maintain proper care of your feet and nails.   Your podiatric physician will review such with you as part of the treatment plan.  The same fungus involved in nail infections are involved in athletes feet also.
  • Any Limitations the day of procedure?  No limitations.  You can go golfing, to the beach, shoe shopping, the same day of the procedure.  etc.  
  • Isn’t fungus in my blood that’s why the pill works?   NO, that is not true. The fungus (dermatophytes) that causes nail and skin infections thrives and feeds on the keratin of the skin and nails.  
  • Will I see immediate results? Since we use the Keryflex resurfacing technology, you will see immediate results when you walk out of the office, this resin will resemble  your regular nail while your real nail grows out in about 9 months underneath.  You will be able to paint, use acetone as well as clip this prosthetic nail as your own. While your real nail flourishes, you can even have pedicures.  


  • Will my medicare or my insurance cover this treatment?  This treatment is not covered by insurances.