PACT® nail fungus therapy - for effective treatment of nail fungal infections
Onychomycosis (also known as dermatophytic onychomycosis or tinea unguium) is a fungal infection of the nail. It is estimated that over half of all nail problems are due fungal nail infections. The incidence of onychomycosis has been increasing and is associated with diabetes, a suppressed immune system, and increasing age. It is caused by a fungal micobe that invades the nail bed thus causing the fingernails and/or toenails to thicken, discolour, disfigure, and split. If left unteated, it can cause pressure, irritation, and pain inside footwear. Two currently available treatments include topical antifungal nail lacquers that are applied daily/weekly and prescription medications. However, patient compliance in regard to topical antifungals and concerns regarding drug interactions and adverse effects of oral antifungals has resulted in the need for an alternative treatment option.
At Morton's Podiatry, we have introduced Photodynamic Antimicrobial Therapy (PACT). This revolutionary method of treatment effectively kills off bacteria, viruses and fungi on skin surfaces, toenails and fingernails without any adverse side effects which can occur following treatment with laser and oral antifungal medications.
How does PACT work?
PACT involves the interaction of light, a photosensitive agent and oxygen to produce a local chemical effect. This photochemical reaction induces fungal cell death without affecting surrounding tissue meaning it is 100% completely safe!
What does fungal nail treatment with PACT involve?
We will debride (cut and file) back as much of the nail as possible to reduce the thickness of the nail and therefore allow better penetration of the nail gel and light as well as reducing the fungal load.
In severe cases and those with nail matrix involvement the PACT treatment can be further enhanced by mild chemical debridement using 40% Urea ointment. Urea ointment is applied to the nail followed by an occlusive dressing for one day. It is then removed and reapplied after a further day when the nail has been exposed. This is repeated for between 1-2 weeks with the ideal outcome being slight softening of the nail. — Treatment regime to be adapted to individual.
We liberally apply the PACT Nail Fungus Gel using a cotton applicator covering the whole nail above and below the nail plate, as well as the nail grooves and in the sulci for 10 minutes.
We apply the PactMED LED at a distance of at least 1 cm for 9.5 minutes positioning the anti-glare shield over the nail and in contact with the toe itself.
Frequency of Application
The frequency of treatment is determined by the severity and duration of the infection, as well as the general health and age of the patient and any co-morbidities.
Initial 3 x 9.5 minutes within 1 month.
Review after 3 months and repeat one application as required, or for prophylaxis.
Initial 3 x 9.5 minutes within 1 month.
Review and repeat treatment (one application) after 1 month.
Subsequent review - Review after 3 months and repeat one application as required, or for prophylaxis.
Containdications and side effects
There are no known contra-indications for the PactMED, however it is important to note the ingredients of the gel and identify those patients who may experience an allergic reaction. The nail retains a blue discolouration that will vanish soon after treatment, however in rare cases it may remain for up to one week. The effectiveness of the treatment can only be assessed after a period of approximately 3 months due to the time it takes for the nail to grow. If the affected part of the nail fails to grow out and spreads to the base of the nail, application can be repeated and prolonged if required. For the purpose of prophylaxis after a successful treatment it is recommended to repeat the treatment every 6 months for 9.5 minutes. Note that extended exposure does not have any adverse affects.
Tips to Prevent Re-Infection
To optimise the success of the PactMED treatment, it is essential to minimise the risk of re-infection.
Some tips include:
Use of a topical anti-fungal solution applied daily
Regular rotation of patient’s shoes for drying and aeration
Treat shoes with an anti-fungal prior to commencement of treatment and regularly after its completion.
A UV light sanitiser can be used as an alternative to treat the shoes
Wash hosiery in hot water and even apply antifungal solution to the washing cycle
Patients should be encouraged to wear thongs in public showers and swimming centres
The use of hosiery/socks containing silver can also minimise re-infection
Disinfect shower floor
Minimise micro trauma to the nails (which makes the nails more susceptible to infection) by ensuring correct shoe fit
Patient should not share nail clippers