Clinical, Cosmetic and Investigational Dermatology (Oct 2023)
Successful Treatment of Dystrophic Nails Caused by Onychotillomania Using Pulsed Dye Laser 595 nm: A Case Report
Abstract
Anon Paichitrojjana School of Anti-Aging and Regenerative Medicine, Mae Fah Luang University, Bangkok, ThailandCorrespondence: Anon Paichitrojjana, School of Anti-Aging and Regenerative Medicine, Mae Fah Luang University 36/87-88 PS Tower 25Fl, Asoke Road, Sukhumvit 21, Klong Toey Nua, Wattana, Bangkok, 10110, Thailand, Tel +66-81-9343050, Email [email protected]: Onychotillomania is characterized by an irresistible urge to pick or pull at one’s nails, resulting in significant damage to the nail and surrounding tissue. In severe cases, it can cause onychodystrophy, which leads to abnormal changes in nail shape, color, texture, and growth. Managing onychotillomania can be challenging due to the lack of standard treatment and concurrent behavioral disorders. Pharmacotherapy and behavioral therapy have shown some positive outcomes from reported cases. The treatment for onychodystrophy varies depending on the underlying cause and may entail the application of topical, systemic, or laser therapies. Nevertheless, there is currently no consensus on the most effective treatment approach. This report presents a case of onychodystrophy caused by onychotillomania successfully treated using a pulsed dye laser 595 nm. The treatment was administered four times, with a two-week interval between sessions. Significant improvement was seen within four weeks of starting the treatment, and by the end of the eight-week program, the dystrophic thumbnails had almost completely resolved. After a thorough ten-month follow-up, it has been determined that the dystrophic nails have not reappeared. Moreover, there has been a significant decrease in the patient’s tendency to pull her nails.Plain Language Summary: Current treatment modalities of onychodystrophy will vary depending on the underlying cause of this condition, including topical, systemic, and laser treatment. Unfortunately, no universally accepted treatment has proven the most effective. This report presents a successful treatment for dystrophic nails caused by onychotillomania using the pulsed dye laser with a wavelength of 595 nm. The patient’s dystrophic nails did not return, and the nail-pulling habit decreased at ten months of follow-up.Keywords: onychodystrophy, nail dystrophy, onychotillomania, pulsed dye laser, laser treatment
