Footfriend - The Lacuna Method

A Simple Effective Treatment for Fungal Nails

The Lacuna Method treatment for fungal nails works by painlessly drilling many tiny micro holes (fenestration) in the infected nail plate through to the skin under the nail (the nail bed). Following the first part of the treatment where the nails are micro drilled, the nails are then treated with Terbinafine spray which is able to get through these holes directly to the source of infection – the infected nail bed. With daily application at home of the anti-fungal agent, the infection in the nail bed is cleared and the damaged nail grows out. (NB: Without delivery of a fungicidal agent to the source of the infection, clearance of the infection is highly unlikely).

Before with micro holes drilled into the infection site.
Nearly grown out several months later

The Lacuna method has shown to be a very effective way of eradicating fungal nail infections in recent studies and is often the preferred treatment of choice, when topical applications have not worked effectively or where taking a prescribed Terbinafine tablet is not indicated to the patient.

This method is discussed with the Patient as a treatment option following a detailed assessment /consultation, to ascertain its suitability for each individual patient. 

Important information about The Lacuna Method

This treatment is not suitable for everyone – we would like to make you aware of the following:

  • There are some contra-indications which will be discussed in your initial assessment along with identifying whether the infection is in-fact fungal.
  • Making holes in the nail although usually painless is not considered painless by everyone. Most patients liken it to having their eyebrows plucked. Any discomfort is short-lived.
  • There is sometimes bleeding from beneath the nail, where some of the holes are made. This is to be expected and a dressing will be applied if required. Treatment with the fungicidal spray can still be started but there may be some stinging on the first few applications.
  • This is not a short treatment – there is no quick fix for fungal nail infections. You need to commit to applying the spray daily for at least 6 months, or the treatment is likely to fail.
  • You will need to return to have your affected nails trimmed approximately every 6 weeks during the treatment to have the holes re drilled and further holes drilled as necessary (as the nail grows) and to check the progress in general.
    No nail varnish may be worn during the duration of the treatment.
  • Please note, we’d like to make you aware that Lamisil spray is a treatment for fungal infection of the skin not the nail. Using it for the nail is deemed as ‘off-licence’. There have however been several clinical trials using Lamisil this way with good results and by drilling through the nail, the treatment is actually reaching the skin in the nail bed, which is the source of the infection, so by treating the source whilst the nail grows out the infection is cleared.
    Any fungal infection of the skin will also need to be treated.
  • Further advice regarding reducing the chance of re infection will need to be followed.
nail fenestration
Micro-holes drilled through the nail plate create “funnels” through which a fungicide can reach the skin beneath the nail which is the primary source of infection.

Lacuna Method Treatment Costs

Assessment appointment £44.00
(Assess the nails and infection, discuss the treatment in detail, it’s implications and any contra-indications.)

Test for dermatophytes £45.00

Course of Lacuna Treatment (4 x Lacuna Treatment appointments at approximately 6 weekly intervals) £300

How can we help

We will need to assess you and possibly test your nail(s) for the presence of the dermatophytes that cause fungal nail infections before a treatment plan can be made.

You can book a Lacuna Method Assessment appointment either online or via our reception.

Contact us to see if this simple, effective treatment for fungal nails is suitable for you. We look forward to seeing you at our Beverley Clinic; serving Beverley, Hull and surrounding villages.

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