Cold plasma in podiatry


Cold plasma in podiatry

Antimicrobial effect meets skin-friendly therapy

Podiatry practices are characterised by microbial contamination, chronic changes and sensitive skin and nail structures. Particularly in cases of onychomycosis, inflamed nails (nail fold) or therapy-resistant skin changes, treatment options are needed that are effective without causing additional stress.

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Cold plasma offers an approach that combines therapy and prevention. Thanks to its antimicrobial effect, it can be used specifically against pathogenic agents, while protecting and even stabilising the surrounding healthy skin areas.

 

How does cold plasma have an antimicrobial effect?

The reactive oxygen and nitrogen species in the plasma generate a short-term oxidative stimulus. This stimulus damages the cells of fungi, bacteria and viruses: cell membranes, proteins and genetic material are attacked, limiting the pathogens' ability to reproduce.

Human skin cells react fundamentally differently. They have antioxidant protection systems and use the stimulus as a signal to activate repair mechanisms, improve microcirculation and stabilise the skin barrier. This context-dependent reaction explains why cold plasma can have an antimicrobial effect without damaging the surrounding tissue.

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Podological areas of application

In podiatric practice, cold plasma can be used for, among other things:

  • Nail fungus (onychomycosis))
  • ingrown and inflamed nails
  • Rhagades and skin cracks
  • Warts
  • Microbially contaminated skin
  • Preventative treatment for sensitive or vulnerable skin

The exact treatment parameters – duration, frequency and interval – can be adjusted individually (see table).

INDICATION RECOMMENDED DURATION OF TREATMENT FREQUENCY OF APPLICATIONS SKIN INTERVAL
Nail fungus 10 minutes 2–3 times/week 1–2
1x/week 3–4
1x/month (from week 5)
5–10 cm
Ingrown, inflamed nail 10 minutes 1–2 times per week 5–10 cm
Diabetic foot syndrome (non-ulcerated) 30 minutes Once a week 10–30 cm
Rhagades 10 minutes 2–3 times a week 5–10 cm
Wart treatment 10 minutes 2 times a week 5–10 cm
Athlete's foot 30 minutes 3 times a week 10–30 cm
Pressure points, irritation, blisters 10–30 minutes 1–2 times a week 5–30 cm
Nail correction with brace 10 minutes After application, at check-up appointments 5–10 cm
Small ulcers* 10–30 minutes 2–3 times/week, close monitoring 5–30 cm
Prophylaxis for sensitive skin 30 minutes Once every 7–10 days 10–30 cm

 

* Only to the extent permitted by regulations and with appropriate qualifications

 

Practical examples: Nail fungus treatment

The documented case studies show typical courses of cold plasma treatment for onychomycosis. An intensive therapy phase lasting approximately 6 weeks is followed by a growth phase in which the nail regrows free of fungus. Cold plasma can be used preventively during this phase.

Therapy phase
Weeks 1–2 2–3 applications of 10 minutes each
Weeks 3–4 1 application of 10 minutes each
Growth phase
From week 5 1 application per month lasting 10 minutes

In addition to reducing fungal infection, additional effects have been observed in individual cases, such as improved sensitivity to touch or improved skin condition in the surrounding nail area. The case studies thus illustrate the potential of cold plasma as an integral part of podiatric treatment concepts.

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Patient (65 years old) with onychomycosis on the left big toe. Treatment from May to September 2025. Nail fungus treatment before the start of therapy (above) followed by four weeks of therapy and a total of three months of growth phase: Afterwards, the affected nail plate (bottom left) detaches and the healthy nail grows back fungus-free (bottom right).

 

 


 

Agenda

Cold plasma: controlled physics for skin, nails and microorganisms