Treating - nail fungus with cold plasma using podiatric methods

The podiatry case

Onychomycosis: Photographic documentation shows complete nail regeneration with cold plasma

A recent case study from a podiatry practice impressively demonstrates how onychomycosis can progress with concomitant cold plasma therapy: from a big toenail showing clear signs of fungal infection to a nail plate that appears to have regenerated completely within 14 months. The series of images documents the progression step by step and highlights another relevant aspect of the concomitant cold plasma application: the regeneration-promoting properties of reactive cold plasma components under controlled conditions.

The case

Treatment of a 74-year-old patient began in May 2025, following basic podiatric care, using the Dr.plajin cold plasma device from GEHWOL TECH. During the first four weeks, the treatment was administered once or twice a week for ten minutes each session. The therapy was then transitioned to a monthly growth, maintenance and regeneration phase.

Treatment and photographs: Christiane Schöpe, Podologin, podiatrist, specialist in podiatry, ICW® wound care expert ICW®

The photographic documentation of the course of treatment is particularly telling: after just a few months, the affected nail plate began to detach, whilst healthy nail tissue grew back. As treatment progressed, the proportion of healthy nail increased steadily. After 14 months, the big toe nail appeared visually normal and was fully regenerated.

The explanation

The success of the treatment cannot be explained solely by the antifungal effect of cold plasma. It is true that the reactive oxygen and nitrogen species (ROS/RNS) contained in the plasma effectively reduce fungi and other microorganisms by impairing their cellular structures and metabolic processes.¹

At the same time, scientific studies suggest that, when administered at controlled doses, cold plasma can stimulate regenerative processes in the skin and nails.^2,3

This aspect is of particular importance in the case of onychomycosis. Dermatophytes infect keratinised tissues such as nails and utilise keratin as a source of nutrients. In doing so, they release enzymes that alter the structure and function of the tissue. Accompanying inflammatory reactions and damage to the tissue architecture can impair the normal differentiation and proliferation of keratinocytes. As a result, the growth of the nail matrix often slows down, making it more difficult for the nail to regenerate.^4,5,6

Cold plasma can support this process in two ways: firstly, it reduces the pathogen load, thereby eliminating a major cause of tissue damage.¹ Secondly, low-dose ROS/RNS can act as biological signalling molecules and activate cellular repair and regulatory mechanisms. Among other things, effects on cell communication, microcirculation and the proliferation of keratinocytes – which are responsible for the formation of new nail substance – have been described.^2,3,7

GEHWOL TECH’s patented Dr.plajin process takes a unique approach: free electrons act as redox buffers and help to regulate the oxidative potential of the cold plasma. This preserves the antimicrobial properties whilst simultaneously supporting regenerative signalling processes.

Conclusion

This case report thus demonstrates a dual therapeutic approach: the treatment creates unfavourable conditions for microorganisms whilst simultaneously promoting a regenerative environment for the formation of new nail structure. The result is more than just a fungus-free nail; it is the visible restoration of a physiological nail plate.

More about cold plasma in podiatry

Find out here about the physical mechanisms behind cold plasma and why controlled concentrations of ROS and RNS are relevant for the skin, nails and microorganisms.

Agenda

Cold plasma: controlled physics for skin, nails and microorganisms

• Cold plasma in podiatry
• Cold plasma in foot care & cosmetics
• How cold plasma treatment with GEHWOL TECH works
• A podiatry case: onychomycosis

Literature review

[1] Gnat, S., Łagowski, D., Dyląg, M. et al. Cold atmospheric pressure plasma (CAPP) as a new alternative treatment method for onychomycosis caused by Trichophyton verrucosum: in vitro studies. Infection 49, 1233–1240 (2021). https://doi.org/10.1007/s15010-021-01691-w
[2] von Woedtke, T., Schmidt, A., Bekeschus, S., Wende, K., & Weltmann, K.-D. (2019). Plasma Medicine: A Field of Applied Redox Biology. In Vivo, 33(4), 1011–1026. https://doi.org/10.21873/invivo.11570
[3] Busco, G., Robert, E., Chettouh-Hammas, N., Pouvesle, J.-M., & Grillon, C. (2020). The emerging potential of cold atmospheric plasma in skin biology. Free Radical Biology and Medicine, 161, 290–304. https://doi.org/10.1016/j.freeradbiomed.2020.10.004
[4] Jartarkar SR, Patil A, Goldust Y, Cockerell CJ, Schwartz RA, Grabbe S, Goldust M. Pathogenesis, Immunology and Management of Dermatophytosis. J Fungi (Basel). 2021 Dec 31;8(1):39. https://doi.org/10.3390/jof8010039
[5] Deng R, Wang X, Li R. Dermatophyte infection: from fungal pathogenicity to host immune responses. Front Immunol. 2023 Nov 2;14:1285887. https://doi.org/10.3389/fimmu.2023.1285887
[6] Geyer AS, Onumah N, Uyttendaele H, Scher RK. Modulation of linear nail growth to treat diseases of the nail. J Am Acad Dermatol. 2004 Feb;50(2):229-34. https://doi.org/10.1016/j.jaad.2003.07.011
[7] Schmidt A, Dietrich S, Steuer A, Weltmann KD, von Woedtke T, Masur K, Wende K. Non-thermal plasma activates human keratinocytes by stimulation of antioxidant and phase II pathways. J Biol Chem. 2015 Mar 13;290(11):6731-50. https://doi.org/10.1074/jbc.m114.603555