Treatment of acquired and small congenital melanocytic nevi with combined Er: YAG laser and long-pulsed alexandrite laser in Asian skin.

BACKGROUND: There is no gold standard for the treatment of benign melanocytic nevi for cosmetic purposes.

OBJECTIVE: To investigate the efficacy and safety of combined treatment with the short-pulsed erbium:yttrium-aluminum-garnet (Er:YAG) and long-pulsed alexandrite laser for acquired melanocytic nevi (AMN) and small congenital melanocytic nevi (CMN).

METHODS: Fifty-eight AMN and 7 small CMN in 24 Korean patients were treated with Er:YAG laser followed by long-pulsed alexandrite laser at 1-month intervals.

RESULTS: At 8 weeks after the final treatment, all treated nevi showed complete removal of pigmentation, and the mean overall improvement score assessed by physicians, with a quartile grading scale, was 3.6 ± 0.7. The mean number of treatment sessions required to treat CMN (1.5 ± 0.3) was significantly greater than that for junctional (1.1 ± 0.2) or compound (1.2 ± 0.5) AMN. Postinflammatory hyperpigmentation (4.6%), erythema (9.2%), hypertrophic scars (1.5%), and mild atrophic scars (10.8%) were observed, but all resolved within 6 months, except for hypertrophic scars and 1 atrophic scar. Recurrence of pigmentation was observed in 1 CMN (1.5%) during 6 months of follow-up.

CONCLUSION: Combined treatment with Er:YAG laser and long-pulsed alexandrite laser is effective for the removal of small benign melanocytic nevi with minimal adverse effects and low recurrence rates.