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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.