What is the best treatment for Nevus of Ota in adults and children?

Doctor's Answers 1

Aesthetic

As the pigmentation of nevus of Ota is located deeper in the dermis rather than superficially in the epidermis, the best treatment are lasers operating in the longer wavelength region (e.g. 755nm or 1064nm) and have very short pulse durations (either in the picosecond or nanosecond range) to target and fragment the pigment and allow for gradual clearance. Multiple treatment sessions are needed for significant lightening.

Besides the type of laser technology, other factors that influence the clinical outcome are also important. These include fluence (“power setting”), the interval between treatment and lasering technique. Treating earlier in childhood appears to lead to better outcomes as well.

It will be best that you consult a trusted and experienced Aesthetic doctor or dermatologist who can assess the severity of your condition and treat you appropriately.

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How does cysteamine and other lightening creams work for melasma?

Melasma is caused by excessive melanin (coloured skin pigment) in the upper layer of the skin (epidermal melasma) and the deeper layer of the skin (mixed melasma). The answer to your question therefore requires a brief discussion on how melanin is formed. Melanin is produced by specialised pigment producing cells in the lower layer of the epidermis called melanocytes. The production of melanin involves a series of enzyme-catalyzed chemical reactions. The raw product for melanin production is L-tyrosine. The first step of melanin production is the conversion of L-tyrosine to L-DOPA.

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Aesthetic

Are there any risks of hypopigmentation after Q-switched laser to remove a birthmark?

It does look like a bit of hypopigmentation and you are correct that it is difficult to treat (most of the time we will have to rely on our own cells to re-pigmentate the area unless you explore other medical repigmentation options). I would suggest laying off the “gentler” laser treatment that you have every 2 weeks for the hypopigmented areas. That being said, the “stronger” laser treatment that you have every 6 weeks should be able to treat the Naevus of Ota (to avoid the hypopigmented areas). Usually, treatment of Naevus of Ota does not leave a white patch.

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