Objective: To demonstrate a combination laser therapy to treat Hori's nevus.
Design: A prospective study.
Setting: A Singapore-based clinic.
Participants: Five female patients, aged 30-46 years, with bilateral malar Hori's nevus.
Measurements: Photographs were taken before treatment and 1 month after laser treatment was completed. These were graded by three independent physicians. The patients were also asked to grade their treatment response subjectively. They were followed up for a total of 3 months after laser treatment to monitor recurrence.
Materials and methods: The fractional nonablative 2,940-nm Er:YAG laser with a fluence of 0.7 J/cm(2), spot size 12 mm, and frequency 15 Hz was used to perform a full-face single-pass treatment. Subsequently, a second pass and third pass over Hori's nevi were done bilaterally till the clinical endpoint of skin whitening. The 1,064-nm Q-switched (QS) Nd:YAG at a fluence of 2.0 J/cm(2), frequency 2 Hz, and 4-mm spot size was used to deliver multiple passes over Hori's nevus till erythema with mild petechiae appeared. We repeated the treatment once a week for 3 more consecutive weeks.
Results: All five patients had above 80% improvement in their pigmentation and two (skin type III) achieved complete 100% clearance. Based on the patients' subjective assessments, all five of them expressed satisfaction and felt that their pigmentation had improved. There were no complications noted.
Conclusion: The fractional nonablative 2940 nm Er:YAG laser and Q-switched 1064nm laser Nd:YAG combination is an effective and safe treatment for Hori's nevus.
Keywords: Hori's nevus; Q-switched Nd:YAG laser; combination laser; facial pigmentation; nonablative Er:YAG laser.