Q-switched mode
lasers have been utilized for treatment of many pigmentary lesions. Because of their short pulse durations (1-100 ns), these
lasers selectively destroy pigment laden cells while sparing the surrounding normal tissues. To determine if the Q-switched
alexandrite laser (QSAL) is effective in the treatment of congenital
melanocytic nevi, 53 patients with these lesions were treated with QSAL; of these, 16 also received CO(2)
laser treatment between QSAL treatments. We observed an average improvement score in the 53 treated patients of 2.623 + 1.13, corresponding to a 72% improvement. Treatment with the combination of QSAL and a CO(2)
laser resulted in a significant enhancement of improvement score (3.06 +/- 1.18) compared to patients treated with the QSAL alone (2.43 +/- 1.07; p = 0.0393). Complications were mild, with 35
nevi (67.3%) showing textural change of skin
after treatment, 2 (3.8%) showing depressed
scar formation, and 4 (7.5%) showing hypertrophic changes, while 12
nevi (23%) showed no changes.
Hypopigmentation was observed in 16 patients (30%), and
hyperpigmentation was observed in 15 patients (28%) 48 weeks after the final QSAL treatment. Repigmentation to a brown to black spot was observed in 44/53 (83%) patients within an average of 5.45 +/- 3.93 months. These results indicate that the QSAL was as effective as other Q switch mode
lasers in the treatment of congenital
melanocytic nevi, but repigmentation is a problem.