Treatment of nevus of Ota with the Q-switched ruby laser

N Engl J Med. 1994 Dec 29;331(26):1745-50. doi: 10.1056/NEJM199412293312604.


Background: Nevus of Ota is a benign bluish or gray-brown lesion of the eye and the surrounding skin that has been reported to occur in about 1 in 200 people in Japan. Prior treatments have either been ineffective or caused scarring. The Q-switched ruby laser can produce very short high-energy pulses and can selectively target cells that contain pigment, such as dermal melanocytes.

Methods: We treated the skin lesions of 114 patients (25 male and 89 female) with nevi of Ota with a Q-switched ruby laser set to deliver pulses of 6 J per square centimeter of body-surface area at a wavelength of 694.3 nm, with a pulse duration of 30 nanoseconds. The interval between treatments ranged from three to four months. Five dermatologists who were not familiar with the patients independently compared a full set of pretreatment and post-treatment photographs of each patient and determined the percentage of pigment lightening of the affected areas using standard criteria.

Results: Of the 35 patients who received four or five treatments, 33 had an excellent response (lightening of 70 percent or more), and 2 had a good response (lightening of 40 to 69 percent). Of the 31 patients who received three treatments, 4 had an excellent response, 26 a good response, and 1 a fair response (lightening of 10 to 39 percent). Of the 25 patients who received two treatments, 2 had an excellent response, 16 a good response, and 7 a fair response. Of the 23 patients who received one treatment, 3 had a good response, 13 a fair response, and 7 no response (lightening of 9 percent or less). No patient had hypertrophic or atrophic scarring; eight patients had postinflammatory hyperpigmentation for up to two months after the first treatment.

Conclusions: Selective photothermolysis with the Q-switched ruby laser is a safe and effective method for lightening nevi of Ota. Multiple treatments increase the response rate.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Face
  • Female
  • Humans
  • Laser Therapy*
  • Male
  • Middle Aged
  • Nevus of Ota / pathology
  • Nevus of Ota / therapy*
  • Phototherapy*
  • Skin Neoplasms / pathology
  • Skin Neoplasms / therapy*