Treatment of congenital melanocytic naevi with CO2 laser

This study assesses the effectiveness of CO2 laser in treating congenital melanocytic naevi (CMN). A retrospective review of 12 patients with CMN treated with CO2 laser was carried out. In all cases, there was minimal visible naevus after treatment. Six patients developed hypertrophic scarring; this was significantly more likely following CO2 laser treatment on the anterior torso, flanks, or arms than on the back or buttocks (P = 0.01, 1-tailed Fisher exact test). We conclude that CO2 laser is an effective treatment for reducing visible pigmentation of CMN. However, it can cause hypertrophic scarring, which has not been reported before. This risk can be reduced by limited use in areas of the body where the dermis is thinner or there is a known risk of hypertrophic scarring. In addition, the cautious use of paint mode and prophylactic use of pressure or silicon dressings may also reduce the risk of hypertrophic scarring.