Ruby laser treatment of congenital melanocytic naevi--a pessimistic view

Congenital melanocytic naevi may be disfiguring and potentially malignant. Treatment with lasers is a relatively new option, and promising results have been published. Most studies include few patients, and describe the effect of different lasers and different techniques. The aim of this report is to evaluate the results of ruby laser treatment on facial congenital naevi in children. Fourteen children (age range 2-16 years) with medium-sized congenital naevi were included. All naevi had a facial distribution, and were considered unsuitable for surgical excision. Ten children (age range 2-5 years) were treated under general anaesthesia and 4 under local anaesthesia. Q-switched and normal mode ruby lasers were used in 12 children and normal mode only in 2. Treatments were performed at intervals of 2-20 months (median 3 months), and the number of treatments varied between 2 and 8 (median 3). The results were monitored by clinical photographs. None of the patients showed a satisfactory result. Based on these results, laser treatment with ruby laser in children with congenital naevi is not recommended outside of clinical studies. Laser treatment may have a malignant potential that in our opinion is not balanced by good clinical results.