Treatment of Benign Pigmented Lesions Using Lasers: A Scoping Review

Area of Science:

• Dermatology
• Laser Medicine
• Aesthetic Science

Background:

• Melanocytic lesions, including café-au-lait macules (CALMs), nevus of Ota (NOA), Becker's nevus (BN), and lichen planus pigmentosus (LPP), are common dermatological conditions.
• Laser therapy is a prevalent treatment modality for various pigmented lesions.
• Evaluating the efficacy and safety of different laser treatments is crucial for clinical practice.

Purpose of the Study:

• To conduct a scoping review of studies on laser treatments for pigmented lesions.
• To assess the efficacy and safety of various lasers, particularly Q-switched neodymium-doped yttrium aluminum garnet (Nd:YAG) lasers, for conditions like NOA, CALMs, BN, and LPP.
• To identify common adverse effects and recurrence patterns associated with laser treatments.

Main Methods:

• A comprehensive scoping review of 77 studies was performed.
• Studies focused on laser treatments for specific pigmented lesions were analyzed.
• Data on laser types, treatment parameters, efficacy, safety, and outcomes were extracted and synthesized.

Main Results:

• The Q-switched neodymium-doped yttrium aluminum garnet (Nd:YAG) laser, especially at 1064 nm, showed high efficacy for NOA and other dermal pigmented disorders.
• Medium-wavelength lasers like Q-switched ruby and Alexandrite lasers demonstrated potential but with variable results.
• Post-inflammatory hyperpigmentation (PIH) and hypopigmentation were frequent adverse effects, particularly in darker skin types (Fitzpatrick types IV-VI).

Conclusions:

• Q-switched Nd:YAG lasers are effective for treating dermal pigmented lesions, offering significant improvement for NOA.
• Treatment outcomes are influenced by lesion depth, patient skin type, and specific laser protocols.
• Standardization of laser parameters, investigation of long-term efficacy, and inclusion of diverse Fitzpatrick skin types are essential for future research and equitable treatment.