Lasers and Acquired Melanocytic Nevi: A Systematic Review

Acquired melanocytic nevi (AMN) are common and cosmetically bothersome. Patients may prefer non-invasive laser modalities, but their efficacy remains uncertain.

To assess the utility of lasers for AMN removal.

The authors systematically reviewed MEDLINE, EMBASE, and Scopus from inception to May 9, 2024, using the terms "nevi" and "laser." Our primary outcome was clinical efficacy, measured by physician/investigator-graded clinical assessments of (1) >75% lesion clearance or (2) 95% to 100% clearance (complete response).

The authors identified 20 studies, including CO2 (n = 5), Q-switched (QS) and long-pulsed (LP) ruby (n = 4), LP or QS Alexandrite (n = 3), QS Nd:YAG 1064 nm (n = 3), Er:YAG (n = 2), LP Nd:YAG 532 nm (n = 1), diode (n = 1) lasers, and 2 combination studies of Er:YAG with LP Alexandrite (n = 1) or QS Nd:YAG 532 nm (n = 1) laser. Combination Er:YAG treatment achieved >75% clearance in 98.5% to 100% of cases, with better outcomes using LP Alexandrite laser. Eight studies assessed complete response. Combination Er:YAG with QS Nd:YAG 532 nm laser (89.4% of cases) or LP Alexandrite (100%) and LP Alexandrite alone (98.1%) demonstrated the highest clearance.

Combination of Er:YAG with LP Alexandrite, LP Alexandrite alone, and Er:YAG with QS Nd:YAG 532 nm laser are most effective for nevi clearance.