Journal of Asia Pacific Aesthetic Sciences

Abstract: Nevus of Ota and melasma are common dermal hyperpigmentation disorders that present significant treatment challenges due to their varied etiologies and inconsistent responses to therapy. This case report presents a 44-year-old Chinese woman with Fitzpatrick skin type IV, diagnosed with Type III Nevus of Ota and melasma. The patient had longstanding pigmentation on the left side of her face and forehead since childhood, which significantly impacted her confidence and self-esteem. She had previously undergone non-ablative laser therapy and used various skincare products without any notable improvement. The patient subsequently received ten sessions of treatment using a 1064 nm Q-switched Nd:YAG laser (QSNYL) in Quickly-pulse-to-pulse (Q-PTP) mode over the course of one year, with intervals of 1 to 2 months between sessions at our clinic. For Nevus of Ota, the QSNYL was applied in Q-PTP mode with a fluence of 4.0 to 5.2 J/cm², a spot size of 4 mm, and a pulse rate of 5 Hz, with one pass over the entire face. For melasma, the same mode was used, but with a lower fluence (0.7 to 0.8 J/cm²), a spot size of 8 mm, and a pulse rate of 10 Hz, with three passes over the entire face. Upon completion of the treatment sessions, the patient's MASI score decreased from an initial score of 5.2 to 2.6 after the 10th session. The patient’s response to Nevus of Ota treatment was classified as Grade II (26%-50% improvement), indicating moderate improvement. Despite this, she reported high satisfaction, particularly with the overall enhancement in skin tone and the reduction in Nevus of Ota. The 1064 nm QSNYL in Q-PTP mode may be a promising treatment option for patients with concurrent Nevus of Ota and melasma. Further research with larger sample sizes is needed to validate its efficacy and safety in the Malaysian population.