Journal of Asia Pacific Aesthetic Sciences

Abstract: Nevus of Ota and melasma are dermal hyperpigmentation disorders that often pose therapeutic challenges due to their diverse etiologies and variable responses to treatment. This case report presents a 44-year-old Chinese woman with Fitzpatrick skin type IV, diagnosed with concurrent Nevus of Ota and melasma, who had pigmentation on the left side of her face and forehead since childhood. She had previously undergone non-ablative laser therapy and topical treatments, but no improvement seen. The patient subsequently received ten treatment sessions using a 1064 nm Q switched Nd:YAG laser (QSNYL) in Quickly-pulse-to-pulse (Q-PTP) mode over one year, with 1–2-month intervals between sessions. For Nevus of Ota, laser settings included fluence 4.0–5.2 J/cm², 4 mm spot size, and 5 Hz pulse rate with a single pass. For melasma, settings included fluence 0.7–0.8 J/cm², 8 mm spot size, and 10 Hz pulse rate with three passes. Following treatment, the patient’s Melasma Area and Severity Index (MASI) score improved from 5.2 to 2.6. Clinical evaluation showed Grade II (26–50%) improvement in Nevus of Ota and moderate improvement in melasma, with enhanced skin tone and patient satisfaction. No major adverse effects were reported. These findings suggest that the 1064 nm QSNYL in Q-PTP mode may serve as a promising therapeutic option for patients with concurrent Nevus of Ota and melasma, particularly in Asian populations. Further studies with large scale studies are needed to validate its long-term efficacy and safety.