Low-Fluence Q-Switched Nd: YAG Laser (LF-QSNY) May Be a Better Choice for the Treatment of Early Nevus of Ota: A Prospective Self-Controlled Trial of LFQS and Picosecond Alexandrite Laser

Background. Low-fluence Q-switched Nd: YAG laser (LF-QSNY) and picosecond 755 nm alexandrite laser (PSAL) have shown superiority in the treatment of nevus of Ota (NO). Objective. To compare the efficacy and safety of PSAL and LF-QSNY in the treatment of NO. Methods. 15 patients randomly underwent split-lesion treatment of the two lasers within three months. The visual analogue scale (VAS) was used to evaluate the efficacy outcomes. The patient’s preferences, recurrence rate, and adverse events were also documented. Results. Fifteen patients with 34 lesions finished the trial. Lesions, operated with LF-QSNY and PSAL, reached VAS scores of 3.47 ± 0.67 and 3.51 ± 0.87, respectively (P > 0.05). Most significant improvement in LF-QSNY was achieved after the first session (VAS = 1.84). One (6.67%) patient experienced a relapse on the PSAL side. Temporary hypopigmentation and hyperpigmentation mainly occurred on the PSAL side. Patients under five years demonstrated superior efficacy (3.81 ± 0.47 vs 3.08 ± 0.66, P = 0.046) than those over with the treatment of LF-QSNY. Limitations. Limited sample and lack of objective evaluation. Conclusion. The difference between the LF-QSNY and PSAL in the treatment of NO was statistically insignificant, while LF-QSNY may be a better choice for the treatment of early NO. This trial is registered with ChiCTR1900022690.