hori nevus treatment

Horis Nevus Treatment

Horis Nevus treatment option is with first-line laser systems such as Picosecond and Nanosecond lasers. These lasers are clinically effective and safe in all skin types.

What Is Hori's Nevus?

Hori’s Nevus is a skin hyperpigmentation condition that appears almost exclusively in Asian women from the second decade of life. It arises from the deeper dermal layer of the skin and is often confused for freckles and melasma.

Hori’s nevus is synonymous with acquired bilateral nevus of ota-like macules (ABNOM) and nevus foscoceruleus zygomaticus.

Horis nevus spots on cheeks
horis nevus
Extensive speckled Horis nevus

What Does Hori's Nevus Look Like?

Hori’s nevus manifests as symmetrical blue-brown to grey spots mainly on the cheeks. In some circumstances, it may affect the forehead, temples and eyelids.

Hyperpigmentation conditions that involve the deeper dermal layers of the skin have a bluish or greyish tinge due to the way light is reflected back into our eyes.

What Causes Hori's Nevus?

A myriad of factors may trigger off the appearance of Hori’s nevus. These include ultraviolet light exposure, genetic susceptibility, skin aging, dermal inflammation, pregnancy and even cosmetic products.

In normal circumstances, the pigment producing melanocytes are located in the superficial epidermal layer of the skin. However, in Hori’s nevus, there appears to be a relocation and activation of the melanocytes in the deep dermal layer of the skin.

How Is Hori's Nevus Diagnosed?

Most cases of Hori’s Nevus can be diagnosed based on history and clinical appearance. While a skin biopsy is gold standard, this is rarely done.

Horis Nevus Treatment Options

Laser is the first-line therapeutic option to effectively reduce the appearance of Hori’s nevus. Lasers work by selectively targeting the melanin (pigment) in the dermal layer. The pigments which are shattered into smaller fragments by the laser energy are then cleared by your body’s natural healing processes.

Dermabrasion, which is invasive, is another horis nevus treatment option, but is now superseded by current laser systems.

laser horis nevus treatment

Laser Horis Nevus Treatment

Laser hori nevus treatment is the main modality to treat the condition. From clinical studies, there are various laser treatment options. These include the Q-Switched (nanosecond), Er:YAG, Carbon dioxide (CO2 laser) and Pico-second lasers. 

At APAX Medical & Aesthetics Clinic, the choice of the laser horis nevus treatment offered would be dependent on your unique condition, skin type and previous treatment response.

Multiple laser horis nevus treatment (at least 4) are usually necessary. Most individuals report good results following laser therapy. 

Pico-second laser horis nevus treatment has been reported to be more effective, less painful and associated with a lesser risk of post-inflammatory hyperpigmentation. The latter is especially important as most individuals with Hori’s nevus are of Asian skin type.

The improvement of the appearance of your Hori’s nevus is correlated with the number of laser treatments. On average, about 4-10 laser treatments may be necessary. As the degree of dermal melanocytes differs across individuals, the number of treatment session will depend on individual response and clearance of the lesion.

Immediate post procedure effects include transient discomfort and swelling. Some initial darkening (hyperpigmentation) of your Hori’s nevus is to be expected after your laser treatment. This is especially so if higher fluence of laser energy is used to break down the deeper melanin, however this is often temporary. Hypopigmentation (white spots) is possible with laser treatment and therefore a cautious gradual approach to your treatment is essential. 

A numbing cream is applied prior to your laser procedure to ensure you comfort.

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References:
  1. Yu W, Zhu J, Yu W, Lyu D, Lin X, Zhang Z. A splitface, singleblinded, randomized controlled comparison of alexandrite 755 nm picosecond laser versus alexandrite 755nm nanosecond laser in the treatment of acquired bilateral nevus of Ota-like macules. J Am Acad Dermatol 2017.
  2. Kaur, HSarma, PKaur, S, et al. Therapeutic options for management of Hori’s nevus: A systematic reviewDermatologic Therapy202033:e13167. https://doi-org.abc.cardiff.ac.uk/10.1111/dth.13167
  3. Zeng R, Liu YZ, Lin T, Guo LF, Ge YP, Zhang ML, Yang Y, Wu QJ, Wu YL, Li M. Effects of Q-switched laser treatments on acquired bilateral nevus of Ota-like macules: A retrospective comparative study. International Journal of Dermatology and Venereology. 2019 Jun 1;2(02):70-6.
  4. Wu, D.C., Goldman, M.P., Wat, H. and Chan, H.H. (2021), A Systematic Review of Picosecond Laser in Dermatology: Evidence and Recommendations. Lasers Surg Med, 53: 9-49. https://doi.org/10.1002/lsm.23244