Nevus of Ota Treatment
What Is Nevus of Ota?
Nevus of Ota is a pigmented birthmark that occurs on one side of the face in individuals of mainly Asian descent. While it mostly poses no physical harm, it can be cosmetically debilitating and impact your quality of life.
What Causes It?
The exact cause of Nevus of Ota is currently unknown. From studies, it is observed that there is presence of pigment producing cells (melanocytes) in the deeper dermal layers of the skin. It follows the distribution of the trigeminal nerves of the face, mainly the ophthalmic and maxillary nerves branches. Whilst the precise cause remains unknown, genetic and hormonal factors may play a role.
Who Gets Nevus of Ota?
Although Nevus of Ota is most common in individuals of Asian ethnicity, it can also be observed in individuals with darker skintype.
Nevus of Ota may present shortly after birth or during the teenage years. It appears that women are 5 times more likely to be affected than men.
What Does It Look Like?
Nevus of Ota can have a bluish tinge or brown discolouration depending on how deep the pigments reside in the skin. With increasing age, you may notice the colour darkening. The pigmentation is most obvious around the eyes, cheeks and forehead. The white of the eyes and inner mouth may be affected in some cases. There may be a risk of glaucoma (increased pressure in the eyes) if there is eye involvement and follow up with an eye doctor is advised.
Nevus of Ota resembles Hori’s nevus in some respect but the latter usually presents bilaterally and onset is in older individuals.
How Is Nevus of Ota Diagnosed?
Most cases can be diagnosed on the history and careful clinical examination. A skin biopsy may be helpful in cases where the diagnosis is in doubt.
Nevus of Ota Treatment
Pigment specific Laser for Nevus of Ota treatment is the main therapeutic modality to successfully treat the condition. In the past, methods included dermabrasion, electrosurgery and cryotherapy but these were associated with higher risks of scarring and side effects.
The most common lasers for Nevus of Ota include the Q-Switched (nanosecond) and Pico-second laser. While the Q-Switched laser is effective at breakdown the pigments, Picosecond lasers are associated with less pain, shorter downtime and smaller chance of post-inflammatory hyperpigmentation.
Picosecond laser uses ultra-short pulses to mechnically (photomechanical effect) breakdown the unwanted pigments into smaller fragments. As there is less thermal output, collateral damage to surrounding skin structures are minimised. From studies, laser Nevus of Ota treatment is both safe and effective.
A numbing cream is applied prior to your treatment to optimise your comfort.
There will be mild redness, swelling and pin-point bleeding immediately after the procedure. However, over the next few days, these will subside almost completely. As with laser procedures, there is a risk of post-inflammatory hyperpigmentation and hypopigmentation.
On average, 4-8 treatment sessions may be necessary to treat the condition. The treatments are spaced at 2-3 monthly intervals so that healing can take place. Some studies appear to show that blue coloured Nevus of Ota respond better to laser therapy.
It is important to avoid direct and intense sun after your procedure. Application of sunscreen and moisturizers are encouraged after your treatment.
Individuals with active skin inflammation and infection cannot do laser treatment until the condition is cleared. Treatment is not carried out in individuals who are sensitive to light, have seizures associated with light, pregnancy and breastfeeding women.
- Treatment of nevus of Ota with 1064 nm picosecond Nd:YAG laser: A retrospective study. Dermatologic Therapy. 2021; 34( 6):e15152. doi:10.1111/dth.15152 , , , et al.
- Achavanuntakul, P., Manuskiatti, W., Wanitphakdeedecha, R. et al. Early Treatment Initiation Improves Outcomes in Nevus of Ota: A 10-Year Retrospective Study. Am J Clin Dermatol 23, 105–114 (2022). https://doi-org.abc.cardiff.ac.uk/10.1007/s40257-021-00637-0
- 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