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Early Treatment Initiation Improves Outcomes in Nevus of Ota: A 10-Year Retrospective Study

  • Original Research Article
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Abstract

Background

Nevus of Ota is a psychologically burdensome facial pigmentation birthmark common in Asian populations. Laser therapy is currently the first-line treatment, but no guidelines on when to initiate treatment have yet been established.

Objectives

Our objective was to determine the correlation between treatment efficacy and safety, risk of recurrence, and age of treatment initiation in patients receiving laser therapy for nevus of Ota.

Methods

We conducted a 10-year (2008–2018) retrospective cohort study of all patients who completed a minimum of five laser treatments at Siriraj Skin Laser Center, Mahidol University, Bangkok, Thailand.

Results

A total of 84 patients (aged 4 months–50 years) with nevus of Ota lesions were enrolled in the study. All patients were treated with a 1064-nm Q-switched Nd:YAG or a 755-nm or 1064-nm picosecond-domain laser (or a combination thereof). Our analysis identified that initiation of laser therapy before the age of 5 years was a significant factor in reducing the number of sessions necessary to achieve aesthetic improvement (P < 0.01; 95% confidence interval [CI] 1.06–3.21). In total, 18 patients (21.4%) initiating treatment before the age of 5 years required an average of 2, 4, and 7 treatment sessions to achieve > 25, 50, and 75% of pigment lightening, respectively, whereas 66 patients (78.6%) initiating treatment after the age of 5 years required an average of 3, 7, and 11 sessions to achieve comparable clearance. The risk of postinflammatory hyperpigmentation was significantly lower in patients starting treatment before the age of 5 years (P < 0.01; 95% CI − 43.76 to − 11.94). Recurrences were not observed in patients achieving > 95% clearance.

Conclusions

In our patient cohort, initiation of laser treatment for nevus of Ota before the age of 5 years significantly improved therapeutic outcomes and reduced the risk of adverse events and recurrence.

Clinical Trial Registration

ClinicalTrials.gov PRS number: NCT04481178.

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Author information

Authors and Affiliations

  1. Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok, 10700, Thailand

    Petchlada Achavanuntakul, Woraphong Manuskiatti & Rungsima Wanitphakdeedecha

  2. Faculty of Economics, Thammasat University, Bangkok, Thailand

    Tatre Jantarakolica

Authors
  1. Petchlada Achavanuntakul
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  2. Woraphong Manuskiatti
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  3. Rungsima Wanitphakdeedecha
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  4. Tatre Jantarakolica
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Corresponding author

Correspondence to Woraphong Manuskiatti.

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Funding

No funding or sponsorship was received for the conduct of this study or the preparation of this manuscript.

Conflicts of interest

Petchlada Achavanuntakul, Woraphong Manuskiatti, Rungsima Wanitphakdeedecha, and Tatre Jantarakolica have no conflicts of interest that are directly relevant to the content of this article.

Availability of data and material

Data sharing requests will be considered by the Siriraj Institution Review Board (SIRB), Faculty of Medicine, Siriraj Hospital, through written request to woraphong.man@mahidol.edu. Anonymized participant data or other prespecified data will be available, subject to a written proposal and a data sharing agreement.

Ethics approval

This study was approved by the Siriraj Institutional Review Board, Faculty of Medicine, Siriraj Hospital, Mahidol University, Thailand (Si 347/2020), and was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Consent to participate

Not applicable.

Consent to publish

Written informed consent was obtained from all subjects whose photographs appear in this article.

Code availability

Not applicable.

Author contributions

WM and RW were involved in the study conception and design. PA and WM carried out all chart review and patient assessments. PA, TJ, and RW performed the statistical analysis. WM and PA drafted the manuscript. All authors read and approved the final manuscript.

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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/10.1007/s40257-021-00637-0

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  • DOI: https://doi.org/10.1007/s40257-021-00637-0

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