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Background and Objectives  Café‐au‐lait spots, also known as café‐au‐lait macules (CALMs), are a common pigmentary disorder. Although various laser modalities have been used to treat CALMs, the efficacy of laser treatment in children differs from that in adults. We investigated the efficacy, safety, and clinical factors of the treatment of CALMs using Q‐switched alexandrite laser (755 nm) therapy in children.    Methods  In total, 471 children with CALMs underwent Q‐switched alexandrite laser therapy at a treatment interval of 3–12 months. The safety and efficacy of the laser treatment were evaluated by reviewing clinical records and photographs before and after treatments.    Results  Of the 471 patients, 140 (29.72%) were cured completely, 124 (26.33%) showed substantial improvement, 110 (23.35%) showed improvement, and 97 (20.60%) showed no improvement after one to nine treatments. The overall treatment success rate was 79.41%, and the treatment efficacy was positively correlated with the number of laser treatments (rs = 0.26,  P  < 0.0001). Sex and the interval of laser treatments were also associated with significant differences in treatment outcomes ( P  < 0.05). No obvious adverse effects were observed. Multivariate logistic regression analysis showed that the number of treatments influenced the treatment efficacy (odds ratio, 2.130; 95% confidence interval, 1.561–2.908).    Conclusions  Q‐switched alexandrite laser (755 nm) therapy is safe and highly effective for CALMs in children, and the number of treatments affects the treatment efficacy. Lasers Surg. Med. © 2019 The Authors.  Lasers in Surgery and Medicine  Published by Wiley Periodicals, Inc.

Treatment of Café‐Au‐Lait Spots Using Q‐Switched Alexandrite Laser: Analysis of Clinical Characteristics of 471 Children in Mainland China