Treatment of acquired junctional melanocytic naevi by Q‐switched and normal mode ruby laser

Summary Background  Acquired junctional melanocytic naevi are harmless pigmented lesions of the epidermis, which can be of cosmetic concern. Various therapeutic approaches have been used in the treatment, but all these methods produce postoperative scarring or alterations in skin texture. Pigment laser treatment of benign pigmented lesions has shown a low potential for scarring by selectively targeting melanosomes in melanocytes and keratinocytes. Objective  To find a fast, effective and safe treatment for the removal of acquired junctional melanocytic naevi. Patients/Methods  We first studied the effect of the Q‐switched and normal mode ruby laser on 12 patients (eight women and four men) with acquired melanocytic naevi. The effect was monitored by histology and clinical photography. Results  If the response to one treatment with the Q‐switched laser mode was not completely effective, the lesions were subsequently treated with one or two sessions with the laser in normal mode. All flat lesions responded completely. After a follow‐up period of 1 year they had not recurred. Slightly elevated lesions showed only a partial response, e.g. disappearance of the junctional part of the naevus but recurrence of the dermal part of the naevus. Red–brown junctional naevi as seen in skin types I and II did not respond well to ruby laser treatment. Conclusions  The Q‐switched ruby laser was very successful in completely removing flat (non‐palpable) acquired junctional melanocytic naevi, but not compound naevi, with one to three treatment sessions, without any scarring or pigmentary disturbance.