Comparison Of The Efficacy And Safety Of Four Kinds Of Laser Therapy In The Treatment For Nevus Spilus

Background Nevus is the most commom benign tumor of skin.It can be divided into two types,congenital and acquired.Different types of nevis are located at different depths within the skin.Based on the depth of the pigment,nevus is divided into: cells in the epidermis?junctional?,dermis?intradermal?,and both areas?compound?.Traditional treatments for nevis include cryotherapy,dermabrasion,chemical peel,microwave treatment and excision.These methods are generally ineffective,invasive,and even result in scars and dyspigmentation,based on the theory of selective photothermolysis and the application of quality-switched technology.Melanin can be specifically targeted by the energy of laser and the surrounding tissue damage is very small.The laser has become the main method for the treatment of nevus.Several types of lasers and lights have been used for this purpose,including carbon dioxide laser,Q-switched Neodymium-doped yttrium aluminum garnet laser,Q-switched Erbium-doped yttrium aluminum garnet laser,Q-switched ruby laser,Q-switched alexandrite laser and fractional laser.Purpose The aim of this study was to evaluate the efficacy and safety of Q-switched Nd:YAG laser?Medlite C6 laser?,fractional CO₂ laser,carbon dioxide laser and fractional CO₂ laser combined with Medlite C6 laser for treating nevus spilus.Methods Forty outpatients diagnosed with nevus spilus were divided into four groups randomly,group A: Q-switched Nd:YAG laser?Medlite C6laser?treatment group;group B: Super pulse fractional CO₂ laser treatment group;group C: carbon dioxide laser treatment group and group D: Super pulse fractional CO₂ laser combined with Medlite C6 laser treatment group.Group A were treated with 1064 nm laser first and then scanned with 532 nm laser.Group B were treated with fractional CO₂laser?Active FX?mode?.Group C were treated with carbon dioxide laser to cleaning the melain.Group D were treated with fractional CO₂laser?Active FX? mode?to remove the nevus.The whole lesion was then scanned with Q-switched Nd:YAG laser?1064and 532 nm per scan?.At 3 months after the last treatment,the efficacy was evaluated using a six-point scale: 0: no change;1: 1-24% improvement;2: 25-49%;3: 50-74%;4: 75-89%;5:90-100%.Results Group A:On average,the patient were treated 1.7 times.Among the ten patient,50-74% improvement was seen in 1 patient,25-49% in two,1-24% in three,three was invalid,no scar were found.The total effective rate was 10%.Group B:On average,the patient were treated 2.1times.Among the ten patient,75-89% improvement was seen in two patient,50-74% in five,25-49% in three,two cases of hyperplastic scar and one case of pitting scar.The total effective rate was 40%.Group C:On average,the patient were treated 1.7 times.Among the ten patient,90-100% improvement was seen in one patient,75-89% in five,50-74% in three,1-24% in one,three cases of hyperplastic scar and three case of pitting scar.The total effective rate was 30%.Group D:On average,the patient were treated 2.4 times.Among the ten patient,90-100% improvement was seen in six patient,75-89% in two,50-74% in two,one cases of hyperplastic scar.The total effective rate was 90%.Conclusion Compared with the other three treatments.The fractional CO₂ laser combined with Medlite C6 laser for treating nevus spilus has a hign pigment clearance rate,lowest incidence of scar and pigment change.It is worthy of a clinical trial.