Summary

Skin nevi, commonly known as moles or birthmarks, encompass a spectrum of benign proliferations of melanocytes or keratinocytes. While most nevi are harmless, their appearance can carry psychosocial burden or, in rare cases, risk of malignant transformation. Traditional management has included surgical excision, dermabrasion and topical therapies, but these may leave scarring or incomplete clearance. Laser therapy has emerged as a precise, minimally invasive modality that targets pigment or tissue with specific wavelengths of light, inducing selective photothermolysis. Q-switched lasers emit nanosecond pulses to fragment melanin-rich cells, whereas picosecond devices deliver even shorter bursts to achieve finer disruption of pigment granules. Fractional ablative and non-ablative platforms create microthermal zones to stimulate remodelling while preserving surrounding tissue architecture. Advances in laser physics and delivery systems have broadened the armamentarium for treating both congenital melanocytic nevi and acquired epidermal variants such as Becker’s nevus. Optimal outcomes depend on matching wavelength, pulse duration and energy density to lesion type, depth and skin phototype. Multiple sessions are often required to achieve satisfactory lightening or hair reduction, balanced against potential side effects of repigmentation, erythema or textural change. Current research seeks to refine protocols, improve consistency of clearance and minimise adverse effects, with an emphasis on objective outcome measures and patient-centred satisfaction.

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Laser Treatment of Skin Nevi publication trend

The graph below shows the total number of articles in laser treatment of skin nevi across all publications each year (not limited to Nature Index journals).

Technical terms

Nevi: Benign aggregations of melanocytes or keratinocytes forming pigmented skin lesions.

Photothermolysis: The process by which absorbed laser energy generates heat to selectively destroy target cells without damaging adjacent tissue.

Q-switched laser: A laser emitting high-energy nanosecond pulses that fragment pigment particles for clearance by the lymphatic system.

Picosecond laser: A laser delivering ultra-short, picosecond pulses to achieve more precise pigment fragmentation and reduced thermal diffusion.

Fractional laser: A device creating microscopic columns of ablation or coagulation, stimulating remodelling while sparing intervening skin.

Hyperpigmentation: Darkening of the skin due to excess melanin deposition, often targeted in nevus clearance.

References

  1. A Retrospective Analysis of the Efficacy and Safety of Q‐Switched and Picosecond Lasers for Treating Becker’s Nevus. Dermatologic Therapy (2023).

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