Table 2.

Summary of advanced treatments for dermal melanocytosis (nevus of Ota and Hori’s nevus) in SoC based on recent studies.

Author	Study Type	Year	Laser	Therapy Parameters	Fitzpatrick Scale	No. of Cases	Clinical Outcome	Adverse Events
Imagawa et al. [24]	Prospective comparative study	2023	550-ps 755 nm and 50-ns 755 nm lasers	Clinical endpoint for fluence choice was immediate whitening, with fluence ranging from 2.33 to 3.36 J/cm2 for ps laser and 5.5 to 7 J/cm2 for ns laser. PD: 550 ps and 50 ns for respective lasers; 2.5–3 mm spot	III–IV	10	Ps laser had superior efficacy, requiring fewer average sessions (4.2) than ns-laser (5.4)	Hyper- and hypopigmentation occurred in the ns group. The ps group had no side effects.
Yang et al. [25]	Retrospective study	2022	ps-755 nm Alexandrite laser	Fluence 1.96–2.08 J/cm2, 3.5–4.0-mm spot	III-IV	86	96.5% of patients achieved >95% clearance in an average of 4.3 sessions. Early onset of lesions (<5 months of age) and darker skin types (type IV vs. III) significantly increased the number of sessions required for clearance. Age at first treatment, sex, and nevus color had no significant effect.	Transient hyper- and hypopigmentation
Koh et al. [20]	Retrospective review	2020	Picosecond 755-nm laser	For NO, the average fluence was 2.02 J/cm2, and for HN, it was 2.08 J/cm2	III/IV	29	In the NO group, mean pre-and-post-treatment Physician global assessment scores were 3.1 and 1.3, respectively (1.8-point change, p = 0.0002). In HN group, mean pre-and-post-treatment PGA scores were 2.6 and 1.1, respectively (1.5-pt change, p = 0.004)	Eleven patients (37.9%) experienced post-laser erythema, and 1 (3.4%) developed transient post-laser hypopigmentation.
Ge et al. [27]	RCT (Split-lesion study in nevus of Ota)	2020	Ps-755-nm Alexandrite laser versus ns-QS 755-nm Alexandrite laser	Each lesion was treated with single-pass method in up to 6 sessions at 12-week intervals. ps-laser: 2–4 mm spot, 1.59–6.37 J/cm2, 5 Hz. Ns-laser: 3 mm spot, 5–7 J/cm2, 5 Hz.	III–IV	56	Higher efficacy, decreased pain scores, and post-inflammatory hyper/hypopigmentation in the ps laser-treated group.	There was an improved clearance, with fewer side effects and more patient satisfaction in the ps-laser arm.
Hu et al. [28]	Retrospective study	2021	Ps-755-nm Alexandrite laser	Fluence 2.73–3.98 J/cm2, spot size 2.9 to 2.4 mm, PD 650-ps, 1 to 4 sessions.	III–IV	36	88.89% of patients had moderate to marked improvement.	Transient swelling and erythema. Transient PIH (in two patients) and hypopigmentation (in one patient) that resolved in 6 weeks.
Yu et al. [29]	RCT (Split-face study in Hori’s nevus)	2018	ps 755-nm Alexandrite laser vs. ns-QS 755-nm Alexandrite	12-week interval. ps-laser: 2–2.5 mm spot, 4.07–6.37 J/cm2, 2.5 Hz. Ns-laser: 3 mm spot, 6–8 J/cm2, 2 Hz.	III–IV	30	The PSAL-treated area achieved significantly better clearance (3.73 vs. 2.4) with less severe pain (4.47 vs. 5.16)	the PSAL and QSAL treatments, lasting for nearly one and a half months
Belkin et al. [23]	Retrospective case series	2018	QS lasers (Ruby 694 nm in type IV and QS Nd:YAG 1064 nm in types V, VI)	Patients were treated without general anesthesia or sedation; corneal shields were used where appropriate.	IV–VI	24 (children <18yrs)	Excellent response (76–100% improvement) in 70% of patients and good to excellent response (51–100% improvement) in 86%. Fewer sessions/lesser fluence required and fewer complications in younger patients.	Two patients (8%) had post-inflammatory hyperpigmentation, one of whom also had focal hypopigmentation.
Nam et al. [30]	Retrospective study	2017	Multiple QS laser modalities	Settings varied for different laser machines.	/	67	An average of 19 sessions (range 10–27, p = 0.001) is required for 95% clearance.	Two patients (3%) had persistent side effects, e.g., atrophic scarring, though not mentioned how many sessions these patients underwent.

PD Pulse Duration; NO Nevus of Ota; HN Hori’s Nevus; / refers to detail not mentioned in study.