Nevi of Ota and Ito Treatment & Management

Updated: Mar 26, 2019
  • Author: Omobola Onikoyi, DO, MSc; Chief Editor: Dirk M Elston, MD  more...
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Treatment

Approach Considerations

It is important to note that some treatment methods may result in scarring, and recurrence is a possibility.

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Medical Care

Cosmetic camouflage makeup can minimize the disfiguring facial pigmentation resulting from nevus of Ota. [39] Nonsurgical methods include chemical peeling, dermabrasion, and topical hydroquinone-based bleaching products.

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Surgical Care

Laser surgery is the first-line treatment. [40] Pulsed Q-switched laser surgery is the treatment of choice for nevi of Ota and Ito, and it works via selective photothermal and photomechanical destruction of dermal melanocytes and melanophages. High success rates and minimal adverse effects have been reported with the Q-switched ruby, [41] Q-switched alexandrite, [42, 43, 44] and Q-switched Nd:YAG lasers. [42, 45] After 4-8 treatments, skin pigmentation is reduced dramatically or removed in 90-100% of cases, with a less than 1% risk of scarring.

In 2016, it has been shown that similar results may be achieved using a 755-nm Q-switched picosecond laser compared with Q-switched nanosecond lasers. In a 2016 study of patients with nevus of Ota, there was no statistically significant difference in visual analog scores for six patients treated with the picosecond laser and ten patients treated with nanosecond laser. Notably, no picosecond laser‒treated patients experienced any permanent dyspigmentation, compared with 16% in the nanosecond laser group. [46]

Other surgical methods currently have been superseded by laser surgery but include the following:

  • Cryotherapy [47]
  • Microsurgery
  • Dermabrasion (alone or combined with other modalities, such as carbon dioxide snow, autologous epithelial grafting)
  • Sequential dry ice epidermal peeling
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Consultations

Secondary to the increased risk of ocular melanoma in patients with nevus of Ota, it is important for patients to receive consultation with ophthalmologists with biannual follow up.

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Complications

Complications of surgical treatment include a risk of scarring.

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