Comparison of a picosecond alexandrite laser versus a Q-switched alexandrite laser for the treatment of nevus of Ota: A randomized, split-lesion, controlled trial

Abstract Background Novel picosecond lasers have been available for various pigmentary disorders. However, there are limited data directly comparing picosecond lasers and Q-switched lasers for treatment of nevus of Ota. Objective To compare the efficacy and safety of a picosecond alexandrite laser (PSAL) compared with a Q-switched alexandrite laser (QSAL) for the treatment of nevus of Ota. Methods Each lesion of the 56 participants enrolled was split into two parts and randomly assigned to either PASL or QSAL treatment arm. Each lesion was treated up to 6 sessions at a 12-week interval. The efficacy and safety were determined based on blinded visual evaluation and self-report at each follow-up visit. Results PSAL arm achieved a significantly better clearance (4.53 vs 4.0) with fewer sessions (5.26 vs 5.87) and less severe pain (5.61 vs 6.40). Patients were more satisfied with PSAL than QSAL (4.5 vs 4.0). Occurrences of post inflammatory hyperpigmentation (26% vs 34%) and hypopigmentation (21% vs 47%) were also lower in PSAL than QSAL arm. Limitations Lack of objective assessments and outcome measures. Conclusions PSAL demonstrated better clinical results and fewer adverse events than QSAL for the treatment of nevus of Ota.