This 3-part series explains in detail the common pigmentary issues we take care of at IYAC.

Melasma, Hori’s Nevus, Age or Sun Spots

Although this pigmentary condition can take 1 to 2 years of regular treatments to clear, when the pigments are gone, the skin stays clear with good skincare.
 

What is Hori’s Nevus?

This acquired pigmentation typically occurs in Asians of Chinese ancestry. It’s more common in females and appears as light brown or blue-grey spots on the cheeks. Over time, the spots can merge to form a confluent patch.

Some visible lightening of the pigments happens after multiple sessions – at least 6 sessions of Laser Circuit or 3 sessions of pico laser 

On average, most patients clear the pigments to their satisfaction after 1 to 2 years of regular treatments (i.e., at least 12 sessions of Laser Circuit or 6 sessions of pico laser).
 

What’s IYAC’s approach to Hori’s Nevus?

Hori’s Nevus requires multiple sessions for visible lightening; skin can remain clear with good skincare once the pigments are gone.

At IYAC, we tackle this challenging pigment using a multimodal approach.

Topicals:

• Pharmaceutical-grade creams containing cysteamine^1,2 (antioxidant) prevent and lighten pigments.

Orals:

• Skin supplements can help to resist new pigment formation.

Skincare:

• Skin well-nourished and hydrated is less prone to new and stubborn pigments. – Use clean skincare that’s been formulated to contain botanical ingredients, with no nasties and with anti-pigment, moisturising and rejuvenation benefits.
• Sunscreen: Apply sufficiently (2 finger lengths to face and neck) with high SPF, UVA and UVB protection. Reapply regularly throughout the day.

Lasers are the mainstay treatment for Hori’s Nevus

• There are FDA-approved lasers to target Hori’s Nevus– the Laser for toning^3,4 and the picosecond pico laser ^5,6.
• These lasers break down pigments and lighten over time
• Generally, at least 6 to 12 sessions are needed before any visibly significant lightening of pigments can be appreciated.
• At each visit, depending on the type of laser and intensity that’s decided, pigments can:
  – Turn 2 to 3 shades darker & gradually lighten up in 2 to 8 weeks or
  – Develop petechiae (small red dots under the skin) & heal over 3 to 7 days, then gradually lighten up in 2 to 8 weeks

Hori’s Nevus requires regular consistent treatments over 1 to 2 years to clear, but when the pigments are gone, the skin can stay clear.

Speak with us at IYAC to let us guide you on a journey to clean and healthy skin.

References:

1. Besouw M, Masereeuw R, van den Heuvel L, Levtchenko E. Cysteamine: an old drug with new potential. Drug Discov Today. 2013 Aug;18(15-16):785-92. doi: 10.1016/j.drudis.2013.02.003. Epub 2013 Feb 14. PMID: 23416144.
2. Mansouri P, Farshi S, Hashemi Z, Kasraee B. Evaluation of the efficacy of cysteamine 5% cream in the treatment of epidermal melasma: a randomized double-blind placebo-controlled trial. Br J Dermatol. 2015 Jul;173(1):209-17. doi: 10.1111/bjd.13424. Epub 2015 May 29. PMID: 25251767.
3. Levin MK, Ng E, Bae YS, Brauer JA, Geronemus RG. Treatment of pigmentary disorders in patients with skin of color with a novel 755 nm picosecond, Q-switched ruby, and Q-switched Nd:YAG nanosecond lasers: A retrospective photographic review. Lasers Surg Med. 2016 Feb;48(2):181-7. doi: 10.1002/lsm.22454. PMID: 26922302.
4. Kaur H, Sarma P, Kaur S, Kaur H, Prajapat M, Mahendiratta S, Kumar S, Thota P, Parsad D, Medhi B. Therapeutic options for management of Hori’s nevus: A systematic review. Dermatol Ther. 2020 Jan;33(1):e13167. doi: 10.1111/dth.13167. Epub 2019 Dec 3. PMID: 31714651.
5. Koh YP, Tan AWM, Chua SH. Treatment of Laser-Responsive Dermal Pigmentary Conditions in Type III-IV Asian Skin With a 755-nm Picosecond Pulse Duration Laser: A Retrospective Review of Its Efficacy and Safety. Dermatol Surg. 2020 Nov;46(11):e82-e87. doi: 10.1097/DSS.0000000000002332. PMID: 32068548; PMCID: PMC7587240.
6. Hu S, Yang CS, Chang SL, Huang YL, Lin YF, Lee MC. Efficacy and safety of the picosecond 755-nm alexandrite laser for treatment of dermal pigmentation in Asians-a retrospective study. Lasers Med Sci. 2020 Aug;35(6):1377-1383. doi: 10.1007/s10103-020-02959-7. Epub 2020 Jan 21. PMID: 31965352.