Investigating the efficacy and safety of the 755-nm picosecond alexandrite laser in treating nevus of Ota: A systematic review and meta-analysis.

[BACKGROUND] The nevus of Ota is an uncommon pigmentary skin condition that causes bluish-gray pigmentation and is traditionally treated with a Q-switched laser. Emerging evidence suggests that the 755-nanometer picosecond alexandrite laser is a safe and effective therapeutic option. We sought to determine the overall effectiveness and safety profile of the 755-nanometer (nm) picosecond alexandrite laser for managing nevus of Ota.

[METHODS] We reviewed 6 databases for studies that addressed the safety as well as efficacy profile of the 755-nm picosecond alexandrite laser for nevus of Ota. Ten studies, including 558 individuals with nevus of Ota, were included. The main outcomes were the rate of excellent clinical response and reported side effects encompassing erythema as well as post-inflammatory pigmentary alterations, including both hyperpigmentation and hypopigmentation. Review Manager Version 5.4 and Comprehensive Meta-Analysis v3 software were used for data analysis.

[RESULTS] The pooled excellent clinical response rate for the 755-nm picosecond alexandrite laser was found to be 36.8% (95% confidence interval [24.4-51.2%], P = .642). Post-inflammatory hyperpigmentation and hypopigmentation were each observed in 20.6% and 12.2% of the cases (P-value < .001), respectively. Post-inflammatory erythema, assessed in 2 studies (n = 23), demonstrated a pooled prevalence of 45.2% (95% confidence interval: 12.9-82.2%).

[CONCLUSION] The 755-nm picosecond alexandrite laser demonstrated moderate effectiveness and a favorable safety profile in the treatment of nevus of Ota. Pigmentary complications occurred at relatively low rates across the included studies. Further high-quality prospective and randomized controlled trials are required to confirm long-term effectiveness and safety.