Combination 1550 nm non‐ablative fractional resurfacing and laser hair removal for treatment of Becker's nevi in skin types III–VI

Abstract Objectives Becker's nevus is a cosmetically bothersome benign hamartoma typically associated with basal layer hyperpigmentation and hypertrichosis. We herein present the largest case series characterizing treatment parameters and clinical outcomes of combined 1550 nm non‐ablative fractional resurfacing and laser hair removal (long‐pulsed neodymium‐doped yttrium aluminum garnet or alexandrite) in the treatment of Becker's nevus. This is also the largest case series of laser treatment of Becker's nevus in Fitzpatrick skin types V and VI. Methods We performed a retrospective review of patients treated between 2016 and 2021. Clinical photographs were graded by three independent physicians using a 5‐point visual analog scale. Results Twelve patients (mean age: 24.8 years, Fitzpatrick skin types III–VI) were treated for Becker's nevus on the face (4) or the trunk and/or extremities (8). Four patients were Fitzpatrick skin types V or VI. On average, patients received 5.3 treatments in 1–4‐month intervals. Ten of the 12 patients had concomitant laser hair removal preceding same‐day non‐ablative fractional resurfacing ( n = 7 with long‐pulsed 1064 nm neodymium‐doped yttrium aluminum garnet and n = 3 with long‐pulsed 755 nm alexandrite). The number of treatments with each modality was determined by patient satisfaction with improvement in hyperpigmentation and hypertrichosis. At follow‐up, which ranged from 6 to 40 weeks (mean 10.5 weeks), patients were given a mean improvement score of 51%–75%. No long‐term adverse events were encountered in either group. Limitations include a small sample size and a lack of long‐term follow‐up. Conclusion Combination 1550 nm non‐ablative fractional resurfacing and laser hair removal is safe and efficacious in the cosmetic reduction of hyperpigmentation and hypertrichosis associated with Becker's nevus, including those with Fitzpatrick skin types V and VI.