Journal of the American Academy of Dermatology · 2026
Model-guided non-whitening endpoint for 755-nm picosecond laser treatment of acquired bilateral nevus of Ota-like macules (ABNOM) in pigmented skin: A randomized split-face trial.
СтатьяРандомизированное исследованиеСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Wang Xue, Wu Xiaojin, Wu Xianglei, Shang Ying, Lin Xiaoxi, Ozawa Toshiyuki, Tsuruta Daisuke, Shimojo Yu, Zhang Zhen
Аннотация
BACKGROUND: Post-inflammatory hyperpigmentation (PIH) is a major concern in laser treatment of dermal melanocytosis in pigmented skin, particularly when immediate whitening is used as the therapeutic endpoint.
OBJECTIVE: To compare a computational model-guided non-whitening endpoint with the conventional whitening endpoint for treating acquired bilateral nevus of Ota-like macules (ABNOM) using a 755-nm picosecond alexandrite laser.
METHODS: In this prospective, randomized, evaluator-blinded, split-face trial, 30 Asian patients (Fitzpatrick skin types III-V) underwent 3 sessions at 6-month intervals. One facial side received a larger spot size and lower fluence designed by a melanosome-disruption threshold fluence model to achieve a nonwhitening endpoint. The contralateral side received a smaller spot size and higher fluence to achieve immediate whitening.
RESULTS: Both endpoints achieved comparable and high clearance after 3 sessions (Global Aesthetic Improvement Scale >3.85/4). However, the whitening endpoint resulted in higher rates of PIH (22.6% vs 4.8%, P < .05) and scabbing (61.9% vs 9.5%, P < .05). Patient satisfaction was high for both approaches, with 68% preferring the non-whitening endpoint.
LIMITATIONS: Single-center study with limited inclusion of Fitzpatrick skin types III-V.
CONCLUSION: The model-guided nonwhitening endpoint achieved comparable efficacy with less PIH and scabbing, supporting a safer strategy for ABNOM in pigmented skin.
OBJECTIVE: To compare a computational model-guided non-whitening endpoint with the conventional whitening endpoint for treating acquired bilateral nevus of Ota-like macules (ABNOM) using a 755-nm picosecond alexandrite laser.
METHODS: In this prospective, randomized, evaluator-blinded, split-face trial, 30 Asian patients (Fitzpatrick skin types III-V) underwent 3 sessions at 6-month intervals. One facial side received a larger spot size and lower fluence designed by a melanosome-disruption threshold fluence model to achieve a nonwhitening endpoint. The contralateral side received a smaller spot size and higher fluence to achieve immediate whitening.
RESULTS: Both endpoints achieved comparable and high clearance after 3 sessions (Global Aesthetic Improvement Scale >3.85/4). However, the whitening endpoint resulted in higher rates of PIH (22.6% vs 4.8%, P < .05) and scabbing (61.9% vs 9.5%, P < .05). Patient satisfaction was high for both approaches, with 68% preferring the non-whitening endpoint.
LIMITATIONS: Single-center study with limited inclusion of Fitzpatrick skin types III-V.
CONCLUSION: The model-guided nonwhitening endpoint achieved comparable efficacy with less PIH and scabbing, supporting a safer strategy for ABNOM in pigmented skin.