Becker Nevus Treatment Response? (Photo)

Question

I have tested two lasers to try treat BN. Mentioned in picture, the nd one month and a half ago and the second 1m. Why is the surrounding lines seems more dark? I have started with nag nd and after one month the doctor did not recommend to continue and said "live with it" because it become spotty. But I insisted we try something different. Can I treat the whole area with Nd and if there are areas not treated well can I only go over it again to reduce until it's even or at least not noticeable

Anna Chacon, MD, FAAD · Answer

Treating Becker Nevus (BN) can be challenging, as this type of pigmentation often responds variably to different treatments. The darkening of the surrounding lines may be due to post-inflammatory hyperpigmentation, which can occur after laser treatments, especially if the skin is sensitive or prone to pigmentation changes.

Here are some considerations and options for managing Becker Nevus:

Laser Treatments: While laser treatments, including Nd:YAG and other types, can be used to target pigmentation, they may not always yield consistent results for Becker Nevus. It's crucial to have realistic expectations and understand that multiple sessions may be needed. Additionally, treating only the uneven areas with laser might help achieve a more uniform appearance, but it requires careful planning by an experienced dermatologist.

Post-Treatment Care: Ensure you are following a post-treatment care regimen, including using sunscreen daily to prevent further pigmentation and protect sensitive skin. This can help minimize post-inflammatory hyperpigmentation.

Alternative Treatments: If laser treatments are not providing satisfactory results, discuss other options with your dermatologist. These might include topical treatments or different laser technologies that might be more suitable for your skin type and condition.

Consultation with a Specialist: Given the complexity of treating Becker Nevus, consider consulting with a dermatologist who specializes in pigmentary disorders. They can provide a more tailored treatment approach based on the specifics of your condition.

Ultimately, while treating Becker Nevus can be frustrating, working closely with a dermatologist to explore different treatment avenues and manage expectations is key to finding a solution that works for you.

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