Nevus of Ota and melasma are dermal hyperpigmentation disorders that present significant therapeutic challenges due to their complex etiologies and variable responses to treatment. This case report describes a 44-year-old Chinese woman with Fitzpatrick skin type IV who presented with concurrent Nevus of Ota and melasma affecting the left side of her face and forehead since childhood. Previous treatments, including non-ablative laser therapy and topical agents, showed minimal improvement.

The patient underwent ten sessions of 1064 nm Q-switched Nd:YAG laser in Quickly-pulse-to-pulse (Q-PTP) mode over one year, with intervals of 1–2 months between treatments. For Nevus of Ota, parameters included fluence of 4.0–5.2 J/cm², 4 mm spot size, 5 Hz pulse rate, delivered in a single pass. For melasma, settings included fluence of 0.7–0.8 J/cm², 8 mm spot size, 10 Hz pulse rate, administered in three passes.

Post-treatment evaluation demonstrated improvement in the Melasma Area and Severity Index (MASI) score from 5.2 to 2.6. Clinical assessment revealed Grade II (26–50%) improvement in Nevus of Ota and moderate improvement in melasma, with enhanced overall skin tone and high patient satisfaction. No major adverse effects were observed.

These findings suggest that the 1064 nm Q-switched Nd:YAG laser in Q-PTP mode may represent a promising and safe therapeutic option for managing concurrent Nevus of Ota and melasma, particularly in Asian patients. Larger-scale studies are required to further validate long-term efficacy and safety.

Dr. Chan Qing Yan is a medical practitioner based at UR Klinik SS2, Petaling Jaya, Selangor, Malaysia, with a focused clinical interest in aesthetic dermatology. She has particular expertise in managing pigmentary disorders in Asian skin types, including melasma and dermal melanocytosis. Her practice emphasizes evidence-based laser and energy-based treatments, prioritizing safety, precision, and individualized treatment strategies to achieve optimal clinical outcomes and patient satisfaction.

Dr. Chan graduated with merits from Universiti Tunku Abdul Rahman (UTAR). She further expanded her surgical exposure through a clinical attachment in Plastic and Reconstructive Surgery at Chang Gung Memorial Hospital, Taiwan, gaining valuable insight into advanced procedural techniques and aesthetic principles. She completed her Housemanship training at Hospital Universiti Kebangsaan Malaysia (HUKM) and subsequently obtained her Medical Aesthetic Certification (MAC), reflecting her strong commitment to the field of aesthetic medicine. She is currently in the process of obtaining her Letter of Credentialing and Privileging (LCP) certification.

Beyond clinical practice, Dr. Chan is active on social media, where she shares educational aesthetic content and clinical insights, advocating for safe, ethical, and scientifically grounded aesthetic treatments.