Importance:Currently, there are no standardized outcome domains or measures in clinical trials for facial aging. Heterogeneity in outcome domains and measurement instruments across clinical trials creates difficulty in directly comparing interventions, determining superior therapies, and developing high-quality meta-analyses. Objective:To develop a core outcome set (COS) of essential domains to be reported in clinical trials evaluating the efficacy of interventions for facial aging. Evidence Review:PubMed/Medline, Embase, Cochrane Central Register of Controlled Trials, and CINAHL were searched from September 2005 to September 2015. An updated search of the same databases was performed from September 2015 to February 2026. Studies were included if (1) they were randomized clinical trial or controlled clinical trial in design, (2) they assessed the efficacy or safety of an intervention for facial aging, (3) they were published in English, and (4) they involved human participants. Complementary sources, including patient interviews, were used to capture further relevant outcomes. Two rounds of Delphi surveys, followed by consensus meetings, were used to identify outcome domains considered most important by both patient and physician stakeholders. Findings:The final COS consists of 6 outcome domains: (1) overall convenience of treatment; (2) time to return to normal work and social activity; (3) overall assessment of focused area of treatment (at the point in time when treatment is expected to provide peak benefit); (4) duration of treatment effect; (5) severity of persistent local or systemic adverse events, including pigmentary change, skin texture change, delayed healing, scarring, and serious adverse events; and (6) patient satisfaction with treatment. Conclusions and Relevance:The 6 outcome domains identified through a Delphi consensus are recommended for reporting in future facial aging trials to ensure that outcomes that matter most to patients and clinicians are measured and that results are comparable across interventions.

Fractional radiofrequency (FRF) has been reported to be effective in improving wrinkles. A combination of microneedle and sublative fractional radiofrequency (SFRF) may have the potential synergy to improve photoaged skin. To evaluate the efficacy and safety of combined microneedle and SFRF in photoaging management. This prospective study included 12 subjects with moderate photoaging (skin phototype III–IV). The subjects received three consecutive combined microneedle and sublative FRF at 1-month intervals. Punch biopsies were obtained before and after three months of treatment. Routine H E, Masson-trichrome, Orcein staining, histometric measurements, as well as Collagen type I and Elastin immunohistochemical staining were performed. Significant improvement was noticed regarding skin tightening and texture (p < 0.05), rhytides, and volunteers’ satisfaction (p < 0.001). Collagen fibers appeared better organized, with a significant increase in collagen type I (p = 0.001). Meanwhile, normal-appearing elastic fibers were restored, and a significant reduction in abnormal elastin was achieved (p = 0.0005). Combined microneedle and sublative FRF may provide a new therapeutic approach for photoaged skin. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Abstract:Background: For unexplained reasons, surgical scars are specific to humans and do not exist in other animals. Excessive collagen synthesis and deposition by fibroblasts results in surgical scars. The current study's objective is to compare the effectiveness of microneedling alone to its use combined with platelet rich plasma (PRP) in the treatment of surgical scars.Methods: The present study included 20 patients suffering from disfiguring surgical scars seeking for better cosmetic appearance. Patients were divided into 2 equal groups: group I (microneedling only) and group II (microneedling plus PRP).Results: Clinical improvement was statistically significantly higher in group II; 42.1 ± 18.0% vs. 31.6 ± 8.3%, p= 0.05. Mild, moderate and good cases among group II were 2 (20.0%), 5 (50.0%) and 3 (30.0%) respectively vs. 4 (40.0%), 6 (60.0%) and 0 (0%) in group I respectively (p= 0.04). Conclusion: For the treatment of surgical scars, microneedling combined with PRP works better than microneedling alone.Keywords: Micro-needling; PRP; Surgical Scars

Background A variety of therapeutic approaches have been introduced for striae distensae (SD) with modest outcomes. Fractional carbon dioxide laser (FCL) and platelet-rich plasma (PRP) are effective separately in improving SD. Objective To assess the safety and efficacy of topically applied PRP combined with FCL in the management of SD. Patients and methods In this prospective, single-blinded, randomized, comparative intrapatient study, 24 patients with bilateral SD lesions were subjected to FCL on both sides and followed by topical application of PRP on one side only allocated by simple randomization. The sessions were performed biweekly for a total of six sessions. Overall clinical improvement was graded using the Quartile Grading Scale. Biopsies, before and after treatment, were stained with H and E, Masson’s trichrome, and Orcein stains. In addition, collagen I and elastin immunohistochemical staining were performed. Results In this study of 24 SD patients (19 females, 5 males; aged 19–39 years), topical PRP with FCL achieved moderate to excellent outcomes 3 months after the last session. Early striae rubra improved after the initial session, reaching marked excellent outcomes within a month after the second session. Manageable side effects were reported. Histological examination showed improved epidermal and dermal thickness, collagen, and elastic fiber quality after treatment, with the combined PRP and FCL side exhibiting more significant outcomes than the FCL-treated side. Conclusion Topical PRP application post-FCL proves to be a highly effective therapeutic approach for SD, expressing superior treatment outcomes, and heightened patient satisfaction compared with the use of FCL alone. In additio, topical application is preferred over intradermal injection, offering practicality, effectiveness, and noninvasiveness.

Background:Striae distensae (SD) is a common cutaneous disorder which appears as linear lesions seen mainly in women. Since previously described in 1889, SD has presented a significant challenge regarding its evaluation and treatment. Carboxytherapy was recently reported as an effective treatment for SD. Objectives:We sought to objectively compare the clinical effectiveness of carbon dioxide therapy (CDT) as monotherapy versus a combination of CDT and fractional CO2 laser in the treatment of SD. Methods:This randomized prospective study included twenty cases with bilateral and symmetrical SD. Each patient was treated with CDT only on the right (Rt) side of the body, while the left (Lt) side received a combination of CDT and fractional C02 laser. Results:Clinical evaluation revealed a clearly significant clinical improvement in SD lesions after both techniques regarding length, width, texture, and pigment changes. Although the Lt side showed slightly better improvement, however no statistically significant difference could be observed between both sides. In the meantime, the objective improvement observed by the 3D camera and histometric analysis correlated with the clinical improvement. Special stains showed collagen deposition which became more compact, dense and better organized, accompanied by evident increase in elastic fibers in a normal linear microfibrillar pattern after treatment on both sides. Conclusion:CDT demonstrated efficacy and safety as a minimally invasive modality for management of SD, as it induces collagen remodeling and better organization of elastic fibers with minimal side effects and downtime.

Microneedling is a minimally invasive procedure using fine needles to puncture the skin.The aim of this study is to compare the clinical efficacy as well as the histological effects of dermaroller versus dermapen in the management of post-acne atrophic scars.The study was conducted on 10 patients with post-acne atrophic scars. A split-face study design was performed for 6 sessions 2 weeks apart. Dermaroller was used for the right side, while dermapen was used for microneedling of the left side of the face with 2.5 mm long needles for both sides. Biopsy was taken from both sides before and at 2 weeks after last session. Each biopsy was stained with Hematoxylin and Eosin, Orcein, and Masson trichrome stains. There was significant improvement (p < .05) on both sides of the face when comparing after treatment to baseline. In spite of better clinical improvement observed on the dermaroller-treated side, however a non-significant difference was observed between both sides of the face (p = .618). Meanwhile, there was a better improvement on boxcar and rolling scars than that on icepick scars. In conclusion, microneedling showed significant clinical and histological improvement in the management of atrophic post-acne scars with no significant difference between using dermaroller or dermapen. The dermaroller session is more rapid as it covers a larger skin surface area, but with more pain and bleeding during the session than dermapen, and post-session erythema and edema are slightly more apparent after dermaroller.

BACKGROUND:Facial erythema in rosacea is a troublesome embarrassing presentation with limited options of treatment. Daily brimonidine gel was shown to be an effective modality of treatment. Being unavailable in Egypt and the scarcity of objective evaluation of its therapeutic effect motivated the search for other alternatives.OBJECTIVE:To evaluate the use and effectiveness of topical brimonidine eye drops for the management of facial erythema in rosacea with the aid of objective assessment.METHODS:The study was conducted on 10 rosacea patients presented with facial erythema. Brimonidine tartrate eye drops 0.2% were applied twice daily for 3 months on areas of red facial skin. Punch biopsies were obtained before and after 3 months of treatment. Routine hematoxylin and eosin (H&E) staining as well as CD34 immunohistochemical staining were performed for all biopsies. Sections were examined to detect the changes in the count and the surface area of blood vessels.RESULTS:Evaluation of clinical results showed good improvement of facial redness at the end of treatment (55-75%). Only 10% of subjects expressed rebound erythema. H&E and CD34 stained sections showed an increased count of dilated dermal blood vessels, which decreased significantly after treatment in count and surface area (P = 0.005, and P = 0.004, respectively).CONCLUSION:Topical brimonidine eye drops proved to be effective in managing facial erythema in rosacea, providing an available and cheaper alternative to brimonidine gel. The study improved the subjective evaluation in the context of objective assessment of treatment efficacy.

BACKGROUND:Microneedling is a technique of repeated puncturing or drilling of the skin to induce repair and collagen induction. There are many reported important factors determining the efficacy of microneedling treatment. The extent of injury needed to produce the desired effect in each condition is one of these important factors.OBJECTIVES:We designed the present split-face comparative study to evaluate the use and effectiveness of two different depths of penetration of Dermapen needles in the management of atrophic postacne scars.PATIENTS AND METHODS:The present study involved 14 subjects with atrophic postacne scars. In each patient, both sides of the face were treated with six sessions of microneedling, using Dermapen at 2-week intervals. A split-face study design was performed. The right (Rt) side of the face was treated with Dermapen using 2.5 mm needle length, while the left (Lt) side was treated using 1.5 mm needle length.RESULTS:There was a significantly better percentage of improvement of acne scars on the Rt side of the face compared to the Lt side (P = 0.02) after six sessions. Both sides of the face showed improvement of collagen bundles and elastic fibers characteristics after six sessions.CONCLUSIONS:The use of 2.5 mm depth proved to be more effective both clinically and histologically in the management of atrophic postacne scars.

The Effect of Microneedling on Acne ScarsMoataz Bellah M. El-Domyati MD, Rasha T. A. Abdel-Aziz MD, Maha Mohamed-Elsayed MSc. Department of Dermatology, STD’s and Andrology, Faculty of Medicine, Minia University, Minia, EgyptAbstractBackground: Postacne scarring is disfiguring. Multiple modalities for treatment of acne scars have emerged and microneedling with dermaroller is one of them.Objectives: To evaluate the efficacy of microneedling treatment for atrophic facial acne scars.Methods: Ten patients with different types of atrophic acne scars were subjected to three months of skin microneedling treatment (six sessions at two-week intervals). Patients were photographed at baseline as well as one and three months from the start of treatment.Results: Compared to the baseline, patients’ evaluations revealed significant clinical improvement in atrophic post-acne scars in response to skin microneedling (p= 0.02).Conclusion: Microneedling is a simple and cheap, means of treatment modality for acne scars remodulation with little downtime, satisfactory results and with the advantage of being a relatively risk-free.Key words: Acne scars, Microneedling.

Background Striae distensae (SD) is a very common skin problem. Although a lot of treatment modalities have been proposed, few of them are effective. Recently, carbon dioxide therapy (CDT) or carboxytherapy was used in many indications of cosmetic dermatology such as SD. Objectives To objectively evaluate the use and effectiveness of CDT for treatment of SD. Patients and methods Twenty patients were subjected to 8 sessions of CDT injection at 2-week intervals using carboxy-gun. Patients were photographed, and skin specimens were obtained from the treated area before and after 4 months of treatment. Using a computerized 3D camera, skin topography was objectively analyzed before and after treatment. Evaluation of collagen and elastic fibers by special histopathological staining, in addition to histometric analysis, was also done to evaluate treatment efficacy. Results Clinically, SD was statistically significantly improved after CDT injection compared with baseline (mean percentage of improvement of length and width, 59.8 +/- 15.9; P < .05). Meanwhile, the improvement observed by the 3D camera correlated with the clinical improvement. Histometric analysis showed an increase in epidermal thickness (P < .0001) in association with re-appearance of rete ridges following treatment. Histochemical evaluation of changes in elastic and collagen fibers after treatment showed better organization of curled and fragmented elastic fibers, which was accompanied by an increase in collagen content that became denser, arranged in bundles and parallel to the epidermis. Conclusions CDT is an effective, promising, and simple minimally invasive procedure for improving SD with few side effects and low downtime.

BACKGROUND:Treatment of vitiligo with intralesional steroid (ILS) injections has shown to be successful in quite a few studies. It is a simple and safe treatment when used with caution with a better response in localized lesions.OBJECTIVES:The aim of the present study is to explore the efficacy and safety of using different concentrations of intralesional corticosteroid combined with NB-UVB phototherapy in the treatment of non-segmental vitiligo (NSV) patients.METHODOLOGY:Twenty patients with non-segmental vitiligo were subjected to different concentrations of ILS injections (triamcinolone acetonide); that was carried out monthly for six sessions. All patients were also subjected to twice-weekly sessions of NB-UVB for 6 months. Punch biopsy was taken from each patch before and at the end of treatment sessions. Each biopsy was stained with hematoxylin and eosin (H&E), Orcein, and Masson's trichrome stains.RESULTS:There was a significant difference between all groups in their repigmentation response (P = 0.017). After treatment, the epidermal thickness (histometry) was decreased (epidermal atrophy), especially with concentrations of 2.5 and 5 mg/ml of intralesional triamcinolone acetonide injection with decreased and disorganized collagen fibers.CONCLUSION:Intralesional corticosteroid injections combined with NB-UVB showed a good and well-tolerated therapeutic option for vitiligo. The concentrations of 0.625 and 1.25 mg/ml of triamcinolone acetonide were the safest with fewer side effects and complications. However, higher concentrations of 2.5 and 5 mg/ml were more effective but with more side effects.

Vitiligo is an acquired pigmentary skin disorder that currently lacks standardized treatment and validated biomarkers to objectively evaluate disease state or therapeutic response. Although prior studies have linked vitiligo autoimmunity with CXCL10/CXCL9-mediated recruitment of leukocytes to the skin, only limited clinical data are available regarding CXCL10 as vitiligo biomarker. To evaluate the utility of systemic CXCL10 as a predictor of disease progression and treatment response on a large cohort of vitiligo patients. CXCL10 levels in lesional, perilesional, and unaffected skin of vitiligo patient (n = 30) and in the serum (n = 51) were measured by quantitative ELISA. CXCL10 expression, recruitment of leukocytes, and inflammatory infiltrates were evaluated by histochemical (n = 32) and immunofluorescence (n = 10) staining. Rigorous cross-sectional and longitudinal biostatistical analysis were employed to correlate CXCL10 levels with disease variables, treatment response, and outcome. We demonstrated that elevated CXCL10 level (2 pg/mm2 and higher) in lesional skin correlates with increased leukocytic infiltrate, disease duration (< 2 year), and its higher level in the serum (50 pg/ml and higher). Changes in CXCL10 serum levels in patients treated with psoralen plus UVA (PUVA) phototherapy, narrowband UVB (NB-UVB) phototherapy, and systemic steroids (SS) correlated with changes in the intralesional CXCL10 levels in repigmented skin. NB-UVB and SS regimens provided most consistent CXCL10 mean change, suggesting that these regimens are most effective in harnessing CXCR3-mediated inflammatory response. Serum CXCL10 is a useful vitiligo biomarker, which predicts lesional skin leukocytic infiltration, and vitiligo treatment response and outcome.

Hidradenitis suppurativa (HS) rarely affects pediatric patients. The literature on pediatric HS patients is scarce. This is a cross-sectional study based on case note review or interviews and clinical examination of 140 pediatric patients undergoing secondary or tertiary level care. Patients were predominantly female (75.5%, n = 105) with a median age of 16. 39% reported 1st-degree relative with HS. Median BMI percentile was 88, and 11% were smokers (n = 15). Median modified Sartorius score was 8.5. Notable comorbidities found were acne (32.8%, n = 45), hirsutism (19.3%, n = 27), and pilonidal cysts (16.4%, n = 23). Resorcinol (n = 27) and clindamycin (n = 25) were the most frequently used topical treatments. Patients were treated with tetracycline (n = 32), or oral clindamycin and rifampicin in combination (n = 29). Surgical excision was performed in 18 patients, deroofing in five and incision in seven patients. Obesity seemed to be prominent in the pediatric population and correlated to parent BMI, suggesting a potential for preventive measures for the family. Disease management appeared to be similar to that of adult HS, bearing in mind that the younger the patient, the milder the disease in majority of cases.

Background The use of stem cells derived growth factors is representing a novel treatment modality in facial rejuvenation. Nowadays, skin needling is considered a very famous treatment of skin aging. However, the addition of such derived products, augments its therapeutic efficacy in the management and delay of skin aging. Objective Comparing the effect of amniotic fluid mesenchymal stem cell derived conditioned media (AF-MSC-CM) combined with skin needling versus the needling alone in the management of facial aging. Methods Both sides of the face of ten volunteers, suffering from facial aging, were treated with five sessions of skin needling, 2 weeks apart. After skin microneedling, AF-MSC-CM was added topically to the right side only. Clinical, histological, and morphometrical assessment of the treated skin was done at 1 month after the last session. Results The percentage of improvement of aged skin increased significantly on the combined treated side (AF-MSC-CM and dermaroller [DR]), when compared with the other side (DR only) (P < .001). Remodeling of the dermal structures was observed mainly on the combined side. Meanwhile, histometry of the epidermis revealed a significant increase in the epidermal thickness on both treated sides. Conclusion AF-MSC-CM combined with skin needling was more efficient in managing facial aging than skin needling alone.

BACKGROUND:A wide variety of minimally invasive treatments are available for skin aging. Recently, carbon dioxide therapy (CDT) or carboxytherapy was used in many cosmetic indications including facial rejuvenation. OBJECTIVE:To compare the efficacy of CDT alone versus combined CDT and fractional CO2 laser in management of facial aging. METHODS:Twenty-Five female patients with bilateral and symmetrical facial aging were included in the study. The right (Rt) hemiface received 8 sessions of CDT whereas the left (Lt) side was treated with combined technique (6 sessions of CDT and 2 sessions of fractional CO2 in between. Clinical and objective evaluation using 3D skin analysis, histological, and morphometric analysis were performed. RESULTS:Clinical evaluation demonstrated that all patients (100%) were satisfied with no significant difference between both sides of the face (P > .05). Regarding texture and pigmentation improvement, the Lt side (combined) showed significant improvement compared to the Rt side (P < .05). Using Antera 3D camera, there was a significant difference (P < .05) in 3D improvement percent in textural changes while there was no significant difference (P > .05) in the 3D percent of wrinkles improvement between both sides. The Lt side showed more significant increase in epidermal thickness after treatment when compared to the Rt side (P < .05) with evident neocollagen formation. CONCLUSION:Carboxytherapy is an easy, safe, simple, and a relatively effective method for facial rejuvenation with minimal downtime. Better results were achieved when used in combination with fractional CO2 laser.

Introduction and hypothesis Er:YAG laser is frequently used in dermatology and gynecology. Clinical studies document high satisfaction rates; however, hard data on the effects at the structural and molecular levels are limited. The aim of this systematic review was to summarize current knowledge about the objective effects of non-ablative Er:YAG laser on the skin and vaginal wall. Methods We searched MEDLINE, Embase, Cochrane, and the Web of Science. Studies investigating objectively measured effects of non-ablative Er:YAG laser on the skin or vaginal wall were included. Studies of any design were included. Owing to the lack of methodological uniformity, no meta-analysis could be performed and therefore results are presented as a narrative review. Results We identified in vitro or ex vivo studies on human cells or tissues, studies in rats, and clinical studies. Most studies were on the skin (n = 11); the rest were on the vagina (n = 4). The quality of studies is limited and the settings of the laser were very diverse. Although the methods used were not comparable, there were demonstrable effects in all studies. Immediately after application the increase in superficial temperature, partial preservation of epithelium and subepithelial extracellular matrix coagulation were documented. Later, an increase in epithelial thickness, inflammatory response, fibroblast proliferation, an increase in the amount of collagen, and vascularization were described. Conclusions Er:YAG laser energy may induce changes in the deeper skin or vaginal wall, without causing unwanted epithelial ablation. Laser energy initiates a process of cell activation, production of extracellular matrix, and tissue remodeling.

Background: Tattoos have played an important role in various human cultures for thousands of years. The creation of high power, short pulse Q-switched lasers (QS) has provided a tool for considerable therapeutic advances in tattoo removal. Objective: The aim of the study is to correlate the clinical efficacy of QS Nd: YAG laser for tattoo removal with histological as well as histometric findings. Patients and Methods: QS Nd: YAG laser was used for blue tattoo removal in 12 Egyptian patients. Sessions were done every 2 months for about 6-10 sessions (average 7). Skin phototypes of patients ranged from phototype III to V. Photographs were taken before and after every treatment session. Skin biopsies were taken from the patients before treatment and after six sessions to perform histological and histometric analysis. Results: Eight patients (66.7%) showed excellent response and four patients (33.3%) good response. No textural change or scarring was observed in any patient. Histological examination confirmed the clinical response. Haematoxylin and Eosin (H&E) stained sections showed a significant decrease or almost complete disappearance of the tattoo pigment. Meanwhile, histometric study objectively confirmed a significant decrease in ink particle surface area after treatment. Conclusion: QS Nd: YAG laser effectively treats tattoos in dark-skinned Egyptian patients with excellent cosmetic outcome and minimal side effects. The histopathologic and histometric findings significantly correlated with the clinical response.

Background: Postacne scars are still a challenge in its management. Microneedling is a popular minimally invasive technique in treatment of such scars. However, the addition of topical stem cell products after microneedling is considered a new treatment regimen for these scars. Objective: To compare efficacy of amniotic fluid-derived mesenchymal stem cell-conditioned media (AF-MSC-CM) and microneedling vs microneedling alone in management of atrophic acne scars. Methods: Ten cases with atrophic postacne scars received five sessions of microneedling, with 2-week interval on both sides of the face. Then, AF-MSC-CM was topically applied to right side of the face after microneedling. Clinical examination with histopathological and computerized histometric analysis was done 1 month after the sessions. Results: There was significant increase in the improvement percentage of acne scars on right side (dermaroller and AF-MSC-CM) vs left side of face (dermaroller; P < 0.001). Histologically, improvement of character of collagen and elastic fibers was noticed, especially on right side. Meanwhile, significant increase in epidermal thickness on both sides of face was detected. Conclusion: Amniotic fluid-derived mesenchymal stem cell-conditioned media combined with microneedling is more effective in management of atrophic postacne scars than microneedling alone.

Introduction: Brimonidine tartrate is a lipid soluble alpha 2 adrenergic highly selective receptor agonist with potent vasoconstrictor activity that had been approved for management of open angle glaucoma, it is also currently indicated for the topical treatment of persistent (nontransient) facial erythema. Aim of the Work: The aim of the present study is to evaluate the use and effectiveness of topical brimonidine (alpha 2 adrenergic receptor agonist) clinically and histologically, for the management of facial erythema. Patients and Methods: The study was conducted on 20 patients presenting with red face. Cases were collected from those attending the dermatology outpatient clinic at Minia University Hospital in the period of July 2014 to April 2017. Results: The present study was conducted on 20 patients, attending the Dermatology outpatient clinic, Minia University Hospital for treating redness of face. The age of these patients at the time of the examination ranged from 12 to 55 years. Fourteen (60%) of them were female and six (40%) were males. Summary and Conclusions: The considerable desire of patients to have healthy skin and to get rid of any dermatologic problem is matched by the number of modalities offered to patients, both medically and nonmedically, to achieve that goal. Many of these modalities have been well studied, whereas others have not.

BackgroundNevus of Ota is a dermal hamartoma that presents as bluish/slate gray pigmentation along first or second branch of trigeminal nerve. Patients search for treatment early in life due to psychological trauma and cosmetic disfigurement. The establishment of high power, short pulse Q switched (QS) lasers has provided a tool for substantial therapeutic advances in the management of dermal pigmented lesions.ObjectivesThe aim of the present study was to correlate the clinical efficacy of QS Nd : YAG laser with histological, as well as histometric findings through studying the quantitative changes of dermal melanocyte surface area in nevus of Ota patients after treatment. Patients and methodsTwelve patients with nevus of Ota were subjected to multiple treatment sessions with 1064 nm QS Nd : YAG laser at 2 months interval accomplished over a period of 2 years. Skin types treated included phototypes III and IV. All patients were photographed before, after each session and at the end of treatment. Skin biopsies were taken from all patients before treatment and after six sessions to perform histological and histometric analysis.ResultsExcellent improvement was noticed in four (33.3%) patients, good improvement in five (41.6%) patients, and one (8.3%) patient showed fair response. While, poor response was seen only in two (16.7%) patients. Hematoxylin and eosin and Fontana-Masson stained sections showed significant decrease in the number of elongated spindle-shaped dermal melanocytes throughout the dermis. Meanwhile, histometric study revealed significantly decreased dermal melanocyte surface area after treatment.ConclusionQS Nd : YAG laser is an effective and easy-to-perform treatment in cases of nevus of Ota in Egyptian patients with minimal side effects. Histological and histometric findings correlated with the clinical improvement attained.