Hori Nevus

  • Best Results9-18 months
  • Treatment Recovery1-4 days
  • Procedure Time2-4 minutes
  • Skin SpecialistDermatologist, nurse
  • Duration of ResultsCan be permanent
  • AnaestheticCooling
  • Back to Work0-1 days
  • Cost$

Hori Nevus

Hori nevus is a form of dermal pigmentation. Other causes of dermal pigment include Ota-Ito birthmarks, acquired dermal pigment such as post-inflammatory & drugs as well as rare causes including silver ingestion. Pico lasers are at the forefront of treating these conditions.

FactsFacts on Hori Nevus

  • This presents as 2-4 mm dots under the eyes
  • It looks like melasma, but Hori is in the dermal layer of skin
  • This is one of the most common causes of pigmentation in Asian women
  • Once treated, Hori nevus is unlikely to recur
  • Pico lasers gives the best outcomes
  • Patients require many treatments over 9 to 18 months

What is Hori nevus?

This is an acquired form of face pigmentation that is super common in Asian women. Onset is around 20 years of age. It progressively darkens over the decades. Hori is characterized by dusky grey to blue macules (dots) on the cheeks & around the eyes.

A fancy name is ABNOM or acquired bilateral nevus of Ota like macules. Both entities are due to pigment cells called melanocytes occupying the dermal layer of skin.

Hori is very different from melasma, sunspots, lentigo, freckles & other common forms of pigmentation.

How common is it?

Hori nevus is one of the most common causes of face pigmentation, especially in Asian women. The clinic sees at least three to six cases a week. Not all patients request treatment. It is not hereditary.

Will Hori pigmentation worsen in time if not treated?

Yes, however progression is slow. Some patients elect not to treat. Others elect treatment when make-up cannot cover pigment.

What are other causes of pigmentation associated with Hori?

The majority of Hori patients will also have what dermatologists’ term as non-specific pigment, meaning elements of dusky dermal pigment, spots from sun & age as well as specific pigment disorders like melasma & Ota. It gets much more complex as some may have associated pigment demarcation lines & constitutional periorbital dark circles.

My team & I approach all cases with a diagnosis, as this confers prognosis & treatments. Hence in most cases we use nana & pico lasers with 532, 730, 1064 wavelengths with pigment correctors. 

Davin’s Viewpoint on treating Hori Naevus

Hori’s is a super common condition in Asian women, literally see one every day, however not all require treatment. The treatment is straightforward- Pico laser or nano with specific parameters. Persistence is the key. As reflected in the literature, we can expect to get 80-90% improvement in Hori, but that takes 12 to 18 months. Sometimes longer.

What is difficult are the other forms of pigmentation associated with Hori, including mixed depth melasma, non-specific dermal pigmentation (probably from regressed lentigos including lichenoid keratosis), lentigo-macular seb keratosis overlap, & the dearth of conditions associated with periorbital dark circles, including pigmentation demarcation lines, post-inflammatory, post treatment purpura (microneedling PRP to blame), contact dermatitis, constitutional pigment, & race associated pigment, vascular changes as well as aging factors (fat atrophy) & anatomical changes including tear thoughts. Pigment is not just pigment. If one identifies the type of pigment, & applies accurate treatments, the vast majority can be improved. Unless the cause-causes are constitutional & or demarcation lines.

It is important to remember that lasers are not the only answers to pigment, however with the advent of technology, Pico lasers are very useful, especially in Asian skin types.

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