Nevus Comedonicus Treatment & Management

Updated: Jan 27, 2020
  • Author: Marjon Vatanchi, MD; Chief Editor: William D James, MD  more...
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Treatment

Medical Care

Asymptomatic lesions may be left untreated or therapy may be implemented for cosmetic concerns. Some lesions improve with topical retinoic acid, [36] salicylic acid, or ammonium lactate lotion. [37]

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Surgical Care

As nevus comedonicus is an asymptomatic benign condition, no treatment is required. Surgical excision of small lesions can be curative and should be considered in consultation with a dermatologic/plastic surgeon. Incomplete excision may result in recurrence of the lesion. [38, 39]

Laser surgery has been tried. Carbon dioxide laser has been used as an ablative technique in eradicating extensive nevus comedonicus; however, this can cause significant scarring and may require grafts if the treatment area is large. [40]

Treatment using a 1450-nm diode laser in conjunction with a topical retinoid has been documented to show improvement in the lesion. [41] In 2019, a case report described improvement of late-onset symptoms with an erbium:YAG laser and, more recently, with a microneedling fractional radiofrequency device. [42, 43]

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Consultations

If defects associated with a nevus comedonicus syndrome are found, consult the appropriate specialist, as follows:

  • Neurologist for seizure disorders

  • Ophthalmologist for cataracts

  • Orthopedist for skeletal deformities

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