Recovery
Results
Treatment Time
Aftercare
Treatment science score
The science of Hori Naevus Treatments
- Hori naevus is a common cause of pigmentation in Asian females
- It is often seen in the 30s to early 50s
- Picosecond lasers provide the best clearance
- Treatments are painless with little to no recovery time
The picosecond laser has revolutionized Hori Naevi treatments. Pigment is cleared twice as fast with much less side effects. Picosure Pro provides fast clearance without any downtime.
What is Hori naevi?
Hori naevus or naevi are brown to gray dots that appear around the eyes in Asian women. Hori starts at around 30 years of age & progressively darkens over the decades. The only way to treat Hori is with specific pigment lasers.
What is the best way to treat Hori naevus?
Pico lasers such as Picosure Pro are the best way to treat Hori naevi. Lasers offer fast, safe & effective removal of pigmentation, especially in Asian skin.
At The Melasma Clinic we employ both Picoway & Picosure Pro in our Brisbane & Sydney locations.
What results can I expect from a Pico lasers?
To date, this is the most effective laser for Hori, as over 92% of cases can be cleared with pico. Additionally, side effects such as hypo (skin lightening) or hyperpigmentation (skin darkening) is much less as compared with older nano lasers.
How many sessions will I require to clear Hori naevi pigmentation?
Though results can be seen within one laser session, we advise a series of 6 sessions, spaced 4-10 weeks apart.
For deeper pigmentation Hori will require several additional sessions for removal.
What is the treatment like?
Treatments are comfortable & fast, taking less than 2 minutes to perform. Picosure feels like tiny nettle flicks on the skin. On a pain scale of 1 to 10, it rates as a 1 to 2.
What is the recovery following Picosure Pro for Hori?
There are two settings we use to treat Hori (depending on your expectations & recovery time). These settings will be discussed with you prior to treatment.
- Slow & steady. This setting takes treatment recovery into consideration. Treatment recovery is uneventful with mild redness after the laser. You will require more pico laser sessions with this setting.
- Speedy & spotty. This may give you some mild but short lived increase in the pigment (only to spots) & redness that may last a few days. You will require less treatments with this setting. Post laser skin darkening may last weeks with this setting.
Our Gallery of Results
Can creams fade pigment due to Hori?
Creams have a marginal effect on Hori naevus as the pigment lies in the deeper layers of skin. We do however recommend pigment correctors after laser as –
- Hori naevi often occur with other forms of pigmentation such as melasma.
- Laser can occasionally activate pigment cells in the upper layers of skin.
The ideal cream formulation will be determined by your dermatologist.
Hori, faded (not completely) in only 2 sessions with Picosure Pro
.
👉End point> Stippled frosting focally over my usual end point of gray/oedema. More aggressive settings give faster clearance, albeit higher risks of post inflammatory hyperpigmentation
.
👉Ideally 2 more sessions
.
Dr Davin Lim
Dermatologist
Brisbane | Sydney,
Australia🇦🇺
.
#melasmaclinic #hori #horinaevustreatment #drdavinlim #sydneydermatologist #pigmentationclinic
Hori, faded (not completely) in only 2 sessions with Picosure Pro
.
👉End point> Stippled frosting focally over my usual end point of gray/oedema. More aggressive settings give faster clearance, albeit higher risks of post inflammatory hyperpigmentation
.
👉Ideally 2 more sessions
.
Dr Davin Lim
Dermatologist
Brisbane | Sydney,
Australia🇦🇺
.
#melasmaclinic #hori #horinaevustreatment #drdavinlim #sydneydermatologist #pigmentationclinic
Pigment is a glow distractor
.
👉Understanding the level of pigment > first step in optimizing your outcome
.
👉Match a wavelength to the level > predictable outcome
.
👉Match an ‘ingredient’ to pigment output > better outcome
.
👉Match an injectable to the level > the icing on the cake
.
👉Reducing UV & visible light > an essential step
.
😎Dr Davin Lim
Dermatologist
Brisbane | Sydney, 🇦🇺
Australia
.
#melasmaclinic #melasma #drdavinlim #sydneydermatologist #pigmentation
Pigment is a glow distractor
.
👉Understanding the level of pigment > first step in optimizing your outcome
.
👉Match a wavelength to the level > predictable outcome
.
👉Match an ‘ingredient’ to pigment output > better outcome
.
👉Match an injectable to the level > the icing on the cake
.
👉Reducing UV & visible light > an essential step
.
😎Dr Davin Lim
Dermatologist
Brisbane | Sydney, 🇦🇺
Australia
.
#melasmaclinic #melasma #drdavinlim #sydneydermatologist #pigmentation
For melasma, it does not mean the deeper you go, the better the results💯
.
👉Superficial peels: slow & steady with glycolic over lactic acid
.
👉TCA: outdated, though 8-10% single to double coating can reduce pigment in some cases
.
👉Phenol: for recalcitrant cases, with the risk of PIH & long lasting hypo
.
👉Novel Peels: probably gives the best results, with a hit rate of around 60+%, best used with medical therapy
.
😎Dr Davin Lim
Dermatologist
Brisbane | Sydney,
Australia🇦🇺
.
#tcapeel #cosmelanpeel #viprecisionpeel #chemicalpeel #melasmatreatment #melasmaclinic #drdavinlim #phenolpeel #pigmentation
For melasma, it does not mean the deeper you go, the better the results💯
.
👉Superficial peels: slow & steady with glycolic over lactic acid
.
👉TCA: outdated, though 8-10% single to double coating can reduce pigment in some cases
.
👉Phenol: for recalcitrant cases, with the risk of PIH & long lasting hypo
.
👉Novel Peels: probably gives the best results, with a hit rate of around 60+%, best used with medical therapy
.
😎Dr Davin Lim
Dermatologist
Brisbane | Sydney,
Australia🇦🇺
.
#tcapeel #cosmelanpeel #viprecisionpeel #chemicalpeel #melasmatreatment #melasmaclinic #drdavinlim #phenolpeel #pigmentation
As with everything medical, advice is based upon probability not possibility, taking into account outliers
.
🧴Creams: can flare melasma. More potent creams containing a mix of estrogen, especially estradiol over estriol (acknowledging that estriol is the predominant form in pregnancy) has a higher chance of flares. The greatest risk is in sun exposed areas
.
💊HRT tablets / systemic/ patches: Has a higher risk compared to creams. Dose related threshold that depends on individuals. Estradiol has a higher risk compared to estriol
.
👉Vaginal Estrogen Creams: risk is very low as systemic absorption is limited
.
🤷🏻♂️Non-hormonal estrogen receptor modulators (Emepelle): risk unquantified
.
👉💯Tips: avoid creams on sun exposed areas, including face /chest / arms
.
👉Are you on HRT, & has your melasma flared up because of it?
.
😎Dr Davin Lim
Dermatologist
Brisbane | Sydney, 🇦🇺
Australia
.
#melasma #HRT #hormonereplacement #themelasmaclinic #melasmaclinic #drdavinlim #sydneydermatologist #menopauseclinic #menopause #menopausemelasma
As with everything medical, advice is based upon probability not possibility, taking into account outliers
.
🧴Creams: can flare melasma. More potent creams containing a mix of estrogen, especially estradiol over estriol (acknowledging that estriol is the predominant form in pregnancy) has a higher chance of flares. The greatest risk is in sun exposed areas
.
💊HRT tablets / systemic/ patches: Has a higher risk compared to creams. Dose related threshold that depends on individuals. Estradiol has a higher risk compared to estriol
.
👉Vaginal Estrogen Creams: risk is very low as systemic absorption is limited
.
🤷🏻♂️Non-hormonal estrogen receptor modulators (Emepelle): risk unquantified
.
👉💯Tips: avoid creams on sun exposed areas, including face /chest / arms
.
👉Are you on HRT, & has your melasma flared up because of it?
.
😎Dr Davin Lim
Dermatologist
Brisbane | Sydney, 🇦🇺
Australia
.
#melasma #HRT #hormonereplacement #themelasmaclinic #melasmaclinic #drdavinlim #sydneydermatologist #menopauseclinic #menopause #menopausemelasma
In the past 10 years there has been a tremendous increase in knowledge regarding the cause/s of melasma, enabling better treatments with longer remission times & higher clearances
.
👉Peels: are a novel way to reduce pigment. They can be effective in 50-60% of cases. We perform Cosmelan, Dermamelan, Vi Precision, AHAs & Jessner. In some cases they provide a slightly faster clearance rate compared to lasers, however their ‘hit’ rate is not as good, providing devices are dialed in correctly. As per diagram, there are many other pathways to consider when treating melasma pigment 💯
.
🙏🏼🙏🏼🙏🏼Sunscreen: correct application overlooked by the majority of patients. This is step on in the algorithm, get this correct before embarking on peels, skin care & lasers
.
😎Dr Davin Lim
Dermatologist
Brisbane | Sydney, 🇦🇺
Australia
.
#melasma #cosmelan #chemicalpeelmelasma #themelasmaclinic #melasmaclinic #drdavinlim #sydneydermatologist
In the past 10 years there has been a tremendous increase in knowledge regarding the cause/s of melasma, enabling better treatments with longer remission times & higher clearances
.
👉Peels: are a novel way to reduce pigment. They can be effective in 50-60% of cases. We perform Cosmelan, Dermamelan, Vi Precision, AHAs & Jessner. In some cases they provide a slightly faster clearance rate compared to lasers, however their ‘hit’ rate is not as good, providing devices are dialed in correctly. As per diagram, there are many other pathways to consider when treating melasma pigment 💯
.
🙏🏼🙏🏼🙏🏼Sunscreen: correct application overlooked by the majority of patients. This is step on in the algorithm, get this correct before embarking on peels, skin care & lasers
.
😎Dr Davin Lim
Dermatologist
Brisbane | Sydney, 🇦🇺
Australia
.
#melasma #cosmelan #chemicalpeelmelasma #themelasmaclinic #melasmaclinic #drdavinlim #sydneydermatologist
Effectively building & keeping collagen in the upper layers of skin can potentially prevent & treat some forms of pigmentation, especially the ones related to aging. This includes late onset melasma & ‘dermal’ dropout, more common in darker skin types
.
👉How to? Topical retinoids can potentially provide very low levels of collagen, more efficient modalities include lasers, RF microneedling (correct depth & settings) as well as HIFU & biostimulatory injectables. The ideal biostimulus depends on the clinical presentation & age of the patient🙌🏼
.
😎Dr Davin Lim
Dermatologist
Brisbane | Sydney,
Australia🇦🇺
.
#melasma #melasmaclinic #biostimulator #skin #melasmatreatment #sunscreens #bioremodelling #drdavinlim #dermatologistsydney
Effectively building & keeping collagen in the upper layers of skin can potentially prevent & treat some forms of pigmentation, especially the ones related to aging. This includes late onset melasma & ‘dermal’ dropout, more common in darker skin types
.
👉How to? Topical retinoids can potentially provide very low levels of collagen, more efficient modalities include lasers, RF microneedling (correct depth & settings) as well as HIFU & biostimulatory injectables. The ideal biostimulus depends on the clinical presentation & age of the patient🙌🏼
.
😎Dr Davin Lim
Dermatologist
Brisbane | Sydney,
Australia🇦🇺
.
#melasma #melasmaclinic #biostimulator #skin #melasmatreatment #sunscreens #bioremodelling #drdavinlim #dermatologistsydney
90% of CALM or cafe au lait macules can respond to pico or QSL.
.
👉This patient: treated with 532 Hollywood Spectra nano laser, sessions spaced 8-10 weeks apart. Anecdotally facial lesions respond better than extra-facial lesions
.
😎Dr Davin Lim
Dermatologist
The Melasma Clinic
Sydney, Australia🇦🇺
.
#spectralaser #lutronic #calmbirthmark #birthmarktreatment #cafeaulaitbirthmark
#birthmarkremoval #drdavinlim #davinlim #sydneydermatologist
90% of CALM or cafe au lait macules can respond to pico or QSL.
.
👉This patient: treated with 532 Hollywood Spectra nano laser, sessions spaced 8-10 weeks apart. Anecdotally facial lesions respond better than extra-facial lesions
.
😎Dr Davin Lim
Dermatologist
The Melasma Clinic
Sydney, Australia🇦🇺
.
#spectralaser #lutronic #calmbirthmark #birthmarktreatment #cafeaulaitbirthmark
#birthmarkremoval #drdavinlim #davinlim #sydneydermatologist
🍊Vitamin C is useful, only if your skin can tolerate it. Why? High bioavailable vitamin C has an acidic formulation with a low pH, much lower than the already acidic environment of skin. This can lead to irritation, which means more potent pigment correctors can’t be applied
.
👉Formulations: L -ascorbic acid, preferably in the morning under make up & a thick layer of tinted sunscreen
.
👉Tips: concentrate on getting your sunscreen application correct before product selection, 90% of melasma sufferers haven’t got this step correct
.
😎Dr Davin Lim
Dermatologist
The Melasma Clinic
Sydney, Australia🇦🇺
.
#melasma #vitaminc #ascorbicacid #vitamincskincare #themelasmaclinic #sydneydermatologist #drdavinlim #themelasmaclinic
🍊Vitamin C is useful, only if your skin can tolerate it. Why? High bioavailable vitamin C has an acidic formulation with a low pH, much lower than the already acidic environment of skin. This can lead to irritation, which means more potent pigment correctors can’t be applied
.
👉Formulations: L -ascorbic acid, preferably in the morning under make up & a thick layer of tinted sunscreen
.
👉Tips: concentrate on getting your sunscreen application correct before product selection, 90% of melasma sufferers haven’t got this step correct
.
😎Dr Davin Lim
Dermatologist
The Melasma Clinic
Sydney, Australia🇦🇺
.
#melasma #vitaminc #ascorbicacid #vitamincskincare #themelasmaclinic #sydneydermatologist #drdavinlim #themelasmaclinic
Will Hori naevus return after treatment?
Once cleared the chances of recurrence is low, however most patients will have pigmentation due to other causes such as melasma & age spots. Simple skin care & sunscreen will help reduce recurrences.
The Melasma Clinic treats all forms of pigmentation
Our specialist clinic is overseen by dermatologists who have extensive experience in the treatment of darker skin types, including management of Hori & Ota naevi. Our doctors have spent many years lecturing in Asian countries on the topic of pigmentary disorders. Combined with the very best in laser technology they deliver outstanding results in the shortest possible time.
Are there any side effects of Picosure laser?
Side effects are rarely seen with pico lasers as they offer a precise way of pigment removal in Asian skin. In some cases we can expect transient & short lived (weeks to months) hyperpigmentation, especially if higher power is used. You will be forewarned if this setting is used.
Dr Davin Lim
645K subscribersHow to treat PIGMENTATION
If I can identify the cause of pigmentation, chances are I can treat it. This can only be achieved with careful real time examination…
More of our mostFrequently asked questions
How does Picosure differ from Picoway for Hori?
How does Picosure Pro clear up pigment?
Will Picosure be effective for all cases of Hori?
How does Picosure Pro compare to older pigment lasers?
Who performs the procedure?
A SummaryTreating hori naevus
Dr Davin Lim | Dermatologist
The Melasma Clinic, Brisbane | Sydney
Hori naevus are commonly encountered causes of pigmentation that often occur with mixed dyschromia & melasma. It affects Asian women & usually starts in the mid 30s to late 40s. Though it can be treated with nano Q switch lasers, picosecond lasers offer better clearances with less chances of skin color changes.
Laser parameters are tiered towards the patient as there are 4 protocols used-
- Low level pico laser. This no downtime protocol takes 15 to 18 sessions to complete. Sessions spaced 3-8 weeks apart. Risk of PIH is very low (almost never seen)
- Medium level: most frequently used, takes 4-7 sessions, risk of PIH is low with pico lasers.
- High level treatment with pico lasers: takes 3-5 sessions, higher risk of PIH, faster clearance but more risks.
- Mixed laser settings with medium energy with two wavelengths- 595 & 1064-755; novel laser settings to address newly reported epidermal> dermal Hori.
Unlike other forms of pigmentation, Hori, once treated with lasers, do not usually recur, hence the effects are long term. The caveat is that it is associated with other forms of pigmentation, including melasma & dermal dyschromia. Ongoing pico maybe indicated for these conditions.
