Long-pulsed Erbium: YAG laser for the treatment of an adult colloid milium: a case report and review of the literature

Colloid milium (CM) is a rare degenerative deposition skin disorder known by multiple small, domed, flesh-colored papules that may coalesce into large plaques or highly disfiguring nodules. CM frequently involves sun-exposed body areas, such as the face and dorsal hands. Currently, there is no single effective treatment for CM. Herein, we present a case of adult colloid milium (ACM) with lesions around his nasolabial fold and perioral region who was successfully treated with long-pulsed Erbium: YAG laser with no scarring, textural changes, pigment alterations, or evidence of clinical recurrence at the 3 years follow-up. A systematic search was conducted in PubMed and Scopus until 25 Jan 2025, evaluating all studies with treatment procedure comprehension for ACM. CO2 laser effectively ablated the lesions, while increasing the risk of thermal damage and scarring. Dermabrasion showed favorable efficacy; however, the authors did not specify whether textural changes or pigmentation disorders occurred. Non-Ablative fractional laser has minimal side effects, while multiple sessions are required for satisfactory results. The long-pulsed Er: YAG laser offers high precision and minimal invasiveness, however, its shallow penetration may require multiple sessions for deeper lesions. Long-pulsed Er: YAG laser should be considered an effective treatment for facial CM lesions. Future studies should compare laser types, optimize parameters, and explore adjunct therapies to improve outcomes.