The efficacy of 1064-nm Nd: YAG picosecond laser for Becker’s nevus: a retrospective analysis of 49 cases

Becker's nevus (BN) is a benign, unilateral hamartoma characterized by hyperpigmentation and hypertrichosis. Laser and light-based therapies represent the primary treatment modalities. To evaluate the efficacy and safety of the 1064-nm Nd: YAG picosecond laser in the treatment of Becker's nevus in a Chinese population. This was a retrospective, single-center study of patients with BN treated between March 2021 and August 2025. Efficacy was assessed via photographic evaluation by two independent dermatologists using a 4-point improvement scale. All patients were treated with 1064-nm Nd: YAG picosecond laser (Picoway, Zoom handpiece, Candela, Wayland, MA USA). SPSS 19 (IBM, Armonk, NY, USA) was used for all statistical analyses. 49patients (18 females, 31 males) with BN were included,24 patients presented with hypertrichosis, 25 patients without hypertrichosis. 25 patients without hypertrichosis were only treated with the 1064-nm Nd: YAG picosecond laser, and the number of treatment sessions was positively correlated with the treatment efficacy (r = 0.615, r²=0.378, P < 0.01). There was no correlation between pigmentation improvement and the number of treatment sessions in the 24 patients with Becker's nevus accompanied by hypertrichosis (r = 0.209, r²=0.044, P>0.05).Adverse events were transient and included pain, erythema, edema, hypopigmentation, and hyperpigmentation. Single-center, retrospective design, lack of a control group. The 1064-nm Nd: YAG picosecond laser is a well-tolerated treatment option for Becker's nevus, demonstrating moderate efficacy. A significant moderate positive correlation was observed between the number of treatments and clinical outcome in Becker's nevus without hypertrichosis.