I. When is the best time to treat nevus of Ota?
Personally, I suggest that it is more appropriate to wait for seven or eight years after the onset of the disease, or wait until you are a teenager.
First of all, the cause of nevus of Ota is still unknown, and all treatment methods nowadays, no matter how high-tech they claim to be, are all allopathic treatments, which can only treat the symptoms but not the root cause. However, according to most of the data at home and abroad, and my personal clinical observation on the treatment of nevus of Ota patients for more than ten years, there is a rule for nevus of Ota: generally, after seven or eight years of onset, the condition will slowly stabilize on its own, and after the condition is stabilized, it will rarely expand again even without treatment. As it takes at least seven to eight years from the onset to the stability of nevus of Ota, if the condition is stabilized and then treated, the recurrence rate will only be a few thousandths, while if the condition is treated before it is stabilized, even if the nevus of Ota is completely receded after treatment, it will still grow out after a long time, so people mistakenly think it is a recurrence. Therefore, according to the existing domestic and foreign experience, realistically speaking, I personally recommend waiting for the condition to stabilize before treating it, so that it will not be easy to relapse.
Secondly, the younger the age, the lower the tolerance to pain. The same pain may be tolerable for adults (even without any anesthesia), but it may be unbearable for children (even if the so-called high-tech local anesthesia technology has been used). Therefore, the earlier the nevus of Ota is treated, the more obvious the pain is. Moreover, the younger the child is, the less he or she will cooperate, and if general anesthesia is required for treatment, there is a certain risk of general anesthesia, and the younger the child is, the greater the risk of general anesthesia, because after all, the younger the child is, the less developed the nervous system is. Existing information shows that nevus of Ota only affects the aesthetics and has little effect on the body, so to risk general anesthesia for the treatment of nevus of Ota, I personally suggest that there is no such need.
Whether to treat nevus of Ota or not only affects the aesthetics, but if general anesthesia causes problems for the sake of aesthetics, is it a gain or a loss, do you think? But I can tell you, for such a small child, local anesthesia or not, the pain is similar, nothing works, even if you anesthetize for half a day, you still have to rely on the adult to grab it. Or there are places that suggest that there is no need for anesthesia, directly by the parents hard grasp treatment, which is also not very appropriate. The reason is very simple, just think about it, nevus of Ota is usually large, and the area is so large that it can’t be done in a minute or two, so parents will definitely cry and scream when they grab it again, can parents bear to grab it for ten minutes? Besides, even if parents can bear, can grab a motionless it, since you can not, then which way to do seriously clean it, can only be made up to do, the effect can be good?
So for too small children, the main problem or treatment is very painful, other recurrence or something, or second, at most, if the recurrence of treatment later, more money, if you do care about it, anyway, just spend more money is also considered good. The main problem is pain, in fact, you just need to go to the hospital and ask the doctor to use the laser to try to hit it to know how painful it is, too small children do this are tossed, suffering. The hospital can say it’s okay, it’s okay, you can do it, you can do it, anyway, when the pain is your child, and not the doctor who did it, the hospital certainly will not refuse you to do it, and not a free clinic, you have to do it and spend a lot of money. But whether it hurts or not you try to play yourself will know how painful that pain is for the child, you try to play yourself, experience enough, you can judge for yourself whether to give such a small child to do it. If you feel the pain when you try it yourself, do you want to do it to your child?
But if you wait a little older, at least eleven or twelve years old, you will cooperate and do it when you want to do it, then you only need local anesthesia, local anesthesia compared to general anesthesia, the safety is completely different. Or older, to 17, eight years old when the treatment, even without local anesthesia, without any anesthesia can be treated, and the recurrence rate is only a few thousandths.
Of course, I can understand your eagerness to get early treatment, so if you want to get early treatment, we have been doing nevus of Ota for more than ten years, and we were the first to carry out it in the whole Haixi region, so of course we can do it, and we will do our best to make the treatment better. Moreover, according to my own experience of treating nevus of Ota for more than ten years, I have come up with a relatively practical method, that is, if adults are treated, they are usually treated with small light spots and high energy, while children are treated with large light spots and low energy in order to reduce pain. The advantage is that the pain can be reduced more, children are more acceptable, but the disadvantage is that because of the large spot, low energy, so to do more than the normal adult treatment several times, generally adults small spot high energy, most 2-4 times is enough, while children generally have to do seven or eight times, eight or nine times. However, as a doctor, out of the conscience of a doctor, I do not want to follow along and encourage you to treat as early as possible, I will still try my best to advise you that many times, something is done and something is not done.
Is the darker the color, the better the effect, or the lighter the color, the better the effect
Of course, the darker the color, the better the effect. The reason is similar to weight loss, the fatter the weight loss, the easier it is to see the effect. In fact, the objective effect may be similar, but subjectively, the deeper the color, the better the effect you feel.
Third, what is the effect of nevus of Ota treatment and how to treat it most appropriately
Laser treatment for nevus of Ota has a history of more than ten years in China. Since 1998, our department has been treating nevus of Ota with laser, and we have used Nd:YAG lasers such as American Venus, American C6, Korean MAX S6 and German Eurostar FotonaQX, and the results are not bad. As for the new emerald laser, which has become more and more fashionable in the past few years and is widely recognized by most top hospitals in Shanghai and Beijing, we are fortunate to be the first users in China and have been using it since 2008. But it is not as different as advertised. The biggest advantage of Emerald is that if you know how to operate it, the number of treatments is generally much less than that of Nd:YAG laser, which used to be treated once every three months, six, seven or eight times in total.
That is to say, the number of times, if the emerald operation is good, do once, top the previous laser three or four times. To use an analogy, just like driving from Shanghai to Beijing, taking the highway and the national highway, both can arrive at the end, to Beijing is actually similar, the difference is to take the highway than take the national highway is much faster, otherwise who is willing to spend money to take the highway. Of course, good or bad equipment is one thing, good or bad operation technology is another thing, just like taking the highway, if you encounter high-speed traffic jams, it is not good than taking the national highway is still slow, so good equipment, if the operation technology is not good, but also does not reflect the advantages, I think, technology is more important than equipment (identify the new emerald laser or the old Nd:YAG laser is very simple, the treatment of the skin will not bleed is The new emerald laser and the old Nd:YAG laser are the ones that bleed when treating nevus of Ota.)
However, generally speaking, due to the different color of nevus of Ota and the different absorption ability of laser for each person, the effect may be a little different. Therefore, realistically speaking, even with the latest emerald laser, most of the results can reach 96%~99%, but it is unrealistic to achieve 100% effect for each and every one of them, that is what the advertisement says. Even with the latest high technology, it is impossible to cure all diseases, which is unrealistic advertising. Similarly, the number of times of treatment for nevus of Ota is related to the quality of the laser, the technical level of the operator, and the absorption ability of each person’s skin, etc. It is hard to say for sure how many times it must be.
But no matter how many times you want to treat, the better the laser, the longer the interval between each treatment can be. Generally, the interval between each treatment of Nd:YAG laser is usually three months, while the emerald laser can generally be interval of more than three months, if the operator has a high level of technology, each treatment of the laser to hit the right words, interval of one year treatment is absolutely possible, emerald laser operation is good, as long as once a year, and Nd:YAG laser a year to do four times the effect is not much difference, that is to say As long as the technique is good, doing it once can be equivalent to doing it four times with Nd:YAG laser. But on the other hand, if the operating doctor is not good, or for other reasons, although the use of emerald laser, but also three months to ask you to do once, that is generally the last to do a seven or eight times or more, that is actually no different from the 1064 laser, then the good equipment, if not operated well, is also scrap metal.
To use an inaccurate analogy, such as our daily three meals a day, as long as we eat every meal, a normal day to eat three meals is enough, even if you eat seven or eight meals a day, there is nothing good for you, if there are really benefits, the Chinese diet has long been changed to six meals a day. Similarly, with the emerald laser, if the operation level is in place, it is enough to do it once a year. If you also do it once every three months, it will not significantly increase your efficacy, but will instead increase the number of times you have to do laser pain, and increase your fear and disappointment in the treatment of nevus of Ota, and frequent treatment is instead sending money to the hospital, which is meaningless. Of course if you use an old Nd:yag, or a domestic laser, which does not have enough energy, or although you use an emerald laser, but the operation level is not enough and the hit is not in place, it is to be done once every three months, which is equivalent to not having enough for every meal, that is to have more meals.
So relatively speaking, the technology is more important than the laser, take our section, when we started to operate in 1998, with our operation technology at that time, we had to ask the patient to do it once every three months, after 8 years of continuous operation, in 2006, only slowly can reach half a year to do it, 10 years later, in 2008, the earliest began to try to use the new (non-old) emerald laser It was not until two years later, in 2010, that we started to be able to do it once a year.
As for why the better the laser interval is, the longer the interval can be for doctors with good technology, this can also be explained by the principle of laser treatment for nevus of Ota. The principle of treatment is the same for any laser, no matter it is a new model or an old model, no matter how it is called high-tech. The reason why it is said to be abnormal is that the size of the pigment particles is much larger than the normal pigment particles in our body. And our body actually has a strong self-purification function for those normal pigment particles. There is a cell in our body that is specialized in swallowing pigment particles, but because the pigment particles of nevus of Ota are too huge, the phagocyte is not capable of swallowing the pigment particles of nevus of Ota.
Laser sounds amazing, but in fact, the function of laser is to produce micro-bursts in the skin, which will burst the pigment particles of nevus of Ota into normal-sized particles that can be swallowed by phagocytes, and then play a therapeutic role through the swallowing of phagocytes. Therefore, even if you keep irradiating the skin with laser every day, at most, more micro-pigment particles will be produced, and the laser itself has no therapeutic effect and will not directly remove the particles. The phagocyte phagocytosis is limited and will not increase because of the increase in the number of times you laser, but rather the more times the laser is used, not only produces a lot of micro pigment particles, but also produces a lot of by-products, the tissue will also produce some microscopic tissue fragments after the laser irradiation, the removal of these fragments, also depends on phagocytes to swallow, so frequent laser treatment, not only will not increase the therapeutic effect, but also may divert part of the original treatment effect. On the contrary, it may divert some of the phagocytes that should be used to swallow pigments to swallow the excess tissue fragments, which will affect the treatment effect. So the better the laser, as long as the operation is in place, the less frequent the treatment, once you can produce enough pigment fragments, and then wait for the skin to absorb them, only the laser energy is not high enough, or the operation is not in place, once the pigment particles can not be refined to a small enough laser, only to frequent multiple irradiation.
The actual laser is actually a good way to get the most out of the laser.
Fourth, what is Q-switched laser
In the course of my clinic, I often encounter patients ask me, director Yang, a certain private hospital advertising that their laser is high-tech Q-switched laser, is this the best laser. Therefore, I would like to say that, in fact, as long as the laser for treating nevus of Ota, no matter you are a domestic or imported one, no matter you are a laser of tens of thousands or a laser of more than one million, all of them are Q-switched, and it is very difficult for you to find a laser that is not Q-switched to treat nevus of Ota. In fact, the Q-switch of laser is similar to the shutter of a camera, just an instant time concept, except that the shutter of a camera is the role of instant exposure, while the so-called Q-switch of laser actually refers to the role of instant release of laser energy (due to different manufacturers, it is about 40-150 nanoseconds, or 0.00004-0.00015 seconds). All cameras, no matter you are a former film camera or a current digital camera, no matter you are a 0.3 megapixel or a 12 megapixel camera, you have to press the shutter when you take a picture, and in the same way, Q-switch is only the basic requirement of laser treatment for nevus of Ota, it is not any high technology, it is all hype and propaganda.
V. Is there any exclusive introduction of the latest high technology for the treatment of nevus of Ota? The answer is no.
The reason is very simple, no equipment can be produced by a hospital, the hospital has no production line and no ability to produce equipment, so it can only go to the manufacturer to buy it. Is to sell equipment to earn money, since this is the case, as long as the sales know that the pursuit of manufacturers is to maximize sales profits, manufacturers of production equipment, whether good or bad, want the whole world’s hospitals to buy their equipment, how can there be a certain equipment other hospitals have not even heard of, and only a hospital exclusive purchase it? That the manufacturer of the production equipment sold this one, not to lose money.
Therefore, the so-called exclusive introduction of different equipments are just packaged with different beautiful names to attract attention, but in fact, they are all the same thing. The more they claim to be exclusive, the more likely they are ordinary domestic equipments or those produced by unknown foreign manufacturers.
Nowadays, the more fashionable treatment for nevus of Ota is the new emerald laser, but whether it is the new or the old laser, it is impossible to be introduced exclusively by any hospital.
VI. Treatment cost of nevus of Ota
Treatment is charged according to the area, but it varies according to the equipment used by each hospital and each region. Take our hospital as an example, for the first time, the price per square centimeter is about tens to more than a hundred, and the price per square centimeter decreases as the area increases, if the area is small, the unit price will be higher, maybe more than a hundred, but the larger the area, the lower the unit price, so the total price does not increase exponentially with the increase of area. Even for those bilateral nevi with a large area, the total cost of bilateral nevi is generally more than 6,000 and at most 7,000 for the first time, and decreasing each time after that. The number of times, with the good or bad laser, as well as the ability of each person’s skin to absorb the laser are related, in fact, realistically speaking, it is difficult for me to say for sure in advance how many times it must be.
But because the fifth time to start each time only a few hundred yuan consumables cost fee, so in fact, no matter how many times to treat, whether you are three times or six times, the total cost of the difference is not very big, the cost of the relationship with the number of times is not particularly large, mainly depends on the size of the area, but also not with the increase in area and unlimited increase, or multiplied, the larger the area, the lower the unit price. Therefore, in our hospital, because the new emerald laser is used, the purchase and maintenance costs of the machine are much higher than those of Nd:yag or domestic laser, so the total cost of general treatment is about 6000-22000, but even for bilateral, very large area, the total area of even more than 200 square centimeters, the general total cost of up to The total cost is not more than 26000.