The nevus of Ota is a benign dermal melanocytic lesion that has previously been proven difficult to treat with the traditional modalities of dry-ice therapy and abrasion. Recently, the Q-switched laser has been successful in treating Ota nevus and tattoos.
Our study evaluated the treatment of 75 patients using a combination of dry-ice with reduced application pressure and frequency(3-5 times) every 3 weeks, serial excision of the pigment area in upper and lower eyelid, dermabrasion (optionally applied) and Q-switched alexandrite laser every 6 weeks. All were administered sequentially as listed. 
 This method of treatment for congenital onset type of nevus resulted in grade II and III lightening. However, the same treatments applied to puberty-onset type resulted in grade IV and V lightening. Effectiveness of the treatment was closely related to the repetitive dose of Q-switched laser on the same sites. Conventional dry-ice and abrasion treatments served only to remove the superficial dermal melanocyte which shielded the deeper dermal melanocyte. Serial excisions of 3-5mm at a 6-12 month interval on the upper and lower eyelids was effective. With patients under 10 years of age more significant improvements in grade IV and V lightening were obtained in nearly all cases.