Nevus spilus (NS), or speckled lentiginous nevus, is a pigmented skin lesion characterized by darker macules within a lighter brown patch. Managing NS is challenging due to its cosmetic impact, recurrence risk, and the need for selective pigment targeting without scarring. Among available treatment modalities, the Q-switched Nd:YAG laser (QSNYL) is considered an effective option, as it selectively targets melanin with minimal collateral tissue damage, offering favorable cosmetic outcomes.We report the case of a 37-year-old woman with NS presenting as hyperpigmentation on the preauricular region. The first two sessions of combination treatment with 660 nm and 1064 nm QSNYL resulted in post-inflammatory hyperpigmentation (PIH), which progressively worsened after the third and fourth sessions with 532 nm and 1064 nm QSNYL. Treatment was subsequently switched to the 1064 nm wavelength alone, which led to improvement of both the NS lesion and PIH, with no adverse effects. This case highlights the potential role of QSNYL in the management of NS.

Chan Hui Ying is a clinical researcher with interests in laser dermatology, pigmentary disorders, and aesthetic medicine. Her work focuses on the clinical application of laser technologies for the management of challenging pigmentary conditions, including nevus spilus. She has co-authored case reports and clinical studies exploring multi-wavelength laser approaches to improve treatment outcomes while minimizing adverse effects such as post-inflammatory hyperpigmentation. Her research contributes to the advancement of evidence-based aesthetic dermatology and laser therapy