Nevus of Ota AND Accutane?

[kellbell341]

I am a 21 year old, blue-eyed American female of Irish decent who was diagnosed with the rare pigmentation disorder (both dermal and occular) Nevus of Ota.  The disease is most commonly found among asian women.  I am paying an exorbitant amount of money to receive treatments with the Q- switched ruby laser but am receiving very limited results due to the depth of the lesion.  I am also suffering from mild cystic acne that could be controlled by the use of the birth control pill, but unfortunately the estrogen increase makes the nevus grow and darken significantly.  I am in a jam, so to speak, because any hormonal steps to improve the acne will then worsen the nevus of Ota.  Developing both of these problems late in life due to hormones has caused me significant emotional problems and have effected my life greatly for the worse.  

I am interested in trying low doses of Accutane to treat the acne (I am taking tetracycline right now with limited success) and was wondering if the cellular effect of this medication COULD BE BENEFICIAL IN REDUCING THE PIGMENTATION, OR IF IN FACT IT COULD MAKE IT WORSE?  My nevus presents itself around my eye and my eyelid, appearing in a greyish/blue/black color that could be mistaken for a black eye.

Finding a doctor to discuss certain treatments to attack both of these diseases, and to answer concerning questions has been frustrating and upsetting, to say the least.  I thank you for your time in reading this.  Also, COULD YOU RECOMMEND ANOTHER ROUTE FOR TREATMENT?  Thanks again and have a great holiday.

[patientl]

A related discussion, Laser Treatment was started.

[Tara9999]

A related discussion, nevus of ota in the eye was started.

[Alan Rockoff, MD]

Lasers are safe and useful.  You should look into it.

Dr. Rockoff

[TN1]

I WAS DIAGNOSED WITH NEVUS OF OTA WHEN i WAS 18 YEARS OLD. IT BECAME MORE PROMINENT WITH AGE. IT LOOKS LIKE I HAVE A BLACK EYE ON THE LEFT SIDE OF MY FACE. I AM NOT OF ASIAN DESCENT WHERE IT IS COMMONLY FOUND. I TOO AM OF IRISH DESCENT WITH LIGHT SKIN. i HAVE NOTICED THAT THROUGH THE YEARS WHENEVER I HAVE BEEN OUT IN THE SUN ALOT IT IS NOT THAT PROMINENT AS WHEN I DO NOT TAN. I ALSO HAVE FOUND THAT ESTEE LAUDER MAXIMUM COVER FOUNDATION IS THE BEST TO USE TO HELP HIDE IT. I HAVE TRIED IT ALL. I AM NOW 29 AN CONSIDERING THE LASER SURGERY. AT THE TIME WHEN I WAS DIAGNOSED I WAS TOLD THAT THE LASER COULD DO MORE HARM THAN GOOD. BUT I AM HOPING THAT IT HAS IMPROVED OVER THE YEARS.

[Alan Rockoff, MD]

I am not sure why you should have such trouble finding a doctor to discuss treating both these diseases.  Actually, treating one need to have no effect on the other.  There are better ways to treat acne than hormones: antibiotics or Accutane.  You should get rid of the acne by appropriate use of these modes--any dermatologist should be able to do that.  As for the Nevus of Ota, I have no personal experience treating that.  Are you sure your insurance won't cover laser treatments--they often do for disfiguring lesions on the face.  If your doctors haven't asked, they should.  If you've been denied, you should appeal.  The way to get insurance companies to listen is to scream bloody murder, especially when the situation warrants it, as it certainly does in your case.

Take care and don't give up.  And Happy Holidays!

Dr. Rockoff