Cheekbone Nevi: Causes, Treatments, and Prevention Tips

Zygomatic nevus

Is a chloasma (melasma) a type of sunspot? What is the difference between chloasma and dark spots? Will chloasma increase in number over time? I have relatively fair skin; will more spots develop after ruby laser treatment? Are there dietary therapies that can help improve this condition? Which season is the best for laser treatment? Why do I have chloasma?

anita, 30~39 year old female. Ask Date: 2001/07/10

Dr. Zheng Lizhen reply Dermatology

The correct medical term for zygomatic nevus is "acquired bilateral dermal melanosis" or "late-onset bilateral Ota's nevus." Following the publication of dermal melanosis by Japanese physician Dr.
Ota in 1939, researchers gradually observed this type of dermal pigmentation, which predominantly affects reproductive-age women of East Asian descent.
Clinically, it presents as brown to bluish-black spots, most commonly occurring on the zygomatic area, cheeks, and nose tip.
Zygomatic nevus can be considered a late-onset birthmark, distinct from sunspots or common hyperpigmentation, as typical hyperpigmentation arises from increased melanin in the epidermal layer, while zygomatic nevus involves pigment cells dispersed within the dermal fibers.
The development of zygomatic nevus is associated with ethnicity, constitution, age, and endocrine factors, with an incidence of approximately 0.2% among East Asian women.
Since the pigmentation in zygomatic nevus is located in the dermis, common whitening agents, chemical peels, and topical treatments are ineffective for removal; laser treatment is currently the most effective method.
Available laser treatments include ruby, alexandrite, and Nd:YAG lasers.
However, the laser treatment for zygomatic nevus is not as miraculous as that for removing freckles or sunspots, and one should not expect flawless results after a single session.

Moreover, there may be a one- to two-month period of post-treatment pigmentation, during which the area may appear darker than before treatment, necessitating patience as the pigmentation fades.
According to research from Kyoto University in Japan, approximately 63% of patients experience temporary pigmentation after the first laser treatment due to the fragmentation of dermal pigment by the laser, which requires gradual absorption by the skin tissue for fading.
After the second or third treatment, the pigmentation response diminishes, and the recovery absorption period shortens, leading to a gradual improvement in the patient's condition.
Although the pigmentation phase can be challenging, with proper post-treatment sun protection and the use of depigmenting agents, it generally fades within two to six months.
Additionally, ultrasound or iontophoresis whitening treatments can be employed to shorten the pigmentation phase, which is also an accepted method.

Reply Date: 2001/07/10

More Info

Cheekbone nevi, commonly referred to as facial nevi or moles, are benign growths that can appear on the skin, particularly on the cheekbone area. They are not the same as sunspots or solar lentigines, which are often referred to as "sun damage" or "age spots." While cheekbone nevi are typically congenital (present at birth) or develop during childhood, sunspots are primarily caused by prolonged exposure to ultraviolet (UV) radiation from the sun.

Causes of Cheekbone Nevi
The exact cause of cheekbone nevi is not fully understood, but they are believed to result from a combination of genetic factors and environmental influences. Some individuals may have a genetic predisposition to developing moles, while others may see an increase in nevi due to sun exposure. Hormonal changes, such as those occurring during puberty or pregnancy, can also lead to the development of new moles.

Differences Between Cheekbone Nevi and Sunspots
Cheekbone nevi are typically darker in color and can vary in size and shape. They are usually raised and have a smooth surface. In contrast, sunspots are flat, light brown or tan spots that develop due to UV exposure and are more common in older adults. Sunspots can increase in number with continued sun exposure, while nevi may remain stable or change over time.

Will Cheekbone Nevi Increase in Number?
It is possible for individuals to develop new cheekbone nevi over time, particularly during childhood and adolescence. However, the number of nevi can stabilize in adulthood. If you notice a sudden increase in the number of moles or changes in existing moles, it is essential to consult a dermatologist for evaluation, as these changes can sometimes indicate skin conditions that require attention.

Ruby Laser Treatment and Recurrence
Ruby laser treatment is an effective method for removing unwanted moles and can result in significant improvement. However, it is important to understand that while laser treatment can remove existing nevi, it does not prevent new ones from forming. If you have a predisposition to developing moles, you may still see new ones appear after treatment.

Dietary Considerations for Skin Health
While there is no specific "food therapy" that can prevent the formation of cheekbone nevi, maintaining a healthy diet rich in antioxidants can support overall skin health. Foods high in vitamins C and E, such as fruits, vegetables, nuts, and seeds, can help protect the skin from oxidative stress and may contribute to a healthier complexion.

Best Season for Laser Treatment
The effectiveness of laser treatment can be influenced by the season. Generally, it is advisable to undergo laser treatments in the fall or winter months when sun exposure is minimal. This is crucial because post-treatment skin can be sensitive to UV radiation, and exposure can lead to complications such as hyperpigmentation or scarring.

Conclusion
In summary, cheekbone nevi are benign skin growths that differ from sunspots in their appearance and causes. While they may increase in number due to genetic and environmental factors, treatments like ruby laser can effectively remove them. However, new nevi may still develop over time. Maintaining a healthy diet and choosing the right season for treatment can contribute to better skin health and outcomes. If you have concerns about your skin or the appearance of new moles, consulting a dermatologist is always a wise decision.

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