CALM or cafe au lait macules are common birthmarks & by far the easiest to treat . . 👀How to treat? Local numbing or injections. Dial your q switch laser to 532 nm, pick a spot size (say 4-6 mm), dial the power mid way, fire one shot. If you get liquid paper frosting - it is all good, if not adjust. Treat evenly. Post laser care of sun protection & emollients, repeat 6-10 wks later. Most require 2 sessions +. Doesn’t matter if you have a nano or pico laser . . 👍🏻Considerations: Majority are not associated with genodermatoses. Think NF - McCune-Albright syndrome as per clinical findings. CALMs occur in 10-20% of births. 1% of individuals will have >3 CALMs with no associated genodermatoses. There is no potential for malignant change in pure CALM lesions cf naevus spilus . . 🔫Treatment: I usually mx when patient is self-conscious, namely teenage years. EMLA or topical, if needed (larger CALMs), local injections. Eye shields if periocular . . 📋Prognosis: Most literature sources state that response is seen in 50% of cases, I disagree. I do believe that the vast majority of CALMs respond to lasers (>>95%), providing the diagnosis is correct in the first place (CALM and NOT a congenital melanocytic naevi/CMN). I also believe that there is a high chance that of recurrence within the first 5 years, recurrence can easily be treated with lasers . . ⚡️Pico lasers vs Nano lasers: In the context of CALM, I do not see a quicker resolution with pico over nano. In fact the filtered 532 of #picosure does not give any end points. #picoway, #enlighten #picoplus are more powerful lasers. Majority of CALMs can be treated within 1-3 sessions of nano laser - #lutronicspectra #revlite #c6 #pastelle etc… . . 📆Recovery following laser: 5-7 days. Bruising ++ for first few days, skin heals within a week. No sunexposure (direct UV) for 4-8 wks post. If needed repeat at 8-10 wks. Unlike Becker naevi, and CMN, CALMs are relatively straightforward to treat . . 🛑Caution: In darker skin types (PIH/hypo) . 😎Dr Davin Lim, Brisbane. Australia🇦🇺 . #birthmarks #birthmarktreatment #birthmarklasertreatment #cafeaulaitmacules #cafeaulaitbirthmarks #birthmarkbegone #dermatologist (at Brisbane, Queensland, Australia) https://www.instagram.com/p/CA7E5KIDv5c/?igshid=1avuz9v2qpjqz