<p>Summary of included studies.</p>

A comprehensive search was conducted on June 2, 2026, across PubMed/MEDLINE, LILACS, SciELO, DOAJ, Cochrane Central, and clinical trial registries, supplemented by citation tracking. Studies evaluating NADRL (980–1940 nm) in patients with ADMH were included. Two reviewers independently screened records and extracted data.

A narrative synthesis and risk of bias assessment using Cochrane RoB 2 and JBI checklists were performed.</p> <p>Results</p><p>Of 193 records identified through electronic database searches, seven studies met inclusion criteria; citation tracking of relevant reviews and included studies did not identify any additional eligible records. These comprised two randomized controlled trials, three retrospective case series, and two case reports, comprising 31 unique patients.

The 1550 nm erbium-doped fractional laser was the most frequently investigated device. Two RCTs showed no clinical or histopathological improvement, whereas observational studies reported favorable outcomes, albeit with significant methodological limitations and concomitant therapies. Laser-induced post-inflammatory hyperpigmentation (PIH) was reported in 23% of patients in one RCT.</p> <p>Conclusions</p><p>Evidence supporting NADRL for ADMH remains limited, heterogeneous, and insufficient to establish independent efficacy.

The proposed dermal remodeling mechanism remains largely untested, as most studies evaluated only pigmentary outcomes. Future research should prioritize standardized prospective studies with histological, molecular, and imaging endpoints to determine whether these devices provide true disease modification.</p></div>