Birthmark removal, At A Glance
- Best Results1-10+ Treatments
- Treatment Recovery4 - 8 days
- Procedure Time5 to 30 minutes
- Skin SpecialistDavin Lim, Dermatologist
- Duration of ResultsVariable - years
- AnaestheticNumbing, Sedation, Gas
- Back to WorkVariable
- Cost$$ Medicare rebate applies
Birthmark Removal
There are over 150 different types of birthmarks. Some respond well to laser therapy, others are best treated with surgery. The ideal treatment will depend on the diagnosis. 90% of red birthmarks can be markedly reduced with laser treatment.
FactsFacts on Birthmark Removal
- Birthmarks can occur at the time of birth or delayed (tardive)
- Some birthmarks increase during puberty
- There are over 150 types of birthmarks
- Some do well with lasers, others respond better to surgery
- Becker’s naevi are one of the harder birthmarks to treat
- Diagnosis is essential as this will dictate treatment options
- Consult a medical dermatologist for a firm diagnosis
What treatments are there for birthmarks?
Depending on the diagnosis, lasers including vascular, Q switched, & pico lasers can fade red & brown birthmarks. Deeper birthmarks including moles are best treated with surgery.
Not all birthmarks can be treated effectively, if you have a Becker’s naevus, chances are it cannot be removed. The very first step in the management of birthmarks is a diagnosis.
What is the best treatment for mole – like birthmarks?
This type of birthmark has ‘roots’ that extend into the deep dermis, and often into the fatty layer of skin. These nests of pigment cells are out of the reach of lasers. Surgical options give the best prognosis.
I do not laser moles, the primary reason is that I cannot predict the recurrence rate. Additionally, pseudomelanoma changes can occur. Google this & you will understand the risks.
What is a Becker’s Naevus & can it be treated?
Becker or Becker’s naevi are very common birthmarks. They appear lighter in childhood, and typically increase in colour, texture & hair growth around puberty. This birthmark contains many elements of skin, including smooth muscle, hair, oil glands, melanin (pigment) & skin cells. This birthmark extends deep into the dermal and fat layer. Becker’s naevi are also very large (most often the size of several hands).
Unfortunately, all treatments to date have been unsuccessful in removing this type of birthmark. Surgery can be considered for very small lesions.
What are sebaceous naevi?
This birthmark is essentially a group of oil glands, as well as other structures found in skin. They generally occupy facial or scalp areas. With hormonal changes associated with puberty, they increase in size. Acne like lesions are not uncommon.
This type of birthmark can be associated with milder forms of skin cancer, including basal cell cancers. The lifetime risk is around 5%. Ideally, you should be followed up by your medical dermatologist with serial photography.
My favoured treatment for this birthmark is excision. Occasionally I do employ CO2 lasers to debulk the birthmark.
View our Treatment Gallery
What is a congenital melanocytic naevus?
Another common type of melanocytic birthmark. This is essentially a big hairy mole. It can range from 0.5 cm to lesions much greater than 20 cm (large).
This type of birthmark has pigment cells called melanocytes that occupy structures surrounding hair follicles. The depth is in the fat layer of skin. Given the location, the treatment of choice is excision.
CO2 lasers have been reported to lighten the lesion, the downside is that it can take up to 20 sessions over 2-3 years. Unfortunately, recurrence is common following laser, but does not occur after surgery.
For larger lesions there is a theoretical risk of skin cancer- in the order of 2-3% lifetime risk. You should be monitored by your medical dermatologist.
How many sessions are required to remove or fade birthmarks?
As a guide, brown birthmarks (CALM or Café Au Lait Macules), fade within 1-3 sessions.
Port wine stains require 3-20 sessions, depending on the site, size, age, skin type & thickness.
Deep dermal birthmarks– dermal melanocytic lesions such as Ota & Ito as well as Hori naevi – naevus zygomaticus require 3-7 treatments.
A slightly acidic skin environment optimizes skin barrier function & reduces the chances of infections as a low (ish) pH is disadvantageous to pathogens
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👉What about very low pH ingredients? Some formulations such as #ascorbic acid, lactic, glycolic, salicylic, mandelic, citric, and beta hydroxy acids function best in a low pH formulation as this increases bioavailability & skin penetration. Not an issue for most skin types, but maybe an issue for those with compromised skin barrier function- namely acne, rosacea, dermatitis-eczema patients.
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👉What about higher pH products? Fortunately the days of alkaline washes/cleansers/soaps are limited. Mainstream brands such as La Roche Posay, Paula’s Choice & CeraVe have cleansers ranging between pH 5.1 to 5.4.
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😎Davin Lim
Dermatologist
Brisbane/Sydney🇦🇺
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#skincare #skincarescience #skinscience #dermaltherapy #dermatology
#healthyskin #skinhealth #drdavinlim #davinlim #dermatoloigstsydney #brisbanedermatology
Picosecond fractional resurfacing with Picosure Pro, 2 sessions spaced 4 weeks apart
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👉Indication: Pigment in all skin types. Our pilot study suggests that off label picosecond laser in the 755 wavelength, delivered in full beam to select spots & high powered fractional is superior to IPL & non-ablative fractional laser resurfacing💯
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👉Cons: It’s off label. Downtime of 48+ hours (still less than 1927 Fraxel & IPL). With the marked cytokine release, I now give a short sharp application of topical CS post treatment to reduce post treatment swelling. For patients with pigment > solar dysplasia, I prefer pico to thulium lasers (& TCA-Jesser peels). The Picosure Pro by #Cynosure is really that good👍🏻
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😎Davin Lim
Dermatologist
Brisbane/Sydney🇦🇺
.
#picosure #skinscience #dermatology #picosurepro #picolasers #skinrejuvenation
#drdavinlim #davinlim #dermatoloigstsydney #brisbanedermatology
Will my birthmark return after treatment?
It depends on the type of birthmark & the treatment. Surgical procedures give the best outcomes; however scarring is an issue. Lasers can help lighten most birthmarks.
Recurrence is variable, as a very rough guide-
- CALM lesions my recur after 1-5 years
- Port wine stains may darken after 1-6 years
- Laser ablation often gives ‘debulking’ for 2-5 years
How successful is laser therapy in treating birthmarks?
Laser therapy is best used to treat red & light brown birthmarks. The success rate will vary depending on the diagnosis, site of the birthmark, size, age and you skin colour.
Red birthmarks including port wine stains & blood vessels respond best. Light brown birthmarks such as Café Au Lait Macules also respond to laser. Moles & thick birthmarks are usually resistant to lasers. Ota & Ito birthmarks can be faded with pico or nano lasers.
Are there any risks of treatment?
All surgical & laser treatments carry risks. These include-
- Scarring
- Skin colour changes (Hypo or hyperpigmentation)
- Infection
- Recurrence
- Partial response
- No response
A detailed risk to benefit ratio will be provided prior to treatments.
How much does it cost to treat birthmarks?
Fortunately, the majority of birthmark treatments are partially covered by Medicare. Patients are out-of-pocket $390- $490 per session. Surgical procedures are also partially covered.
Who should I see if I have a birthmark?
If you would like a diagnosis, a general dermatologist will be able to assist. If you require treatment, a procedural dermatologist can be of value. If you live in Victoria, Prof. Philip Bekhor can diagnose & treat.
If you reside in Queensland, & would like a paediatric opinion, consult the dermatologists at The Children’s Hospital. They can arrange laser treatments if appropriate.
Davin’s Viewpoint on Treating Birthmarks
Birthmarks are very common, occurring in 1 in 3 births. They range from common ‘brown macules or Café Au Lait Macules’ & stork bite birthmarks, to extensive port wine stains & melanocytic naevi.
Almost any organelle in the skin can differentiate to give a birthmark, these include-
- Pigment cells or melanocytes, to give melanocytic birthmarks including congenital naevi & café au lait macules.
- Blood vessels to give port wine stains, stork marks, essential telangiectasia, agminate spider naevi.
- Smooth muscles to give harmatomas, Becker’s.
- Collagen & elastin, namely collagenomas & elastomas.
- Sebaceous gland to give acneiform lesions, sebaceous naevi, segmental acne
- Nerve cells to give neurofibromas
- Epidermal cells or keratinocytes to give epidermal naevi
Some birthmarks are associated with syndromes. Most birthmarks do not have any associations. Before you seek treatment, a diagnosis is necessary, consult a medical dermatologist for a real time physical examination.
