Birthmark removal

Birthmark Removal

A birthmark is something that is present at birth or appears very early after birth (within 1st month) and is described as an irregularity of the skin. This means that it looks different to the rest in skin in terms of:

• Colour
• Texture and 
• Elevation

The birthmark can vary in:

• Shape
• Size
• Colour
  • Tan
  • Brown
  • Black
  • Pink
  • Red
  • Purple
• Location
• Elevation

What the cause of a birthmark is nobody really understands and is not down to the mother. It is suggested that they could be:

1. Vascular birthmarks which are overgrowth of blood vessels and these are generally red, pink and purple and include:

• Haemangiomas
• Port wine stains and
•  Salmon patches

     2.Pigmented cells which are usually tan, brown and black in appearance and include:

• Moles
• Café-au-lait
• Mongolian spots

Birthmarks are generally considered harmless and don’t require treatment and can often fade over the years. Birthmarks are also generally benign although some birthmarks can be associated with underlying conditions or in rare cases the risk of skin cancer.

 A wise move is to get the birthmark examined by a professional especially if the birthmark changes in size, colour and shape or becomes painful, itchy or bleeding.

Removing birthmarks 

Birthmarks can be removed safely and effectively or can at least be faded. The best method of removal is dependent on the type of birthmark, its size, its location and the colour of the birthmark. The age of the personal and the skin type will also determine the method of removal.

People consider birthmark removal for the following reasons:

• Cosmetic appearance (could be large and disfiguring and affecting self-confidence)
• Medical (could be growing and causing medical problems or could be a risk of developing into a serious type of mole.

The main methods of removal which will go through in further detail are:

• Lasers
  • Pulsed dye lasers
  • Nd:YAG laser
  • Q switched lasers
  • Fractional lasers
• Surgical incision
• Medications
• Cryotherapy 

Laser therapy for birthmark removal

This is one of the most common and effective methods for removing birthmarks. Different types of lasers have different characteristics that make them suited to removing certain types of birthmarks.

Pulsed Dye Lasers (PDL): 

Gold standard for vascular birthmarks like port-wine stains. They target the red pigment in blood vessels, causing them to shrink and fade. Pulsed Dye lasers are preferred by Nd:YAG can be used for deeper larger lesions

Long pulse Nd:YAG lasers (neodymium-doped yttrium aluminum garnet)

This laser is a versatile tool used in aesthetics and can be successfully used for the treatment of certain types of birthmarks. It's particularly known for its effectiveness on pigmented lesions due to its specific wavelength.

Nd:YAG lasers are primarily used for birthmarks that are pigmented, generally caused by overproduction of melanin. The types of birthmarks include 

• Café-au-lait spots: These are flat, light brown to dark brown patches. Nd:YAG lasers show good effectiveness in fading these, though recurrence can occur.
• Congenital Melanocytic Nevi (Moles): Moles are generally best treated with surgical incision but can be treated with laser. The laser can be used to lighten the mole.
• Mongolian Spots: These present as blue/grey patches and are often seen on the lower back and buttocks of younger children. They generally fade but Nd:YAG laser can be effective.
• Nevus of Ota/Ito: These present as deep blue/grey deep or brown and often appear on the face  

Q-Switched Lasers (e.g., Nd:YAG):

Very effective tool for pigmented birthmarks like café-au-lait spots and moles. These short high intensity pulses break down the pigment and then the body then removes them. 

Fractional Lasers

Can be used alongside other laser treatments and are particularly good for resistant birthmarks or to improve skin texture.

Safety and Effectiveness of lasers

Effectiveness: Lasers can provide significant fading or clearance for appropriate birthmarks. Multiple session needed 6-8 weeks apart and to allow fragment to disperse. Sessions depends on size, depth and colour of lesion

Safety: Vital to be performed by an experienced and qualified professional. The laser is precise so avoids damage to surrounding tissue so is considered a safe procedure.

Discomfort: Often described as feeling like the flick of a rubber band. Topical anaesthetic cream can be applied to minimize discomfort, especially for more sensitive areas or children.

Side Effects: 

• Temporary redness and swelling
• Bruising and crusting usually fades
• Temporary pigment changes may appear lighter or darker making skin typing and test patches vital especially in darker skin tones
• Blistering not common
• Scarring very rare

Surgical Excision for birthmark removal

This involves physically cutting out the birthmark and stitching the skin back together.

Effectiveness: This is often associated as the gold standard especially for birthmarks such as moles which is important to consider for malignancy.

Safety: A generally safe procedure.

Side Effects: 

• Most common is scarring and this is based on the size and location of the birthmark and the person performing the surgery.
• There is also a small risk of infection
• Bleeding is common as well as
• Some pain and discomfort which can be managed with over-the-counter medications. 

Medications for birthmark removal

Certain medications can be used for the treatment of birthmarks and mainly vascular birthmarks. Medications such as

• Beta-blockers (e.g., Propranolol): Commonly used for infantile haemangiomas (strawberry marks) to reduce blood flow, slow growth, and lighten the mark
• Corticosteroids: Can also be used to shrink vascular birthmarks

Effectiveness: Can be very effective in shrinking or fading certain types of birthmarks. The earlier these are started the better.

Safety: Generally safe under medical supervision

Cryotherapy for birthmark removal

Involves freezing the birthmark with liquid nitrogen, which destroys the abnormal cells.

Effectiveness: More commonly used for smaller, superficial birthmarks.

Safety: Can be effective, but carries a risk of scarring and temporary skin discoloration.

Important Considerations for Safety and Effectiveness for all treatment options of birthmark removal

1. Consultation with a Specialist – a must
2. Individualized Treatment - one-size does not fit all 
3. Multiple Sessions – Often required especially with laser treatments
4.  Aftercare – crucial for healing and minimizing side effects
5. Expectations - Be realistic about the outcome

Other methods to deal with Birthmarks

At home remedies for birthmarks

There is no scientifically proven evidence to support home remedies for removing birthmarks and trying can often lead to adverse outcomes. 

Home remedies are considered ineffective. The types of things used maybe  such as applying 

• Lemon juice
• Olive oil
• Garlic 
• Essential oils

They may temporarily lighten the skin but will not remove the birthmark. Harsh ingredients and wrong technique can lead to skin irritation or burns and exacerbate the issue. 

Makeup for Camouflage of birthmarks

Makeup can be a great tool for dealing with birthmarks as a non-invasive way to cover up and even out skin tone. Specialist makes have a higher pigment content to help with coverage. 

Popular brands for these makeups are:

• Dermablend
• Kryolan Dermacolor Camouflage Creme
• Covermark
• Veil Cover Cream

Dermabrasion for superficial birthmarks

This is a skin resurfacing procedure that uses a rapidly rotating device with an abrasive tip to effectively sand away the outer layers of the skin. It removes old skin and allows new skin to grow in its place. 

It is used for superficial birthmarks and predominantly pigmented ones not vascular (avoid bleeding). It was popular for raised moles, café-au-lait spots and beckers nevus though the advent of laser has made dermabrasion less popular. 

Sclerotherapy for vascular birthmarks (haemangiomas)

Sclerotherapy is a medical procedure and can be used to treat vascular birthmarks and in particular venous malformations. It works by injecting a chemical solution directly into the vessel. This induces a chemical burn of the vessel walls causing them to stick together and close off the blood supply. 

Cost of birthmark removal procedures

The cost of birthmark treatment depends on 

• Type of birthmark
• Size of birthmark
• Location of birthmark
• Type of treatment
• Number of session
•  Clinic type 
• Clinic location
• Person doing the treatment 

Laser treatment is often £100 - £300 per session for small lesions. Costs can go into the thousands for larger complex treatments

Surgical Removal can range from £300 - £800 for a single excision and then can go into thousands for complex removals.

Cryotherapy Often used for smaller, superficial lesions and can range from £50 -£200 per session

Sclerotherapy Primarily for vascular malformations can range from £100 -£500 per session

Birthmarks and pregnancy

Removing birthmarks during pregnancy requires careful consideration and is often advised to wait until after delivery and after breastfeeding.