Birthmarks are skin markings that are present at birth or develop shortly afterward. These are splotches on our skin that can appear in a variety of colors, shapes and sizes. Most birthmarks fall into one of two categories: port-wine stain birthmarks or coffee-and-cream birthmarks.
• Port-wine stains are vascular birthmarks, caused by a high concentration of blood vessels in a particular area. When found on the forehead, eyelids or side of the face, these birthmarks are associated with an increased risk of glaucoma and seizures.
• Coffee-and-cream birthmarks are simply patches of skin that have a high concentration of pigmentation. In some cases, certain types of birthmarks can become a health risk. Some birthmarks do fade or completely disappear over time, however, there are others that will never fade or go away.Until the 1990s, doctors didn’t have the technology required to effectively remove birthmarks.
Due to the introduction of high-energy pulsing lasers, birthmarks can now be removed with precision and ease. Birthmark removal offers a solution to people who are self-conscious about their appearance and even help reduce the possibility of health risks associated with certain moles.
About the Procedure
There are different ways that a birthmark can be removed, depending upon its type, size, location and other factors.
Laser therapy: Lasers are used to treat birthmarks that are close to the surface of the skin such as port-wine stains. This method can be performed at any age. During treatment, short bursts of laser light are aimed at the birthmark in order to shrink it, make it less noticeable, and cause it to stop growing. As the laser penetrates the surface of the skin, it lightens the darkened areas. In many coffee-and-cream birthmark cases, laser procedures can eliminate the mark altogether. It usually takes multiple treatments to remove most portwine stains and hemangiomas (“strawberry marks”), because the laser only penetrates a small distance into the skin.
Multiple visits may be necessary to achieve optimal results. However it is not used to treat cases where it is found on an internal organ, or deep within the skin.
Surgery: This method is used when other non-surgical treatments have not worked. A hemangioma that is large or found on an internal organ also requires surgery and general anesthesia.
However, sometimes, medication is enough to treat certain types of birthmarks.
Length
The laser treatment usually takes about 15 minutes to a few hours, depending on the size and extent of a patient’s particular birthmark. Treatments of port-wine birthmarks may require multiple procedures spaced several months apart.
Benefits
Sometimes, birthmarks can attract unwanted attention, particularly when they are on exposed areas of the skin such as the face and/or the arms. Facial port-wine stains can be especially problematic for children who may be alienated due to these pronounced and unusual markings. Generally, birthmark removal can boost social confidence both in adult and children. The use of high-energy pulse lasers on birthmarks can quickly and effectively eliminate these unwanted markings.
Who is an ideal candidate?
The best candidates for laser birthmark removal are:
• Mature enough to fully understand the procedure
• Knowledgeable about the procedure
• In good physical and psychological health
• Wanting to improve their appearance and/or comfort
• Realistic in their expectations
• Non-smokers or able to stop smoking during the healing process
• Not using marijuana or anabolic steroids
• Not heavy users of alcohol
However, one must remember that cosmetic surgery is meant for improvement, not perfection. It is important to have realistic goals and expectations when considering birthmark removal.
Recovery
Very little healing time is needed after a laser birthmark removal. There may be very mild bruising or pain in the first few days following the procedure. However, both should resolve within a week or so.
Planning your surgery
Before deciding to undergo this procedure, you should consult your doctor regarding his or her previous experiences and ask for reference from past patients who have undergone the procedure. The following are the questions you should consider while consulting your doctor:
1. Are the desired results I described realistic?
2. Is there an alternative remedy that I should consider as well?
3. How long will the procedure take?
4. What kind of anesthesia is used, if any?
5. How much does it cost?
6. What is your experience in performing this procedure? (How long has he/she performed this procedure, and how many has he/she has performed in the past year?)
7. What percentage of patients has had significant complications? (The physician should disclose this information to you.)
8. Will you repeat or correct procedures if it does not meet agreed upon goals? And if the procedure must be repeated / corrected, will I be charged again? (The physician should provide you with his/her policy on this issue.)
9. May I see "before and after" photos of recent patients? The physician should provide many photos of recent patients.
10. Could I observe the exact procedure I am considering before I decide to have it done? (Either on videotape or ask to view one in real life.)
11. What should I expect after the procedure in terms of soreness, what to watch for, medication, bathing, and level of activity?
12. Have you ever had your malpractice insurance coverage denied, revoked or suspended?
13. What are the risks, limitations and benefits?
The surgeon should provide information about anesthesia options, the location and description of where the procedure will be done – in a hospital or office surgical suite.
Preparing your surgery
While preparing for your surgery, be sure to:
• Tell your doctor about any allergies you have (to foods, drugs, environmental elements)
• Tell your doctor about all medications you are taking (both prescription and non-prescription)
• Carefully follow any instructions your doctor gives you.
• Avoid aspirin and aspirin-containing medicines as well as anti-inflammatory medicines such as Nuprin, Motrin and Advil for 2 weeks prior to surgery.
• Avoid herbal remedies such as St. John’s Wort, gingko biloba, some types of Chinese black mushrooms and other natural medicines and foods that may thin the blood.
Anesthesia
Usually, general anesthesia is used to perform this procedure.
Risks / Complications / Side effects
There are several risks associated with any laser treatment, but most are very rare.
• Unexpected deepening
• Lightening of skin coloration can occur
• Patchy skin with areas of darkened skin surrounded by spots of lighter pigmentation. Such side effects are uncommon and easily treated with a secondary corrective procedure.
• Minor bruising
• Scabbing
• Bleeding
• Infection
• Scarring: If a scar is left, other treatments like skin grafts may be used to correct this condition. This also applies to large hemangiomas removed from the body.
• Allergic reaction to the anesthesia
After your surgery
After undergoing laser therapy, the treated skin becomes dark purple. This should only last about 7 to 10 days and disappear soon after. However in some cases, it can take 6 to 8 weeks for the purple area to completely disappear.