Birthmark Removal Surgery

Birthmarks are skin surface irregularity and altered coloured changes that is immediately present after birth, or appears shortly after birth. Birthmarks are generally categorised into two groups. Pigmented and vascular birthmarks. Pigmented birthmarks include congenital moles, cafe au lait macule, Mongoloid spots and Nevus of Ota. Vascular birthmarks include salmon patch, cherry haemangiomas and port wine stain. Nowadays, advances in technology has allowed birthmark removal surgery to be carried out safely and effectively across all skin types.

Why do people get birthmarks?

There is no good answer to this question at the moment. While some birthmark can run in families, most occur as result of a random occurrence. 

Thankfully most birthmarks are harmless and do not pose any dangers to health. However, certain birthmarks may be associated with a underlying genetic disorder or medical condition. In fact, newborns with the giant congenital moles are at risk of skin cancer, and must be monitored closely. 

birthmark-removal-surgery

Cafe au lait Macule (CALM)

A common birthmark is the Café au lait spot. Café au lait spots take on a coffee with milk hue (very much like the ‘Kopi’ we order here in Singapore), hence the name. It should probably be called Kopi spots in the Singapore context. Café au lait birthmarks are brown and flat with varying sizes, sometimes growing as large as 10cm!

While most Café au lait spots are harmless, multiple café au lait spots and those with other skin changes may lead your doctor to suspect an underlying genetic disorder such as Neurofibromatosis or Tuberous Sclerosis.

Birthmark removal surgery with lasers are effective and safe in all skin types.

The Laser Pigmentation removal treatment can be used to treat Café au lait spots.  CALM birthmarks are known to recur after laser, and may require repeated treatments.

Nevus of Ota

First described by Japanese doctors in 1939, the Nevus of Ota birthmark appears as a blue or grey patch and is more common in Asians. It commonly involves one side of the face, temple and forehead. The eye and inner lining of the mouth may also appear to be pigmented in some cases. While the underlying cause is unknown, this birthmark appears along the distribution of the nerves of the face, and tends to get darker with the passage of time. Individuals with Nevus of Ota are at risk of glaucoma, a condition where pressure builds up within the eyes, and should therefore get their eyes checked regularly.

As this birthmark resides deeper into the dermal layer of the skin, topical lightening creams are not effective. The laser pigmentation removal treatment for birthmark removal surgery is a first line treatment. Laser removal for Nevus of Ota work by selectively destroy the pigment producing cells lying within the skin. The treatment delivers good results and minimal scarring after 4-8 laser sessions. With modern day advanced laser technology, more than 90% of the pigmentation is cleared, and scarring rate is minimal.

laser birthmark removal

Nevus Spilus

The nevus spilus is also known as Speckled Lentiginous Nevus. It usually presents as a brown patch with variable number of moles within the patch. It can appear at any body area, and the majority appearing at birth or within the first few years of life. With only a prevalence of 0.2-2.3%, it is mostly a benign and harmless birthmark. However, if the nevus spilus is large, there should be monitoring to ensure there are no changes. Q-switched laser systems can be used to improve the appearance of these birthmarks, but does not remove completely in most cases.

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References:

  1. Kim HR, Ha JM, Park MS, Lee Y, Seo YJ, Kim CD, et al. A low-fluence 1064-nm Q-switched neodymium-doped yttrium aluminium garnet laser for the treatment of café-au-lait macules. J Am Acad Dermatol. 2015 Sep. 73 (3):477-83.
  2. Liu J, Ma YP, Ma XG, Chen JZ, Sun Y, Xu HH, et al. A retrospective study of q-switched alexandrite laser in treating nevus of ota. Dermatol Surg. 2011 Oct. 37(10):1480-5.
  3. Chan HH, Leung RS, Ying SY, Lai CF, Kono T, Chua JK, et al. A retrospective analysis of complications in the treatment of nevus of Ota with the Q-switched alexandrite and Q-switched Nd:YAG lasers. Dermatol Surg. 2000 Nov. 26(11):1000-6.