birthmark removal singapore

Birthmark Removal

There are generally 2 groups of common birthmarks; pigmented or vascular.

Birthmark removal depends on the type of birthmark, location, size and colour.

laser birthmark removal in Singapore

WHat is a birthmark?

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 laser 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. 

Types of birthmarks

birthmark-removal-surgery
Cafe au lait macule

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.

 

Treatment of calm

Picosecond and Q-Switched lasers are effective at treating Café au lait spots. CALM birthmarks are known to recur after laser, and may require repeated treatments.

nevus of ota treatment
Nevus of Ota

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.

 

Treatment of Nevus of Ota

From experience, Dr. Ng finds the Picosecond laser treatment for nevus of Ota to be very effective. 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 laser protocols specific to your skin type, more than 90% of the pigmentation is cleared, and scarring rate is minimal.

laser birthmark removal
Nevus Spilus

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.

treatment of nevus spilus

Dr.Ng uses a combination of CO2 laser with Picosecond laser to treat this condition. Laser treatment can improve the condition but may not be completely removed.

mongoloid spot
Mongoloid spot on the back

Mongoloid spot

A common blue-grey dermal pigmentation of the skin. It is often seen at birth or a few weeks after birth. Common areas include the back, buttocks and thighs. Most cases disappear by 4 years of age, but some can persist throughout life.

Treatment is not needed in most cases, but Q-Switched and Picosecond lasers may help to reduce the appearance of stubborn mongoloid spots.

port wine stain
Port wine stain

Port wine stain

Port wine stains represent one of the most common childhood vascular malformation, affecting up to 0.5% of newborns. While they are present at birth, they do not disappear over time. Over time, they may thicken, develop bumps on the skin and involve the soft tissues. More than 50% of patients over the age of 50 will developed thickened port wine stain. Most cases are located at the head and neck region. A multidisciplinary approach is needed as it may be associated with Sturge-weber, Beckwith-Wiedeman, Klippel-Trenaunay syndromes (rare).

Complications include:

  • Bleeding
  • Prone to trauma and injury
  • Thickening of soft tissue of face and limbs.

Treatment of Port wine stain

Vascular lasers such as the 589nm ADVATx laser and the 595nm Pulsed dye lasers are effective. Early treatment is beneficial when blood vessels are smaller and skin is thinner. The first 3 treatments yield the most obvious results, but successive treatments can further improve the appearance of the condition.

Haemangioma or Strawberry marks

Haemangioma

Haemangiomas are common vascular tumours seen in about 5% of infants. They usually make their appearance in the first few weeks of life as pale looking skin that then turns into red patches. More commonly found in girls, they are associated with prematurity, low birth weight and multiple pregnancies.

They grow the most rapidly during the first 3-6 months of life, after which the growth of the haemangiomas slow down. Most haemangiomas shrink with age; 50% by 5 years of age, 70% by 7 years of age and 95% by 12 years of age. 

Complications include:

  • Bleeding
  • Ulceration
  • Pain 
  • Infections

treatment of haemangiomas

Most haemangiomas can be left alone as they regress over time. However, treatments may be necessary if it is rapidly growing, affecting an individual psychologically, cosmetically unacceptable or causes functional problems.

  • Topical timolol or Imiquinod
  • Oral propanolol (for ages between 1-3 mths)
  • Vascular laser

Frequently Asked Questions

The exact cause of birthmarks is not always known. Some birthmarks are caused by abnormal blood vessels (vascular birthmarks), while others result from an overgrowth of pigment cells (pigmented birthmarks). In many cases, the cause is not clear.

While some birthmarks may fade or disappear on their own over time, others may persist into adulthood. The persistence of a birthmark depends on its type, location, and individual characteristics.

Yes, many birthmarks can be removed or reduced in appearance through various dermatological procedures or treatments. The effectiveness of treatment depends on the type of birthmark, its size, location, and other factors.

The level of discomfort associated with birthmark removal depends on the type of treatment used and individual pain tolerance. Some treatments, such as laser therapy, may cause mild discomfort or a stinging sensation, while others, such as surgical excision, may require local anesthesia to numb the area.

The timeframe for seeing results from birthmark removal varies depending on the type of treatment used and the individual’s response to treatment. Some treatments may produce noticeable improvement after a single session, while others may require multiple sessions over several weeks or months to achieve optimal results.

Birthmark removal should be performed by a qualified and experienced dermatologist or cosmetic surgeon who has expertise in treating birthmarks. It’s essential to choose a reputable provider and discuss treatment options, risks, and expected outcomes during a consultation.

SCHEDULE A CONSULTATION FOR birthmark removal IN SINGAPORE

A consultation and assessment is one of the first steps to helping you treat your birthmarks. The type of birthmark, whether pigmented or vascular and factors such as general health, location and severity of birthmarks help to guide treatment. Contact us today for an initial assessment.

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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.