Birthmarks are rather curious features, given that no one really knows why we have them. Some birthmarks can be hereditary, while others simply appear in one of two ways. The first kind happens as a result of sudden growth of pigment cells in one area, called pigmented birthmarks, or from irregular blood vessels that crowd together beneath the skin, known as vascular birthmarks.
- Types of PRocedures
- Procedure Details
- Before Care
- After Care
- Number of Treatments
- Side Effects
It’s no secret that the way we look plays a crucial part of who we become, and how we’re treated as human beings. Our physical attributes, especially when they’re on the face or other more noticeable areas of the body, can effectively work for us or against us in numerous ways—and this experience of living in our bodies can shape our personalities and determine our levels of self-confidence. For those of us with certain physical characteristics that make us stand out a bit too far from the crowd, the possibility of changing our appearance can be quite welcome—especially if that certain part of us negatively affects our emotional health or development.
Birthmarks, interestingly, can be a blessing for some and a curse for others. After all, a strategically placed, beautiful birthmark can add character to someone’s face—the famous cheek moles of Marilyn Monroe, Cindy Crawford, and Eva Mendes are all examples of how distinctive beauty marks can build characters and even careers.
When birthmarks are unwanted, however, their presence can harm a person’s emotional, social, and physical development—beginning in infancy and lasting throughout childhood and adulthood. If you’re someone that feels uncomfortable living with a birthmark, removal surgeries can be wonderful options for getting rid of them permanently, if that’s what you want—whether they’re port wine stains, large, raised moles, or even a beauty mark of the small, flat, Marilyn Monroe variety.
Birthmark Removal Overview
The range of pigmented and vascular birthmarks is extensive. They can come in a variety of colors (from black and brown to red, purple, and blue), shapes, and sizes. Some birthmarks (like angel kisses, strawberry marks, and Mongolian blue spots) fade or lighten with age, while others (salmon patches, port wine stains, etc.) do not fade and may even darken over time. Birthmarks like facial hemangiomas, meanwhile, can grow and lead to other health issues.
Removal of a birthmark for cosmetic reasons can be an important surgery for many people, whether it’s a cancerous mole or common types of harmless but unattractive spots. Thanks to developments in laser technology and other treatment options, it is now more achievable than ever before to have all kinds of birthmarks reduced in appearance or completely and permanently removed.
In this introduction into birthmark removal surgeries, you’ll learn more about different types of moles and birthmarks, and how they can be treated using state-of-the-art removal techniques. We’ll also give you the pros and cons of each form of surgery, and everything else you’ll need to know to plan your removal procedure.
What Types of Birthmark Removal Procedures Are There?
Several birthmark removal techniques can safely and effectively remove vascular or pigmented birthmarks. Vascular birthmarks are a result of the clustering of blood vessels underneath the skin, while pigmented birthmarks happen when pigmented cells are over-concentrated in one area.
The procedures used to treat birthmarks will depend on the type of birthmark you have, and where it’s located. Laser resurfacing using either an ablative or non-ablative laser tool is suitable for both vascular birthmarks like port wine stains and salmon patches, and pigmented birthmarks like moles, cafe au lait marks, and Mongolian spots. Another birthmark removal technique called light therapy uses intense pulsed light therapy (IPL) to remove vascular birthmarks or flat, pigmented birthmarks.
For many types of moles, the best form of treatment is to have them cut right out of the skin, using a variety of surgical techniques like shave excisions, punch excisions, and surgical excisions. These are typically simple surgical procedures that your doctor can perform to safely remove moles that go deeper than what can be treated with lasers or light therapies.
Children with pigmented moles called congenital nevi can benefit from a procedure called giant nevi removal surgery. The goal of giant nevi removal surgery is to remove the mole completely or at least as much as is possible.
Birthmark Removal Procedure Details
Since there are such a wide variety of birthmark types, there are a vast number of technologies that have been created to remove them.
Laser resurfacing is a highly versatile procedure used for multiple procedures besides birthmark removal, including acne scar removal and skin rejuvenation. For birthmark removal, laser treatments improve and diminish both vascular and pigmented birthmarks with a fractional laser that can be either non-ablative or ablative. The laser beam emits energy to break down the cluster of pigment cells into tiny fragments, which are then taken away naturally by the body’s immune system, causing the birthmark to fade.
Light Therapy (IPL) is another technique that is primarily used to remove unwanted acne, scars, freckles, age spots, and vascular birthmarks like port wine stains, though it can also work on flat, pigmented birthmarks as well. This method closes off the blood vessels underneath the skin that form the birthmark, which will eventually cause it to fade.
In a shave excision, your doctor will use a small blade, scalpel, or curved razor blade to scrape growths, including moles, from the surface of the skin. Shave excisions are preferred when the reason for the removal is cosmetic because the process is not as likely to leave a scar as more invasive methods of mole removal can. Shave excisions are also used to collect samples of growths for certain types of cancer cells, though this method is not recommended for detecting all types of cancer.
Raised moles less than 8mm in diameter can be extracted with punch excision or surgical excision for those measuring larger than 8mm. Both methods are used to remove birthmarks for cosmetic reasons, and to obtain a sample of the dermal or subcutaneous tissue around the lesion to be diagnosed for cancer cells. It should be noted that a surgical excision, also known as a full-thickness excision, is the only method available that fully extracts the lesion in its entirety. If a mole that was previously removed with a punch excision grows back, surgical excision may be scheduled as the last resort.
Ideal Candidates for Birthmark Removal Procedures
Many people are suitable candidates for birthmark removal. A consultation with a board-certified plastic surgeon or a dermatologist will confirm if you qualify. Your doctor will revise the birthmark you’re hoping to have removed, and let you know which approach is the most suitable for your skin.
In general, candidates for laser birthmark removal or light therapy treatments should have healthy and well-hydrated or slightly oily skin and hope to remove vascular or flat pigmented types of birthmarks. Ideal candidates for both treatments should not be prone to keloid formation (excessive scar tissue growth), or other severe scarring issues. In these cases, birthmark treatment could cause excessive scar tissue growth over the site being treated, resulting in a more obvious and even less attractive lesion.
In light therapy (IPL), patients with drier skin types can also be treated effectively if the intensity of the pulsing light is well controlled. Those with darker skin color tones are not typically good candidates for light therapy, nor are those taking supplemental blood thinner medications like warfarin or heparin.
For both shave excision, punch excision, and surgical excisions, the ideal candidates will be those hoping to remove raised, benign appearing moles for cosmetic reasons. For surgical excisions, the ideal patient will want to remove a mole that’s larger than 8mm, and punch excision candidates will want to remove moles measuring smaller than 8mm. Those with suspicious-looking moles should not choose these types of surgeries before consulting with a dermatologist about the possibilities of skin cancer.
What Results Can I Expect After a Birthmark Removal Procedure?
The ultimate goal of a birthmark removal procedure is to either reduce the appearance of a birthmark or to remove it completely. Laser resurfacing treatments and light therapy (IPL) can both work efficiently to significantly fade the appearance of either vascular birthmark types, or flat, pigmented birthmarks. These procedures can also remove birthmarks completely, depending on the individual and the characteristics of the lesion.
For patients with large, raised moles that are too thick to be effectively treated with laser or light therapies, surgical extraction is your best bet for having them removed permanently—with either a shave excision, punch incision, or surgical excision. Moles removed by either a shave excision or a punch incision have a slight chance of growing back, though moles removed by surgical excision will not. If your mole grows back after a shave or punches excision procedure, your doctor may recommend scheduling a surgical excision to remove it completely.
Is Anesthesia Required?
The purpose is to numb the area and prevent the patient from feeling any pain, ensuring their comfort throughout the procedure. For birthmark removal treatments, anesthesia may be required, depending on the treatment.
Topical anesthesia is most commonly used for both laser resurfacing and light therapy removal treatments. For mole removal treatments like shave excision, punch excision, and surgical excisions, local anesthetics are administered to keep the patient comfortable during the surgeries.
Before Treatment Care
Before any surgical procedure, it is important to take appropriate steps that will prepare you for the treatment. These instructions will vary according to your procedure and your doctor’s orders.
In general, before treatment care for patients having laser resurfacing and light therapy treatments will require well-hydrated and moisturized skin. Your doctor will instruct you on how to keep your skin moisturized by drinking plenty of water and using a hydrating lotion. You’ll also be advised to stay out of the sun to avoid sunburn or other sun damage.
Laser resurfacing and light therapy patients should not smoke for at least a month before being treated. Aspirin®, some anti-inflammatory drugs, and certain herbal medications should not be taken in the weeks leading up to your appointment, as these can sometimes cause a risk of excessive bleeding during the procedure. Certain antibiotics and topical creams can affect skin sensitivity, so ask your doctor if you’re taking any prescription drugs or medicated lotions before your treatment.
If you have a medical problem involving a history of herpes, you may be prescribed with antiviral medication before having your procedure. Birthmark removal procedures like laser resurfacing and light therapy can trigger herpes to flare up, and medication will help to reduce your chances of an outbreak.
Mole removal excisions are relatively minor surgeries. However, there are certain risks involved in the procedures. Your doctor will let you know which medicines to stop taking, to lower your risk of complications during surgery. This will include medicines like blood thinners, some natural health products, and aspirin.
After Treatment Care
Once the procedure has been performed, you will need to follow the advice of your surgeon to prevent any unnecessary complications and allow your body to heal properly.
Immediately after having a birthmark removed by laser resurfacing or light therapy treatment, you may feel as though you have a slight to moderate sunburn in the treated area. This will usually subside within twenty-four hours, and completely disappear within one or two days after treatment. Scabs or blisters may appear after being treated, although this is uncommon. If scabs or blisters to appear on the skin, patients should try to avoid picking or scratching these to keep the skin from scarring. Your doctor may advise you to avoid hot water and prolonged sun exposure for up to two days after the procedure.
Shave excision procedures usually require no sutures, and the treated site will heal on its own. Patients should take care to not touch the site and to keep the area clean, to allow the natural healing process to take place.
After having a mole removed with a punch excision or a surgical excision, patients should protect the affected area from dirt, water and sweat, making sure to cover the site while showering, washing dishes, or any other water-related activity. Avoid doing strenuous exercise or anything that may result in excessive sweating, including bending, stretching, or anything else that might affect the treated area.
After a punch excision or a surgical excision, your doctor will instruct you on how to keep the area dry and protected from dirt, water, and sweat. You will also learn how to dress the wound, and how to change the dressing, which will need to be done every two to three days. You’ll also need to take care not to affect the wound by bending, twisting, or exerting yourself in such a way that might affect the treated area from movement or excessive sweating. Your stitches will be removed after two to three weeks.
How Many Treatments are Needed to See Results?
Surgical excision is the only procedure that guarantees a total and permanent removal of its target, which is a raised mole. Other treatments can also offer permanent, lasting results after only one treatment, though this will depend on the situation of the patient and cannot be guaranteed.
Patients will also see results after one treatment for mole removal with a punch excision or a shave excision. Sometimes, moles grow back after a punch excision, and also after a shave excision—and can appear darker and larger than before. In this case, another treatment may be required; your doctor may recommend a surgical excision as a last resort to permanently remove the mole.
The best results for laser resurfacing can usually be achieved within three to eight treatments, each one spaced at least three to five weeks apart. Throughout these treatments, the birthmark will fade and eventually disappear completely. Similarly, light therapy will also require three to eight treatments in most cases, with each treatment scheduled from four to six weeks apart.
For both laser resurfacing and light therapy procedures, periodic treatments may be required to maintain the desired results. In most cases, treatments should be repeated on an annual basis.
What are the Possible Side Effects?
One side effect that all treatments for birthmark removal have in common is a pain. Though mild in all cases, there is a chance that your chosen procedure will cause minor pain during or after the procedure or both. Anesthesia is administered either topically (laser resurfacing or IPL), or locally (shave, punch, or surgical excision procedures) to numb the area and keep patients comfortable during surgery. If there is pain after the treatment, your doctor will recommend a pain reliever like Ibuprofen to manage the symptoms, though these should disappear completely within 48 hours.
Patients having laser resurfacing treatments to remove birthmarks may notice mild temporary bruising or lightening of the skin (hypopigmentation) on the treated area. This side effect is normal and can be a sign that the laser is working to lighten the color of the lesion. The whitening effect will fade away on its own, and you’ll be able to notice the birthmark fading along with it. You may also experience swelling, redness and peeling for a short time after your procedure. Redness and swelling could last up to two days after treatment while peeling or flaky skin could last for approximately a week.
Swelling, peeling, and a sunburn-like sting on your skin can be a common side effect of light therapy treatments. Another side effect of an IPL treatment could be hypopigmentation or lightening of the skin. This occurs when too much light is pulsed in any one area, and the risk of this can be significantly reduced when choosing a board-certified plastic surgeon that’s well-qualified to perform the procedure.
Shave, punch, and surgical excisions are all minor surgeries with various potential side effects and complications. For shave and punch excisions, the risks include scarring, hyperpigmentation, and a potential regrowth of the mole. Surgical excisions can also leave scars, though the risk of scarring is low and will depend on your skin type and other factors.
What is Recovery Like?
Recovery from birthmark removal treatments is an easy process, with minimal downtime and very little to no pain. Patients can expect to return to work and other normal activities the next day after having the procedure. Immediately after a laser resurfacing procedure, your skin will probably appear red and slightly swollen and might sting or burn. These symptoms should completely disappear after one to three days. Some patients will also experience dryness, peeling, and flaking for a week after treatment, which can be minimized by applying a gentle facial moisturizer for sensitive skin, like Cetaphil® or CeraVe®.
Light therapy patients may notice red and irritated skin for four to eight hours after treatment, and a slight stinging sensation similar to a mild sunburn in the treated area. The stinging sensation should subside within four to six hours and can be minimized with over-the-counter pain relievers like Ibuprofen. Cool packs or moist cloths may be applied to help reduce the sensation, and mild swelling in the treatment areas will usually dissipate within several days.
Healing after a mole removal by shave excision can take around one week. The site of excision on the skin must be kept dry for 24 hours. It is important to protect the excision site from sun exposure during the complete recovery period, which can last anywhere from one day to one week.
For punch excisions and surgical excisions, patients can expect to feel comfortable in public about five or six days after facial mole excision. At that time, the non-absorbable sutures are removed from the skin surface, and the skin may have a slightly ridged appearance until it settles down throughout the next couple of months.
What Do Birthmark Removal Treatments Cost?
The cost of your procedure will depend on several factors, including the type of treatment and the number of treatments required to reach the desired results. In general, birthmark removal by laser resurfacing can cost between $1000 to $3000 per treatment, while birthmark removal by light therapy can cost between $300 to $450 per treatment. Mole removal procedures like shave excisions, punch excisions, and surgical excisions have similar price ranges between $100 and $500.
Removing a mole may take time, money, and perhaps a tiny bit of pain—but the results of these procedures are usually very successful and well worth the cost of the treatments. If you’re wondering whether one of these procedures is right for removing your port wine stains, café au lait marks and au lait spots, stork bites, salmon patches, or angel’s kisses, ask your doctor for guidance in choosing the right form of treatment for you.