Birthmarks in NYC, New York and Long Island: Laser Removal

A birthmark is a splotch on our skin, which can appear in a variety of colors, shapes and sizes. While some birthmarks are small and inconspicuous, others have a more prominent appearance, which can be bothersome to some, and can even lower their self-esteem. 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. 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.

Types of Birthmarks

Before determining how to remove these birthmarks, here is some information on the more common types and how to identify them:

Pigmentation-type birthmarks

These can include various types of birthmarks including moles (congenital nevi), Coffee-cream spots, and Mongolian spots. Mole is a nonspecific term for nevus, which is a pigmented skin spot. While most moles pose no health risks, some large nevi may have cancerous effects later on during one’s life. Coffee-cream spots are caused by too much pigment in the skin. They do not fade away, but do not require treatment. Mongolian spots are flat, slate blue-grey patches commonly found in children. These birthmarks usually disappear when children reach school age.

Macular stains (salmon patches)

These are very thin, light pink, flat patches of discoloration. These are usually found on babies, either on the back of their neck, or on their upper eyelids. Most of the salmon patches on the eyelids disappear during the child’s first year, while most of the ones found on the neck do not.

Vascular malformation

These are caused by abnormal development of blood vessels and are almost always present from birth. Port-wine stains, a very common birthmark, are a type of vascular malformation and can be found anywhere on the body. These can be identified as flat birthmarks that are pink-red at birth and darken to a red-purple color after several years. Port-wine stains do not fade or go away. These birthmarks may be a concern if located on the face above or around the eye because they may be associated with eye and/or brain problems.

Hemangiomas

Hemangiomas are strawberry-colored “birthmarks”. They are not rare, and vary from tiny blebs to large and multiple tumor-like growths. They are not true birthmarks since they are mostly not seen at birth, but start in infancy and then begin to grow. Hemangiomas first appear from birth up to 18 months, and then slowly shrink. Port wine stains and other true birthmarks are fully formed at birth and do not grow wider.

Hemangiomas that require early aggressive treatment include those that are cosmetically deforming, growing rapidly or obstructing vision, hearing, breathing, eating or any other body function. Hemangiomas on the lower face and neck may later block internal airways. Large facial hemangiomas may cause psychosocial impairment. Also, larger hemangiomas that are left alone to regress (shrink away over years) will eventually look better if the resulting saggy, stretched out skin and fatty tissue is surgically removed.

Most hemangiomas when first diagnosed are superficial only. These can be treated with a laser as soon as they are diagnosed, and early treatment is key as laser becomes less effective if you wait. The laser selects the red and shrinks the vessels so that the result is a less noticeable lesion. Repeated treatments can almost completely remove the superficial component. However, since the laser can only penetrate 1-3mm, it cannot shrink any deep component. Sometimes early treatment will prevent further growth, although deeper portions may still persist and grow. The flash-lamp pulse dye, pump dye and sclero-laser are the primary lasers used for treating hemangiomas. The risk of scarring is small. Complete removal of every trace should not be expected.

Symptoms
Strawberry hemangiomas are bright red (or purple), soft, raised, squishy birthmarks with sharp borders. They often start as little red dots surrounded by a pale halo before they grow. They are most common on the head, chest, or upper back.

Deeper cavernous hemangiomas often appear bluish, and the borders look less distinct. If the hemangioma is deep enough, the overlying skin might look normal. Most are found on the head or neck.

Most hemangiomas grow rapidly, doubling their size, and then plateau for a while before collapsing and disappearing. When the color becomes dull, or the center appears gray or pinkish-gray, the hemangioma may be entering the slow disappearing phase.

Treatment
Cavernous hemangiomas that involve the eyelid and obstruct vision are generally treated with injections of steroids or laser treatments that rapidly reduce the size of the lesions, allowing normal vision to develop. Large cavernous hemangiomas or mixed hemangiomas are treated, when appropriate, with oral steroids and injections of steroids directly into the hemangioma.

Recently, lasers have been used to reduce the bulk of the hemangiomas. Lasers emitting yellow light selectively damage the vessels in the hemangioma without damaging the overlying skin. Some physicians are using a combination of steroid injection and laser therapy together.

Please consult with a physician about these conditions.