A birthmark is a mark or splotch on the skin which can appear in a variety of colors, shapes, and sizes. Pigmented birthmarks are usually present from the time of birth and are comprised of melanosomes, which are cells that contain an abnormally high density of melanin. Melanin is the pigment that creates color in your skin. The cause of birthmarks1 is unknown, but it has been determined that the occurrence is higher in darker-skinned individuals like Hispanics, Asians, and African Americans.
There are many who might think that birthmarks should not be removed–that they are an inherent part of your identity. However, many patients experience a great deal of discomfort due to their birthmarks. Many birthmarks can be large or attract unwanted attention. Some patients have expressed that they find others paying more attention to a birthmark than to a face. For those seeking to remove or lighten a birthmark, Dr. Rokhsar offers several minimally-invasive treatment2 options for his New York office.
Birthmarks are categorized into two groups:
Birthmarks are further divided into subcategories of pigmentation-types, macular stains, vascular malformation3, and hemangiomas. Some birthmarks fade or completely disappear over time, but those who are self-conscious about their appearance may wish to consider birthmark removal procedures.
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.
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 it’s located on the face above or around the eye because they may be associated with eye and/or brain problems.
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 are 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 sclerotherapy are the primary lasers used for treating NYC patients with hemangiomas. The risk of scarring is small. Complete removal of every trace should not be expected.
Fraxel Repair: The Fraxel:repair laser system uses an ablative treatment that treats the tissue deep within the dermis, which is also where pigmentation abnormalities are present. The procedure uses CO2 laser technology to fractionally treat microscopic sections of the birthmark, with little risk of scarring or hypo-pigmentation. Multiple treatments may be required, depending on the birthmark size and color.
V-Beam Pulsed Dye Laser: The V-Beam Perfecta uses and energy that targets the area with an intense but gentle pulse that selects the discolored birthmark, ablating the pigment responsible for the mark. Multiple treatments are usually performed and, for many patients, improvements can be seen immediately after treatment.
Dr. Rokhsar specializes in cosmetic laser treatment and is recognized in New York and throughout the country as an expert in his field. If you are interested in learning more about birthmark removal and what the different procedures can do for you, contact us to schedule a consultation at our Garden City or New York City location.
*Results may vary.
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1 How to Remove a Birthmark. Available: https://www.healthline.com/health/beauty-skin-care/birthmark-removal.
2 Skin Conditions: Pigmented Birthmarks. Available: https://www.webmd.com/skin-problems-and-treatments/birthmarks.
3 Vascular and pigmented birthmarks. Available: https://pubmed.ncbi.nlm.nih.gov/10943257/.