I Have a 8 Y/o Who Has a Dark Spot on His Face. Is Laser the Best Way to Remove It?

Is laser treatment the best way to perform on young children to get rid of dark spot? I'd like to know before I go to see a dermotologist.

Doctor Answers 5

Dark spot on child's face--laser for removal?

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Expert examination by physicians experienced in skin lesions (Dermatologists, Plastic Surgeons, ENT surgeons, and perhaps some General Surgeons or Family Practitioners) should in most cases allow the doctor to identify the most likely diagnosis of the "dark spot." You may simply be interested in removal for cosmetic reasons, but what if this is a melanoma?

I don't want to scare you, but too many "dark spots" are simply shaved, lasered, burnt, or frozen without regard to WHAT was just destroyed, and (if indeed it was a "bad thing") whether or not it was COMPLETELY removed.

I have taught laser surgery for over 20 years. I have also removed skin cancers and melanomas (the worst kind of skin cancer) for 25. Too many "dark spots" are mistreated without first determining WHAT it is. Most dark spots are, or course, not of concern, and removal is indeed strictly for cosmetic reasons. Unless your son's spot is a freckle or keratosis, laser is probably NOT the best (least scarring or deformity-causing) method of removal. Plastic surgical excision along lines of relaxed skin tension will leave the smallest, least conspicuous scar for mole removal. Some Dermatologists follow these techniques and do quite nice work (and some plastic surgeons may think that mole removal is too "putzy" to worry about doing a good job), but my son's dark spot would be removed by a caring, experienced plastic surgeon who not only knows lasers, but also takes pride in doing a lesion removal in any anatomic location that cannot be bettered anywhere, by any other specialty, with the most precise technique and tiniest sutures not tied too tight or left in too long so they don't leave marks.

So, get a diagnosis by an expert. Then, if necessary, see another expert about removal. Best wishes!

Dark spot on your son's face

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It is important that the dermatologist examine the dark spot with an magnifier called a dermatoscope...also known as a dermascope. The use of a dermascope will help the dermatologist determine the exact type of growth that is present. After that, the dermatologist should review all of the available treatments, including laser, for the spot. There are numbing creams that can be used prior to treatment of the spot...we don't want your son to feel any discomfort should the area get treatment.



Christine Glavey, MD (retired)
Alpharetta Dermatologic Surgeon

Pediatric Melanoma: Protect Your Kids

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Fortunately the incidence of pediatric melanoma is on the decline.  This serious form of skin cancer can be largely prevented by following several tried and true rules which have lead to the encouraging decrease in pediatric melanoma:  effective public health initiatives, a shift to youth participating in more indoor activities, and increased parental awareness to use more sun protective measures with young children. 

Dark atypical lesions should be evaluated by a Board Certified Dermatologist and biopsied if necessary.  Laser is not an option for darkly pigmented, suspicious lesions.

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Lasers for Dark Spots

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Thank you for your question. First, you should have your son get an exam, with a diagnosis of the spot (a biopsy may be needed), then a plan of treatment by a Board Certified Dermatologist with expertise in pediatric dermatology. The lesion may not be amenable to a laser procedure and may need to be cut out instead, depending on the diagnosis I hope this helps.

Dark spot in a child may not be responsive to laser

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The most important aspect of your son's situation is that the correct diagnosis of the lesion is made. Is this a congenital nevus (not all are present at birth)? Is it flat or raised? Are there hairs within it? Some are tan and flat and called a cafe au lait macule while others may have elements of smooth muscle enlargement or hair follicles, such as a Becker's nevus.  A cafe au lait macule may be associated with other findings on his skin surface over the body and a dermatologist or pediatrician should make sure that it is not part of a more concerning syndrome. After throrough evaluation, and ensurance given by the expert that there is no other worrisome condition, and if the lesion is flat and homogenously tan, it may respond well to a Neodynium-Yag, Alexandrite or Ruby laser, depending on your son's pigmentation of his normal skin.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 38 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.