What is the Best Way to Have a Flat Birthmark Removed? Laser or Excision?

The type of birthmark is very critical to the method by which it can be removed.  If the birthmark is red or vascular, there are a variety of lasers which can remove the birthmark.  A few of these lasers are, pulsed dye laser, intense pulsed light device, KTP, Nd:YAG.  

If the birthmark is brown, then lasers are largely ineffective because the brown pigment is due to melanin in the skin.  Melanin is what gives skin its color and lasers cannot selectively remove pigment.  While there are some reports in the literature about removing brown birthmarks with laser, surgical excision is generally the procedure of choice.

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.
Best,
Dr. Karamanoukian
Realself100 Surgeon

Thank you for your question.  It will be dependant on which type of birthmark you have.  It will depend on the size to whether excision would be possible.  Please do have a consultation with a board certified plastic surgeon.  All The Best