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

Question

I have a birthmark on my lower back that my doctor said is not anything to be alarmed about but is something that we should watch. However, I HATE the appearance of it. It's dark brown, flat, and oval shaped. Hair grows out of it and it's disgusting. I would rather have a scar there than this birthmark. What is the best way to take care of it?

John L. Burns Jr., MD · Answer

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.

Raffy Karamanoukian, MD, FACS · Answer

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

Amir Nakhdjevani, MBBS, MRCS, FRCS(Plast) · Answer

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

Larry S. Nichter, MD, MS, FACS · Answer

A Pigmented birthmark, also called a nevus or mole, are directly should always be removed surgically. In most cases after removal  it can be closed directly after removal leaving a line scar in most cases. See a board certified plastic surgeons for best result and make sure what is removed is sent to Pathology for testing to make sure it is not malignant or pre-malignant.

Milan Doshi, MS, MCh · Answer

Depending upon the position, size and color of the birthmark either of the technique can be used. You need to consult your nearest dermatologist and proceed accordingly. 
  
Take care and wish you a speedy recovery.

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

Answers (7)

Answer: Pigmented Birthmarks should be surgically removed and not by laser

Answer: Pigmented Birthmarks should be surgically removed and not by laser

Answer: Birthmark Removal

Answer: Birthmark Removal

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Everything you need to know about Laser Resurfacing

Our mission is to create a world where every investment in modern beauty is Worth It.

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

Answers (7)

Answer: Pigmented Birthmarks should be surgically removed and not by laser

Answer: Pigmented Birthmarks should be surgically removed and not by laser

Answer: Birthmark Removal

Answer: Birthmark Removal

Browse related questions

Recommended reading

Everything you need to know about Laser Resurfacing

Our mission is to create a world where every investment in modern beauty is Worth It.