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

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?

Doctor Answers 3

Birthmark Removal

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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.

Dallas Plastic Surgeon
4.7 out of 5 stars 56 reviews

Surgical over laser

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Brown birthmarks, especially in this location can easily be treated with excision - either in one session (if small) or several sessions spaced a few months apart- called serial excisions. 

This is critical as microscopic examination of the birthmark can reveal if there are any abnormal cells. Laser treatment is an option, however it will require many (up to 6-8 treatments) over a year. If hair is growing, you may need to use a second type of laser to remove the hair follicle, as pigment cells often regenerate from this area. 

I personally would recommend excision by a Plastic Surgeon or Surgical Dermatologist. 

Hope this helps

Dr Davin Lim 
Laser and Aesthetic Dermatologist
Brisbane, Australia

Pigmented Birthmarks should be surgically removed and not by laser

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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.

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.