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

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.

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.

Thank you for your question.
Judging by your description, i would recommend you consult a board certified plastic surgeon to discuss excision (laser are not really effective on dark brown birthmark), depending on the size you may need serial excision.
Best Wishes
Dr Genevieve FCaron, Board Certified Plastic Surgeon
Montreal, Canada

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 helpsDr Davin Lim Laser and Aesthetic DermatologistBrisbane, Australia