My son(11yrs/Korean ethnicity) has a nearly 2cm diameter melanocytic nevus on the right side of the nose. This has become darker over the years and thicker (as one would expect) and increasing number of hairs within it. We want advice on how to choose the best treatment to make the scar least, with our ethinicity being considered.
Treatment Options for Nevus on the Nose For 11 Year Old Boy? (photo)
Doctor Answers 3
Excision is an option for the nevus on the nose
Laser for mole on nose
Congenital moles of this type extend deeply into the skin and exicison would leave a large, deep wound. A skin graft would look sunken in and would be unacceptable in my opinion. Closure would require a large, multi-staged flap and there would be risk of significant scarring and as well as risk of alar rim elevation and distortion. I would consider laser therapy which is done with some frequency for these types of moles in Asia. In the US, I would see Dr. Rox Anderson at Massachusetts General Hospital. Laser does not remove the mole in its entirety but can be very helpful to make it less dark and less noticeable. Laser would also reduce the hair growth within the mole. There is a small risk of malignant melanoma within these types of moles so any change within the mole should be evaluated by a dermatologist.
This is one of the most difficult areas to reconstruct especially in a young person with very little skin laxity and the need to minimize the scars.
I would excise and cover with a full thickness skin graft. If the cartilage gets exposed then a flap is needed. A nasolabial fold flap next would be a forehead flap. The skin graft has the least scars but not a super cosmetic results. Flaps may give a better cosmetic result, but more scars.