Want to Remove a Large Brown Birthmark on the Back with Hair?

I'm Asian, has a large brown birthmark on my back with hair. It's like roughly 1/4 of the size of my back. My mother said it was a small spot when I was a baby, but it gets bigger as I grow. Is there anyway that I can remove it? I've watched a tv program once, and a doctor suggested to do laser, and it'll remove the pigment and hair. Is that right?

Doctor Answers 3

Very difficult question, and more complex answer-

This sounds like a giant congenital naevus, and is very very difficult to treat. We do not have the technology at this moment in time to treat this effectively, especially one so large. Surgery will leave you with a huge scar, as will dermabrasion (old technology). 

Just over the horizon companies like Syneron are developing Picosecond Q switch lasers- super exciting stuff as it leaves the current nanosecond lasers for dead. Its like a super computer. The catch is  1. we have not trialled this on congenital moles, 2. We don't know the recurrence rate, 3. You may still need a laser to treat the hair follicle (as pigment hides in this area) 4. There is remote risk of skin cancer or melanoma forming in this mole. 

My suggestion is be patient, results from multi center studies will emerge in the upcoming years. I certainly will be publishing our results, so stay tuned. 


Dr Davin Lim 
Laser Dermatologist
Brisbane, Australia

Brisbane Dermatologist
4.7 out of 5 stars 75 reviews

Treatment of Giant Hairy Nevus

The best way to remove this would be direct excision with closure in such a way to leave a minimal scar. This is a fancy way of saying - moving making sure you scar is in a skin crease if possible or close to a normal anatomical structure after removal so that you scar is less noticeable. Lasers are generally not used and it is customary to send what was removed to a pathologist for analysis.                                                                              Because of the large size this would require serial excisions (more than one surgery) and or the use of Tissue Expanders (a type of water balloon that stretched normal skin near by so that it can be used to replace your abnormal skin, nevus.)

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 154 reviews

Birthmark Removal on the Back

Hello garconNYC!

It's not possible to give you precise answers without seeing the type of birthmark and the location or size. However... laser can reduce pigment and hair, although it is likely to require many treaments and may be quite expensive for a birthmark that is 1/4 the size of your back. Laser treatment is not likely to completely remove your birthmark.

The surgical option is to have your birthmark excised. Given the large size of your birthmark it is unlikely that this could be done in one surgery. Sometimes tissue expanders are inserted under the normal skin and gradually inflated (by injecting saline into the tissue expanders, with a needle through your skin) so that you "grow" more skin. That new skin can be used to cover the area where your birthmark is.

For birthmarks that are not so large it may be possible to serially excise the birthmark. This is done in a series of surgeries planned a few months apart. At each surgery some of the birthmark is removed, and the wound stitched together. Between the surgeries the surrounding back skin relaxes and so at the next surgery more of the birthmark is removed.

Given the size of your birthmark I recommend that you see a plastic surgeon for an assessment and to find out what your options are.

No matter what you decide, it is wise to keep a watch on your birthmark because (rarely) you can develop skin tumours in birthmarks. If an area of pigmentation changes, ulcerates or looks abnormal you should see a doctor to get it checked out.

Good luck!

Jill Tomlinson, MBBS, FRACS
Melbourne Plastic Surgeon

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.