There are several types of birthmarks that respond well to laser treatment. At the Medispa Institute, we can treat café-au-lait macules, which are brown birthmarks of varying size, and Nevus of Ota, a birthmark that normally appears around the eye on one side of the face.
Q. What is involved in the treatment ?
Skin blemishes that are present at birth or appear soon after are generally referred to as "birthmarks". These may be red or brown and represent an overgrowth of superficial blood vessels or pigment cells. The treatment of these birthmarks depends on the type of lesion.
Port wine stain birthmarks
These flat red marks are present at birth and will not disappear over time. Until recently, these disfiguring birthmarks were life-long problems which have the potential to thicken and become more unsightly with ageing. As the foundation director of the laser unit at the Royal Children's Hospital, Dr Bekhor has been using laser therapy to fade and, in many cases, remove these birthmarks in young children before they start school.
This has enormous social implications in an unkind world. The Candela Vbeam PerfectaT pulsed dye laser is the treatment of choice for these birthmark lesions. Young children can be treated at the Royal Children's Hospital. Adults who have missed out on early intervention may also benefit from treatment, with the Perfecta laser, the FlexT IPL (intense pulsed light) and / or the Long Pulsed Nd YAG laser, including the GeminiT laser. The Dermatology Laser Unit at the Royal Children's Hospital is the only specialist paediatric centre that can offer safe treatment under general anaesthesia.
Haemangiomas (Strawberry birthmarks)
These are flat red birthmarks that are not present immediately at birth but appear in the first weeks of life. They birthmarks often grow and thicken rapidly and, in extreme circumstances, ulcerate. This type of haemangioma will usually disappear by 10 years of age, but may cause developmental and social problems before this. Again, Candela PerfectaT pulsed dye laser is the treatment of choice to arrest the growth and thickening of these birthmarks.
Laser Treatment is only successful on flat lesions, so early diagnosis and intervention of these haemangiomas is extremely important. Usually a paediatrician or Infant Welfare nurse will identify the early signs of birthmarks and refer babies to our experienced dermatologist.
If a haemangioma appears on an eyelid, nose, lip or extensively over the face, this should be regarded as a medical emergency requiring urgent medical intervention. The mainstay of treatment in these situations are steroids, usually oral but occasionally injected into the haemangioma. In selected cases where the birthmark is still flat, laser may be used. Infants presenting with these birthmarks are usually managed by the team at the Children's Hospital where the combined expertise of medical specialists, including laser dermatologists and paediatricians, achieves the best outcome.
Spider naevi
These small annoying red spots often appear in young children and can lead to teasing at school. They are caused by the dilation of a small arteriole close to the skin. Fortunately, they respond very well to laser treatment with the pulsed dye laser and usually only a single laser treatment is necessary.
Brown birthmarks
Like vascular (red) birthmarks, some of these are present at birth while others appear over time. The skin colour- producing cell is known as a melanocyte and the brown colour produced is referred to as melanin. Brown birthmarks are caused by a proliferation of melanocyte cells or an increase in melanin production in a specific area.
The laser treatment of choice is Q-Switched Laser (Ruby, YAG or Alexandrite). Café au lait (flat, milk coffee coloured marks) birthmarks respond in 50% of cases. Naevus of Ota and naevus of Ito usually respond well, as does Hori's naevus. Becker's naevus, unfortunately, only responds to laser treatment in a minority of cases. Usually a laser test treatment is carried out to establish whether the lesion is responsive to laser removal.
The Laser Unit at the Royal Children's Hospital is the only location that can offer extensive laser treatment of brown birthmarks on children under general anaesthetic.
Congenital Melanocytic Naevi are essentially moles that appear at birth. Sometimes they can be extremely large and are known as "Bathing Trunk Naevi". These lesions may sometimes respond to laser treatment.
At Laser Dermatology, most birthmarks are subjected to a test treatment to establish responsiveness before proceeding to full laser treatment. In most cases, multiple laser treatments are required. As with other lasers, the sensation is that of a flick with a rubber band. Treatment under safe paediatric general anaesthetic for children with extensive birth marks is available at the Laser Unit, Department of Dermatology at the Royal Children's Hospital.
Before
After
Recovery
With café-au-lait macules, you may resume normal activities immediately, however, you may experience some redness and/or swelling for several hours. For Nevus-of-Ota, the treatments are of necessity very strong, therefore you can expect 2-7 days of redness, bruising, crusting, and tenderness.
Results
With laser birthmark removal, although we aim for complete clearance, a more realistic expectation is significant lightening of the birthmark to about 70-90%, which is a very good outcome of the laser treatment.
complications
As with any medical procedure, there is always a possibility that something can happen. With this type of procedure, normal reactions are redness, bruising, swelling, crusting, increased pigmentation (hyperpigmentation), lightening of the skin (hypopigmentation). These reactions are typically transient and will resolve over time.
Risks
There aren't many risks to having a birthmark removed through the use of lasers.
Here are the possible risks, though most are quite uncommon : -
Uneven skin tone, with excessively light and/or dark areas of skin
Patches forming in the skin
Bleeding and scabbing
FAQ's
Q. What age is appropriate for laser birthmark removal treatment ?
You can have a birthmark removed at any age. However until you are 16 you'll need your parents' approval. In any case, it's important to seek the advice of your GP or a dermatologist before making any decisions.
Q. Will it come back ?
Generally, after laser birthmark removal, the lesions do not come back. However, a few extremely rare cases of spontaneous reoccurrence have been documented, and there is no predictive measure of when or how or what causes the recurrence. We have not had any cases of recurrence in our clinic to date.
Q. Will there be any scarring ?
Scarring is not the result of laser treatment, but the result of your skin's inability to heal properly. We will ask you prior to treatment if you scar easily and briefly examine your arms and legs for scarring to determine if you are a good candidate for laser treatment of birthmarks.
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There are several types of birthmarks that respond well to laser treatment. At the Medispa Institute, we can treat café-au-lait macules, which are brown birthmarks of varying size, and Nevus of Ota, a birthmark that normally appears around the eye on one side of the face.
