A Guide to Birthmark Removal: Options, Costs, What to Expect
The two main types of birthmarks are vascular birthmarks and pigmented birthmarks. Most birthmarks are not serious; many go away on their own. But sometimes dermatologists recommend birthmark removal to prevent a medical or cosmetic problem later on.
This article explains different types of birthmarks and how doctors treat and remove them. It also covers risks and complications, what to expect after a birthmark removal, and things to consider with costs.
A birthmark is a spot, patch, or lump that looks different from the rest of your skin. Some babies have them when they’re born, while others develop birthmarks soon after birth.
Birthmarks come in many shapes, sizes, and colors. The two main types are vascular birthmarks, when blood vessels don’t form correctly, and pigmented birthmarks, a cluster of cells that create skin color, or pigment.
Vascular birthmarks are typically flat and superficial. They are thought to occur due to nerve problems with blood vessels. There are three main types of vascular birthmarks: hemangiomas, macular stains, and port wine stains.
Hemangiomas typically appear as superficial “strawberry marks” on the surface of the skin. Another name for this birthmark is superficial infantile hemangioma.
Deep hemangiomas form deeper in the skin surface and can look like a lump. They may be slightly raised and bright red or bluish. The medical name for this birthmark is cavernous infantile hemangioma
A macular stain is a pink, red, or salmon-colored patch, and is sometimes called a “salmon patch.” The medical name is nevus simplex. These birthmarks are commonly found on the forehead, eyelids, nose, or back of the neck or head. People call them “angel kiss” when on the face. They may be more noticeable when the baby cries. Most macular stains disappear by age 1–3.
Port-wine stains appear as irregular shapes on the face, neck, arms, or legs. They can be any size and tend to darken, thicken, and change texture as the child grows. This type of birthmark does not go away on its own.
Without treatment, port-wine stains tend to progress into thickened irregular plaques. This can lead to significant psychological conditions, including anxiety and depression. For this reason, physicians recommend treatment as early as infants 1 year or younger.
Pigmented birthmarks result from an overgrowth of melanin, the cells responsible for skin color. This type of birthmark can have irregular or regular borders, can be raised or flat, and colors may be a combination of brown, black or blue.
Café-au-lait spots range in color from coffee with milk on fair skin to black coffee on dark skin. They can appear anywhere on the body. Most children have one of these spots, and others may have more than one. This type of birthmark remains on the skin for a lifetime.
Mongolian spots are flat blue-gray spots. They are often found on the lower back or buttocks. They are more common on darker skin. These spots will usually fade by the time a child reaches 3–5 years old.
Moles can appear flat or raised and vary in color from tan, brown, or black. Some may have hair growing from them. Some may disappear naturally, while others may remain for life. Large moles have an increased risk of developing skin cancer, while small moles have less risk.
Your dermatologist may recommend birthmark removal if there are signs of disease, such as skin cancer (melanoma) or neurofibromatosis, a disease that can cause tumors on the nerves.
Your dermatologist may also recommend removing a birthmark that:
- appears on the face near your child’s eye, nose, or mouth, such as with a strawberry hemangioma, which tends to grow quickly
- is located near the groin, which may cause pain later on
- will not go away with time and can grow and thicken, such as with a port-wine stain
- affects your child’s appearance, which could cause problems with self-esteem
The goal of birthmark removal is to remove or minimize a birthmark. Types of birthmark removal include medication, laser or light therapy, and surgery. The type of treatment depends on the type of birthmark and the reason for removal.
Doctors may prescribe medicines to prevent a birthmark from growing or to shrink a growing birthmark. These include:
- Beta-blockers: These medications, including propranolol, commonly treat high blood pressure and other heart problems. They can treat infantile hemangioma.
- Timolol gel: This topical beta-blocker gel is applied to the birthmark to treat a growing hemangioma.
- Corticosteroids: This type of anti-inflammatory medication can help shrink a growing hemangioma. A doctor may inject it in the birthmark or prescribe it in pill form.
- Interferon: Interferon helps fight infections and tumors. It is reserved for life threatening birthmarks.
Laser or light therapy
Laser or light therapy shrinks or eliminates blood vessels, which can help lighten birthmarks and make them less noticeable.
A dermatologist places an intense but gentle beam of light on the birthmark without damaging surrounding tissue. This is a good option for birthmarks that won’t go away with time.
The two main types of laser or light therapy are:
- Intense pulsed light (IPL): Also known as photo facial, this therapy uses a broad range of wavelengths known as polychromatic light. This light targets and destroys blood vessels and melanin just below the skin’s surface.
- Pulsed dye laser (PDL): This therapy uses a focused intense beam of yellow light, which is a single wavelength. The light is more intense than IPL. It heats and destroys all traces of the blood vessels under the skin without harming nearby tissue. The PDL machine first releases a cold spray to numb the area before emitting the intense beam. This laser therapy is particularly effective on port-wine stain birthmarks.
Depending on the type of birthmark, several treatments every 1–3 months may be needed to clear a birthmark.
This is usually done in the doctor’s office. Your doctor will numb the area with local anesthesia and use a small scalpel to scrape or cut out the birthmark. Rarely are stitches needed with this procedure.
Very large birthmarks may require general anesthesia in a surgical setting. Your doctor may close the removed area with stitches or replace it with a skin graft or flap of normal skin.
A board-certified dermatologist can prescribe medication or perform laser therapy to remove a birthmark. Your dermatologist may recommend a dermatologic or plastic surgeon for surgical procedures.
Medication side effects are possible. Contact your doctor about any symptoms that are severe or won’t go away, including:
Call your doctor immediately or seek emergency medical treatment for these side effects:
- shortness of breath or trouble breathing
- difficulty swallowing
- slow, irregular heartbeat
- sudden weakness of an arm or leg
Symptoms associated with laser therapy include:
Surgery or shaving
Signs of infection to look for after surgery or shaving include:
- redness around the incision
- pus or fluid coming from the incision
What to expect during recovery depends on the birthmark removal treatment.
Birthmarks treated with medications may shrink or lighten but not disappear altogether. Serious side effects are rare, but watch for symptoms that require medical attention.
Laser or light therapy
Skin generally lightens by 70%–90% with laser or light therapy. It may take several weeks and treatments to see significant changes.
Laser or light therapy may cause stinging or swelling of the treated area. You can reduce this discomfort by applying cool washcloths.
The skin may look pink or red skin and can last 4–8 hours after treatment. Protect the skin from sun damage by applying sunscreen. Multiple treatments are commonly needed with at least 4 weeks between treatments.
With surgical birthmark removal, downtime after surgery is typically minimal. Extra care is needed with stitches, especially avoiding strenuous activity after surgery while the area heals. Surgical birthmark removal is typically permanent. Some scarring is possible.
The cost of a birthmark removal depends on:
- the type of procedure
- the size of the birthmark
- the number of treatments needed
If you have health insurance, coverage will likely depend on the reason for removal. Birthmarks removed for cosmetic reasons may not be covered. Be sure to check with your insurance company.
Cost for pulsed dye laser
PDL therapy is available as an in-office procedure without anesthesia or with sedation. It is also available as an outpatient procedure with general anesthesia. Cost ranges include:
- in office without anesthesia: $530 – $997
- in office with intravenous sedation: $1,131 – $1,597
- in operating room with general anesthesia: $3,730 – $4,070
Your dermatologist may recommend birthmark removal if there are signs of disease or a potential cosmetic problem.
Medication, laser therapy, and surgery are procedures to remove or minimize a birthmark. While risks and complications are rare with all treatments, it’s important to watch for side effects and signs of infection after any treatment.
Depending on the type of birthmark, several treatments may be needed for permanent results. Some birthmarks may lighten but not go away completely.