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VERIFIED CONTENTConsultation: lek. med. Bartosz Pawlikowski, dermatologistGiant birthmarks, the so-called Pigmented moles are changes that occur on a baby's skin. What is known about them today? How to treat giant moles and is it always worth it …? More about them will be told by the dermatologist Dr. Bartosz Pawlikowski, who has been specializing in pediatric dermatology and laser therapy for many years.
Giant (pigmented) neviis divided into congenital and acquired nevi, divided into: small (20-30 cm), medium (30-40 cm) and large (above (40 cm). 2% of birthmarks occur in children under 1 year of age.They occur 1.5 times more often in girlsThe risk of developing melanoma from birthmarks may be as high as 5 % of the population, therefore they cannot be underestimated. Congenital dyes are classified into: small, medium and large.
Dermatologist Dr. Bartosz Pawlikowski stated that"birthmarks disappear very rarely" . - The percentage of children with spontaneously resolving birthmarks is very low, and the clearance of changes is never complete and does not exclude the development of melanoma - explained the dermatologist. On the other hand, the percentage of children with acquired pigmentary nevi (e.g. solar nevus, genetic) that disappear, is high.
How to treat giant birthmarks?
According to Dr. Bartosz Pawlikowski, treatment of giant nevi, both surgically and by other methods, is "important because the risk of melanoma development increases with the size of the nevus, and it is particularly high in the area of moles over 10 cm". As he added, "the matter is serious, because congenital birthmarks may also be associated withdisorders in the central nervous system and disorders of the brain development.
Two methods of treatment are used giant birthmarks:
- conservative method- removal of benign nevi of various sizes (no features necessary for tumor development) using a dye removal laser (small or large moles) or ablation laser (small moles). Before the treatment is implemented, the birthmark is examined with a videodermatoscope. If the nevus is benign, the procedure is performed under infiltration anesthesia (intradermal and subcutaneous). Laser treatmentsusually performed in series every 4 weeks.
- methodradical- surgical removal of moles with cancer risk. Thanks to histopathological examinations, it is possible to remove the birthmark with a scalpel. The treatment is one-off.
What are the indications for laser removal of giant birthmarks?
Dr. Bartosz Pawłowski, whenever he diagnoses a small patient for laser therapy, assesses whether the birthmark is acquired or congenital, large or small.The location of the birthmarkis also important (e.g. located in difficult places, for example around the eye). According to the doctor, "there are still very few such treatments in the world". - Parents hope that the birthmark will disappear on its own, which is of course impossible or will fade significantly - noted the dermatologist from Lodz. Parents also come to the doctor who want to avoid any risk of developing the nevus towards cancer, but also for fear that their child may be rejected by their peers due to their appearance.
Minimizing the visibility of the birthmark by surgical methods - according to the doctor - are not an ideal solution. - Sometimes you have to stretch the skin with special expanders to remove the birthmark completely, otherwise, after cutting such a large area of the skin, a facial deformity will appear, who knows if it is emotionally more painful. Hence, reducing this method to a minimum brings a great improvement, the child will not be crippled - explained Dr. Bartosz Pawlikowski.
In his opinion"laser treatments also reduce the risk of melanoma" . - In my opinion, the laser method is the best alternative to radical surgery that may deform the area from which it is removed. Laser and surgical procedures can be combined in a short period of time, and the order does not matter. Personally, I suggest starting with a laser - suggested the doctor.
When asked when is it best to perform the giant birthmark removal procedure, Dr. Bartosz Pawlikowski replied: "It is not about removing them in 1 month of life". He said, "It is recommendedto undergo pre-pubertal treatmentsdue to the increased risk of developing cancer during this stage of life." Besides, this does not only apply to these birthmarks, there is, for example, Jadassohn's birthmark, mentioned by the doctor, which may undergo neoplastic transformation in adolescence.
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