Removal of Pigmented Birthmarks

Birthmarks may be present on the skin even at birth. The size can range from pinhead to palm. Their count is gradually growing till adulthood, reaching even 20-40 pieces. During puberty there is an increase in number and dimension; they can appear or increase during pregnancy as well. 
Nowadays pigmented birthmarks are often removed, because the increasing UV radiation may induce the malignant transformation. 

Pigmented birthmarks can be removed by several methods and devices. In case of a non-unambiguous banal lesion supported by clinical and dermatoscope analysis, excision with conventional scalpel, electrocauter or laser assisted haemostasis, wound closure with sutures are indicated. It is reasonable to remove healthy tissues surrounding the lesion: in case of melanoma suspect with a margin of some centimetres, in case of simple pigmented birthmarks with a margin of some millimetres from the edge of the visible lesion. It is very important to make the excision of the pigmented lesions along with surrounding healthy tissues. Should a larger skin be removed, flap surgery is necessary for the appropriate aesthetic outcome. 
There are such pigmented or coloured lesions, proved to be unambiguously harmless by clinical dermatoscope analysis, such as: age spots, cornification, enlarged blood vessels, fibromas, water warts, etc. Those lesions are carrying very slight oncologic risks. Treatments with laser, electrocauter, and cryosurgery are sufficiently safe. 

Patient’s minimal operational stress and favourable aesthetic outcome are the main advantages of the above surgical methods. Removal of bigger skin surfaces, flap surgery, sutures are unnecessary. Experienced medical specialist can choose the suitable removal method of the pigmented lesions. 

Before removing a pigmented birthmark, dermatologic consilium is always necessary, and dermatologists often send the patient to surgeon.
It is recommended to have the bigger, dark pigmented hairy birthmarks removed, because they can become malignant and they are aesthetically disturbing.
A malignant tissue, the melanoma may develop from some pigmented birthmarks, therefore the histologic analysis of the birthmarks is essential.
Light skin and excess sunshine may trigger the appearance of birthmarks. Often appear on healthy skin, and don’t contain pigment.
In women appears on the lower limb and on the face; in men on the shoulder.
However in small percentage of the cases, melanoma may develop from dark pigmented birthmarks as well.
At the beginning, those spots have a bit uneven edges, they don’t cause discomforts. Scabs may appear on the surface, the may itch.
Sometimes in the multi-coloured birthmark appears a rosy, rapid growth. Don’t delay with the medical investigation of the continuously growing birthmark with uneven edges!!
Neglected, not adequately treated or excised tumours build soon metastasis with the adjacent lymph nodes, and then through blood circulation metastatic tumours can appear in the liver and in the lungs.
Special attention is to be paid to the behaviour of the pigmented birth marks. You had rather to have checked your birthmarks every year than to neglect any of them.
Dermatologist has to decide about the destiny of the birthmark, if possible. Never have a pigmented birthmark removed without medical specialist and histologic examination.