Birthmark treatment

Getting the diagnosis right

The word covers very different things. Vascular birthmarks such as port wine stains and haemangiomas are made of blood vessels and respond to vascular laser. Pigmented birthmarks such as café-au-lait macules and congenital naevi are made of pigment cells and behave quite differently.

Some pigmented birthmarks, particularly larger congenital naevi, carry a small increased risk of malignant change and need monitoring rather than cosmetic treatment. Some vascular lesions in infancy are associated with underlying conditions requiring paediatric assessment. Establishing which category you are in comes before any conversation about lasers.

Vascular birthmarks

Pulsed dye laser targets haemoglobin in the abnormal vessels, causing them to collapse without damaging surrounding skin. Port wine stains typically require a course of treatments and, importantly, usually lighten substantially rather than disappear entirely. Results on the face are generally better than on the limbs.

Pigmented birthmarks

Response is far less predictable. Some superficial pigmented lesions lighten with pigment-directed laser. Others recur, or repigment over months to years, and some are made worse by treatment. Where the honest answer is that laser is unlikely to give you a result worth the cost and risk, that is what you will be told.

Expectations

This is an area where patients are frequently oversold. Photographs in marketing material represent the best possible outcomes, not typical ones. Dr Babamiri will give you a realistic view of the likely degree of improvement for your specific lesion before you commit to anything.

Risks and limitations

No treatment is without risk, and you are entitled to the full picture before you decide rather than a summary afterwards. These are discussed with you individually at consultation, in the context of your own history.

• Incomplete clearance — partial lightening is the usual outcome, not removal
• Pigmentary change, either lighter or darker, particularly in deeper skin tones
• Blistering, crusting and bruising after vascular laser
• Scarring, uncommon but possible
• Recurrence or repigmentation over time

Where you would be seen

Consultations and minor skin surgery take place at CLNQ Manchester on the ground floor of the South Tower at Deansgate Square, and at CLNQ Knutsford on King Street in Cheshire. Patients travel from across Greater Manchester and Cheshire — Altrincham, Hale, Bowdon, Wilmslow, Alderley Edge and Didsbury are all within easy reach of one or other site.

Where a lesion needs a theatre rather than a treatment room, the procedure is arranged at Deansgate Hospital, a CQC-registered private hospital a few minutes away in Manchester city centre. Any specimen requiring histology goes to a UK histopathology laboratory and the result is discussed with you directly.

• CLNQ Manchester — Deansgate Square 11 Owen Street, Manchester M15 4YB Ground floor of the South Tower at Deansgate Square, Manchester city centre.
• CLNQ Knutsford — Cheshire 49-51 King Street, Knutsford WA16 6DX King Street, Knutsford, serving Cheshire and the surrounding area.
• Deansgate Hospital Madison House, 37 Little Peter Street, Manchester M15 4QJ CQC-registered private hospital in Manchester city centre, for procedures needing a theatre.

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