Should I Have My Facial Nevus Removed?

Q: Dr. Eppley, I have two issues: 1) a birthmark the full length of my cheek which I’ve had my whole life and 2) the facial hair covering the birthmark is substantially thicker than that covering my other cheek. Can you help with either of my two issues? Photos attached.

A: What you have is a congenital nevus of the face. Its characteristics are well known and include being born with it, the involved skin is thicker and more pigmented and the hair that grows from it is often darker and thicker. The key concept to understand about congenital nevi is that involve the full thickness of the skin. Thus they can not be removed or reduced by laser resurfacing or treatment method. The entire full-thickness of the skin needs to be cut out (excised) either through serial reductions or as a single surgery and then covered with a skin graft. While this would cure the nevus, it would result in a worsening of the aesthetic appearance of the face and I do not believe you would consider it an improvement. This is a long way to say you are better off to leave it alone as the treatment of it is worse than the problem.

Dr. Barry Eppley

Indianapolis, Indiana