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Mumsnetters aren't necessarily qualified to help if your child is unwell. If you have any serious medical concerns, we would urge you to consult your GP.

sebaceous naevus - my DD needs an operation

(14 Posts)
monkeymonkeymonkey Mon 27-Oct-08 11:48:20

My 21 month old DD has a sebaceous naevus on her head. It is about 4cmx2cm.
We have just seen the plastic surgeon and he has listed her to have it removed.
Apparently there is a risk of cancerous change if we leave it, and hers is at the top of her head, and tends to get very badly sunburnt in the summer despite us taking a lof of effort with sunblock, sun hats etc, which I imagine will increase the risk.
The plastic surgeon says that it will take 1 or 2 operations to have it removed. They will either take it all off at once, or take part of it, let it heal and the skin stretch across and then do it again.

Has anyone else had birthmarks removed from the scalp? Did you get a good result?
The surgeon said that there was a chance that the scar could widen, if the skin wouldnt stretch enough, though I'm not too worried about that as it will be a smaller mark than she has at the moment. How long should I expect the surgery to take?

I feel quite worried about this. I have always known that it would need to come off eventually, but now that I'm faced with the reality it is a bit frightening. None of my children have ever had a GA, and now DD will be having 1, maybe 2. They said that she will wait about 4 months for the operation, so she will be just over 2, the surgery will be done as a day case apparently, so at least she shouldnt need to stay overnight in hospital.
Any advice or reassurance would be much appreciated!

monkeymonkeymonkey Mon 27-Oct-08 17:52:49

Hopeful bump smile

RubyRioja Mon 27-Oct-08 18:04:27

Had never heard of this, but from your description and googling I am pretty sure my dd has one too. I always assumed it was a brthmark.

She too has to wear sunblock on it. I think I am off to doc now.

Sorry no info, but thanks.

monkeymonkeymonkey Mon 27-Oct-08 20:42:55

Ruby, I hope that you are ok and not too upset, the googling isnt pleasant reading is it. At least after reading it I do feel convinced that removing it is the right thing to do.
Good luck with the doctor.

roisin Mon 27-Oct-08 20:51:41

ds2 is having a large hairy naevus (c.10cm x5cm) removed on his lower back at the moment. He had 1 (of 3 or 4) operations in August and is due to see the plastic surgeon again next Monday to plan the next one.

The op was about 30 mins only and the scar is very neat. We went home a few hours later. I was very worried, but will feel more relaxed for the next one.

He is 9. I think it's probably harder when they are older, and it's good to have it done now.

He asked the GP about having it removed, and we were then told about the cancer risk and it being advisable to have it removed.

RubyRioja Mon 27-Oct-08 21:06:29

Am a bit shocked actually. GP noticed it as ababy and she had hormonal/steriod cream iirc, but it did nto work.

Since then, have not made an issue at all.

She is only 6, so plan to get things moving. I think hers is q small (sort of jagged v). So GP asap for us I think. Cancer was never mentioned as a risk

RubyRioja Tue 28-Oct-08 16:53:22

Seen GP today. He confirmed it was seb nev - so another successful MN diagnosis.

He is watch and wait school of thought - on the basis that nothing usually happens before they are 18 or so. It looks as thought the long term risk is about 25% which I am very unhappy about, so we are off to see a dermatologist privately this week.

GPs opininon seems to differ from just about everything I have read, so whilst he is a very nice doc, I really am not prepared to wait and see unless someone else can give me compelling evidence.

However cannot fault GP service - was seen in an hour and a half.

Hard to have a sensible conversation about risk with dd in room. Apparantly higher risk for a blondie.

Have been in bits all day actually.

monkeymonkeymonkey Tue 28-Oct-08 19:47:05

roisin

Thanks for your post. I feel a bit better about it after reading what you had written, it would be nice if it was all over relativly quickly.

ruby

So sorry that you are having to deal with this. When we saw the plastic surgeon he had no hesitation about removing it - he looked at it for about 2 seconds and then said he would list her to get it removed.
I was told that it was better to get them removed when they are relatively young, as the skin is more elastic then, so not sure about leaving it till they are 18?
Hope that you are able to get helpful advice out of the dermatologist.

RubyRioja Tue 28-Oct-08 19:49:30

thanks mmm
Just think of the good your post has done.
More research suggest the more current thinking is watch and wait and measure and photograph, but I still want it gone.

Canot wiat to see dermatologist

roisin Tue 28-Oct-08 22:15:30

What ds2 has is not a seb naev, but a 'hairy naevus' on his back, and it is different. but often medical messages are not clear, as you will see from our story:

When he was born the GP advised us to keep an eye on it and report any changes, and to keep it covered up or apply sunblock in sunny weather.

When we saw the GP 9 yrs later (who has some kind of specialism in skin complaints) she said there was no cancer risk associated.

When we saw the consultant dermatologist (prof) he said there definitely was, and that it must be removed. (He said little ones had little risk associated, giant ones had giant risk, but often couldn't be surgically removed because they were so large. But that ds2's was 'medium' so was therefore prime candidate for removal.)

When we saw the plastic surgeon he was rather dismissive of that and said the research is not yet conclusive.

But I'm still pleased it's going.

anonandlikeit Tue 28-Oct-08 22:18:21

Hi Monkey

DS1 has one on his scalp, he has lots of thick hair but he always wears a cap in the summer.

When he was born the DR's thought it was a scratch from the birth & I only mentioned it again to the GP last year (he's 8) blush.
he was seen by a dermatologist & he has put his name down for ds to have his removed at about the age of 13.
We were told that there was a slight increase risk of it becoming cancerous in later life but changes do not occur before puberty & its extremely unlikely to occur before middle age.

He recommended 13 to be about the right age so time off of school etc doesn't interfere with exams etc but he also said they had removed them on much younger children but in his experience with not such good long term cosmetic results. Not sure what he meant??

Good luck with your dd's ops, hope all gos well

RubyRioja Thu 30-Oct-08 15:44:27

Hi all, saw dermatologist who was very reassuring. He agrees no need to remove dds - if we dd would be cosmetic and take 2 ops..

He thinks ten years time and only then if required. He also reassured that even in worse case, is not scary type of malignancy (it sounded better coming from him) so advised not to worry.

He made lots of records and microscopic inspection and agreed might be handy to photograph twice a year to watch for increase in size, but was very relaxed about whole thing.

I think I am mainly reassured by getting consistent advice from GP and specialist.

So calming down here. Hope all goes super smoothly with your dd monkey. Thanks for raising this.

roisin Mon 03-Nov-08 20:25:21

ds2 saw the plastic surgeon today, and got the green light for the second op. He asked how ds2 would feel about having it done under a local rather than GA. Ds2 looked horrified, so we're not going that route!

So hopefully we should get this second op in this side of Christmas. Last time we got a date very promptly.

popsales Tue 04-Nov-08 11:32:23

Hi there,

I've just got back from seeing a dermatologist at the hospital about my 8 month old's sebaceous naevus. The doctor said I could opt for removal which would involve a GA or leave it until later. She advised that most people leave them as they usually 'behave themselves' until puberty and then only a very small amount become malignant during teenage years (she said 1% and not to believe the 5-20% you read about online and in books).

After reading all your comments though I am now a bit worried. I did ask if, when my son gets older, he could choose himself whether to have it removed if he was bothered by it and she said yes, and this would probably be better as it would only be a LA. The hospital took photos there and then to keep on file and she said to keep an eye on it and if it changed at all, to get another appointment.

I really don't want my son to have an uneccessary operation but I also don't want to leave something that could become cancerous.

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