Surgery for DS’s facial birthmark

[BeCalmFox]

Hi everyone

First time poster really looking for some views.

my DS (4) was born with a large red birthmark on his face. It was originally diagnosed as a port wine stain but after it faded significantly in his first year it was diagnosed instead as very extensive stork bites or salmon patches. It has continued to fade although at a much slower rate and, until now, hasn’t caused him any problems and other children haven’t mentioned it. It’s faint pink now and not immediately noticeable unless you spend a bit of time with him. It’s more noticeable when he’s cold or excited or upset etc. It is definitely still there though and I’m conscious of how perceptive and cruel other children can be. He starts school on august and we have just been given an NHS appointment to have it treated by laser. The procedure requires general anaesthetic and 10 days off nursery. It may also require repeated procedures depending on the skin’s reaction.

My DH and I are torn about what to do. On one hand we don’t want to put him through an operation requiring GA and a disruption to his life for something that is not medically necessary, massively noticeable and may continue to fade further.

On the other hand, I am concerned about him being bullied or treated differently because of it and this affecting his confidence. If we waited another few years, I’m concerned that some damage may have already been done in this respect. We may have a chance to just deal with it now and draw a line under it before school.

AIBU to put my DS through this procedure?

Thanks that’s really helpful. I do think that part of the reason that they’re willing to offer the treatment is that the birthmark was much darker when we were added to the waiting list. Not so sure they’d agree to treat if they’d seen us for the first time with it as it is now.

If they think it's improving without treatment they may say to wait a bit longer.

Not the same, but I have a birthmark on my arm that I have endured shitty comments on my whole life, particularly during childhood. I wish there could've been an option to get rid of it as a child.
So I say YANBU.

I think many people are not reading your post thoroughly. The experience of someone with a very noticeable facial difference isn’t really relevant in your situation. Given it’s fading on its own and not noticeable to most people I think it falls into unnecessary risk category to have multiple GAs. As you have said yourself it’s improved so much you aren’t confident you would even be offered treatment if it was to be assessed now.

My DD when she was about 6 or 7 developed a red spider vein cluster on her face. We were told it would disappear on its own and it did, but took about two years. Some kids would ask what it was, she’d respond and they’d go on their way. Meanwhile parents at school were urging me to take her to have laser treatment ‘because kids are so cruel’. It was the adults who couldn’t deal with a small imperfection, who couldn’t countenance waiting ‘when you can get rid of it now’. The kids were absolutely fine.

I have a brown birthmark on my neck, probably the size of a walnut. Kids were occasionally curious about it when i was growing up, but never mean. Adults can be stunningly rude though - I've regularly been mocked by people thinking it's a lovebite, and called a slut for the same reason. A guy once crossed the street to tell me I should have it checked for cancer. And when I was little I remember going to the doctor to have a mole frozen off because it kept on catching on my clothes and the doctor said "I suppose you could have the birthmark removed but it would probably make more of a mess than is there now". I still remember that 35 years later, and feeling incredulous that he would think I would want to remove it. It's part of me and I would have been devastated to lose it then, and the same now.

It's completely different, but I have a condition with one of my eyes and when I'm tired/run down it becomes really lazy and floats. It's not a big deal to anyone, and nobody normally notices it unless I point it out. I however am incredibly conscious of it, and as a child learnt to not make eye contact because I was so paranoid of people looking at it. I would be called "Chinese eyes" from being as young as 5.
I used to have a long fringe/wear make up certain way etc. it had a major effect on my own confidence growing up.
If there had been anything that could've been done to eradicate that when I was younger I can honestly say it would've changed my life and how I felt about myself growing up.

I know it isn't a birth mark, but it is a visiual difference. I hope that is helpful.

Believe me, it's not children who are nasty, it's adults who will be the nasty ones, when your child becomes an adult. Having a disability, I speak from experience.

Thank you, that is important to point out. We’re definitely not in the category of having a very noticeable facial difference. It has faded and might well continue to fade but we really don’t know how it will end up. If we were told it would fade completely we certainly wouldn’t be considering treatment simply to expedite that. However, it might not fade much more or could take a very long time to fade further. In that time, I’m worried about the effect on his confidence when he or others start to notice. Given the size of it, I think it’s unlikely to disappear completely. If he decides at a later point that he does want it treated I’m worried that he’ll wonder why we didn’t just do it when he was little.

I went to secondary with a girl who had a good sized strawberry (raised reddish purplish birthmark) on her jawline.

It really wasn't commented on much - new kids asking her what it was "a birthmark" "oh", maybe, but no one teased her.

The thing is, if a kid gets bullied over a birthmark/glasses/gingerness etc...they were going to get bullied anyway. Bullies sniff out vulnerability, and come up with a "reason" for it later.

@BeCalmFox I understand it is difficult when you don’t have certainty either way.

When I look at the young adults I know now, those whose parents jumped in to correct/fix/perfect things are not noticeably more confident than those who were given the chance to work through experiences or accept imperfections about themselves. Some of them are perhaps a bit less confident?

Im not from the UK so I don’t know exactly how the NHS works. Where I live you could just decide when you wanted to intervene so the wait and see approach might be more practical. If this is your one chance to have it done on the NHS and it would later require private treatment then I understand why you might opt for it.

Thank you. We are in the fortunate position that we could afford to do it privately when he’s older. However, we live in Scotland and we’d have to go to London for it to be done privately. We are not averse to doing that and the cost is not prohibitive but recognise that it would probably add stress to him and having it done locally might be a better solution.

I know someone who had the lazer and it was painful and decided not to go back. So definitely ask about expected pain. This was a while ago so techniques may have improved

@BeCalmFox I’d get it done, too.
My son had a hydrocele that the GP said could be left til adulthood, and son could remove it in f it bothered him-
But the thing was getting bigger, so we opted to have it removed - son was 2 yrs old-

Son is adult now and said thank goodness you did it when I was young!

He remembers the hospital- But in a nice way!

Marks on the face can be very upsetting to children and adults- if they can be lasered away, do it.

Teasing is horrible-and red marks will be noticed- why should he have to put up with it if they can be got rid of?

This is exactly what the hydrocele GP said - Son said he was bloody relieved to have had it done as a 2 yr old.

It’s a confidence thing.

If it’s “bad” enough to warrant NHS treatment they must obviously think his life will be improved by doing it.

They don’t offer things like this for fun.

Your son probably will be grateful to have had it treated as a young child rather than in teenaged years where self consciousness really can kick in .

@Cheepcheepcheep Your son’s hernia surgery was possibly like my son’s- ( hydrocele)
We were told it could be left til adulthood- but son ( now adult) says how glad he was to have had it done as a little child.
just a faint bramble scratch scar left-

Prince William had the same operation, too as a young child!

I have a birthmark that covers around 1/4 my face - it surrounds one of my eyes, and most of my forehead (it is darker underneath my eye than it is on my forehead). It's not red however, it is brown. It also affects my eyebrow colours (one eyebrow is my natural hair colour, and the other is black). it also affects a patch of hair, which is also black (the hair on top of the black patch covers this, though) - no dye will ever change this hair patch.

However, I also have an olive skin tone, so my mark does blend in better, and it has faded over the years (but it is still noticeable).

As a child, I was called 'Patch', and often asked (as an insult/jibe) who had given me a black eye (in fact, my DH and I were waiting at a bus stop once, and an elderly lady came up to me, glared at my DH, and asked me if I was okay. When I looked very confused, she pointed to my eye, I laughed it off, thanked her, and told her that it was a birthmark - she at least, meant well, unlike others who have used it as an insult).

However, the comments I received? They were from a very small number of people, and the comments weren't that common (I've never been relentlessly bullied due to my mark). I remember discussing it with a friend once, and she said, "Yeah, I noticed it the first time I ever met you. Now, I don't notice it at all, it's just you/your face."

As a teenager, my mum gave me the option to have it lasered (she was willing to take out a loan for it). I thought about it, and declined. Partly because I didn't want her getting into debt for it (but I will also admit that as a selfish teenager that was secondary to my main reason), but mostly because I pointed out to my mum that I wouldn't look like me anymore (in fact, I remember being quite upset that my mum suggested it, as I thought she was implying that I was ugly).

The truth is - I do have a rather large mark on my face, and two different coloured eyebrows, as well as a patch in my hair. But that's always been how I have looked. In the same way, I've always had a left thumb, and nobody is suggesting I remove that either! However, I do understand that it can give others more confidence to remove it etc (people need to make the right decision for them). Similarly, if my mum had decided to remove it for me, as a child, not having it would be part of me too. However, I'm glad this wasn't an option for her (as I believe if it had been available for me on the NHS, she would have done it) - I've got other medical issues that have had been in and out hospitals since childhood, I'm glad that a domestic issue on my face wasn't another thing for me to be in for,

I have a strawberry birth mark on my jaw/cheek. I don't remember ever being bullied for it. Sometimes I got asked if I had hurt myself, and I would say 'no its my birth mark' and they would say 'oh, i never noticed it before' (just been there all my life 😂).

I ended up getting some laser surgery in my teens. Maybe it was a different kind, but I didn't have to go under GA, and I don't remember any pain at all. More itchy, once it started to heal. Anyway, I don't think I realised how bad it would look after the laser. I had major trypophobia! And the vain teenager in me just wanted to hide away until it had fully healed. That was it, I couldn't go back for my next course! So of course, no change to the birth mark was visible after just one course. Kind of regret going for the laser as the birth mark has really not had any negative impact on me before or after.

Worst school said that children are very resilient and insinuated he just had to get used to unkind comments as he was probably already experiencing them... they got an ear full.

The school that we chose told us about the step by step process if it was persistent. They shared how they talk about differences, had books in the library to link to it. It is a faith school so they made links there. When the one incident happened the other student was spoken to immediately, communication between school and myself was immediate. It then happened again in front of me, I addressed it kindly. School then spoke to child again, and mum. School also borrowed my birthmark book and read it to his class.

I'm a teacher specialising in pastoral care so I had some high standards with my background and then his birthmark on top!

I had a birthmark on my eyelid as a child, it was purple and swollen, my parents decided not to have it removed and it completely disappeared on its own (I think maybe by age 8).

I also have a 4 year old DC who has a ‘spot’ on their face, I want to get it removed as soon as possible before it bothers them but the dermatologist said Its too young to have GA for the removal so we have to wait. It is only small but very noticeable, I don’t think it will go on its own. I also have fear of putting them through a GA for a superficial thing, I’m hoping it can be done under local instead in a couple of years.

I don’t know what I would do. it’s such a difficult decision with no right or wrong answer but I can understand your concerns. I would also worry about giving my child the message that we have to go through something difficult and painful in order to look a certain way, if that makes sense.

I can understand though your fears that ds might wish he’d had the treatment. Would the treatment still be available to him when older if he then decided he wanted it, if you declined for now? Or would it be more effective at a young age?

Thank you. It would still be available at a later date either on NHS or privately. I suppose I’m just wondering if it would be better to do it now before he’s had to endure any negativity relating to it rather than in response to that negativity.

It's a tough decision.

Have you had any advice from a dermatologist about whether there are any risks associated with not treating the birthmark; would it make his skin more vulnerable to sun damage for example or would there be a higher risk of developing skin cancer or anything like that?

If there were additional risks that could be reduced by having the laser treatment, that would decide it for me.

If it's purely cosmetic, I think it would depend on the risks and side effects of the procedure. If they were minimal I would be tempted to try it once and see how it goes. If DC finds it difficult for whatever reason then I wouldn't do it again.

I personally would rather focus on teaching my child to feel confident about himself, warts and all. Explain that everyone have flaws that could be used as a mean to tease by unkind children and in that case, the problem is with their parents not teaching them to accept people for who they are.

I would explain that it's ok for others to ask about it and for him to explain but that if anyone makes fun of him in an unkind way, to ignore them and tell the teacher.

If they are kind and tolerant themselves, they will have no issue making friends. Don't give him the idea that he should modify himself through a painful procedure that will need repeating but to that if he is kind, kind children will want to be friends with him.

Have you asked that question?

Exactly this.