Surgical treatment usually consists in fusiform excision of a lesion directed along the so-called Langer’s line with a margin of approx. 1 mm and full thickness of the skin, and afterwards suturing the cavity. Such procedure is necessary if birthmarks are located deeper, e.g. blue or hairy birthmarks (deeply located hair follicles that may contain melanocytes). If the birthmarks are located superficially (from papillary layer to dermis), tangent excision, without full thickness of the skin should be taken into consideration, often together with electrodesiccation of the cavity bottom and with secondary healing by epithelialization.
Such procedure allows for obtaining aesthetic, flat scar. Selection of method depends on the nature of the lesion, its size and location. During a consultation, a surgeon assesses the birthmarks, gathers history which is often very helpful in determining the lesion type and makes a decision which choice would be the most appropriate.