In most cases, congenital nevi don’t cause any physical problems and don’t require treatment. However, they can make some people self-conscious.
It’s hard to surgically remove congenital nevi, especially large and giant ones. These may require several cuts, stitches, or even skin replacement. All of this can result in scarring that some people find more bothersome than the mole itself.
Your doctor can give you a better idea of whether surgery will work based on the size and type of nevus.
Some alternatives to surgery include:
- Dermabrasion. This treatment uses a wire brush or diamond wheel to remove layers of skin. While it won’t completely remove a congenital nevus, it can lighten its appearance. However, it can also leave scarring. Dermabrasion is most effective when done in the first six weeks of life.
- Skin curettage. This involves scraping away the top layers of skin. Like dermabrasion it is best performed in the first six weeks of life.
- Tangential excision. The top layers of skin are removed using a blade. Like other options, it won’t remove the nevus completely, and it may leave scarring. However, it can make the nevus less noticeable.
- Chemical peels. These may help to improve the appearance of lighter-colored nevi. Phenol and trichloroacetic acid are common chemicals used in peels.
While most congenital nevi are harmless, they can occasionally become cancerous. Giant congenital nevi carry the highest risk. Keep in mind that surgery isn’t a guarantee against cancer. Fifty percent of melanomas found in people with giant congenital nevi occur elsewhere on the body. In addition, the estimated lifetime risk of melanoma for a person born with a giant nevus varies from 5 to 10 percent.
Medium and large nevi may also have a higher risk of becoming cancerous.
Anyone born with a large, giant, or even medium congenital nevus should get regular skin exams. Make sure to tell your doctor if you notice any of the following:
- darkening of the nevus
- increase in size
- irregular shape
- changes in color
Neurocutaneous melanocytosis is another possible complication of giant congenital nevi. This condition involves the presence of melanocytes in the brain and spinal cord. It affects an estimated 5 to 10 percent of people with giant congenital nevus. In many cases, it doesn’t have any symptoms, but it may occasionally cause:
- developmental issues