Friday, July 20, 2007

Lula’s Birthmark

Lula has a birthmark on her right arm. It is a vascular malformation which covers her elbow and extends through the inside of her arm. It is large but not disfiguring, and for the most part Bump and I have shrugged it off.

When Lula developed a patch of eczema on her birthmark, her pediatrician recommended a pediatric dermatologist. The dermatologist said the eczema was no reason for concern, and prescribed a cream that cleared it up in a couple of days. He said the eczema was likely to recur, and we should just follow the same regimen.

Then he asked if we were going to have the birthmark removed.

It was something Bump and I never considered. I figured someday she might realize she hated it and demand its removal, but that choice was hers to make. I also assume she may want to pierce her ears at some point, but I am not going to do it for her.

End of discussion, right?

Here's the wrinkle: apparently for Lula’s type of birthmark, laser treatment before one year of age is more effective than the same treatment later in life.

Here’s the catch: the laser hurts.

Our first reaction was “It will hurt her? HELL no.”

I am less and less sure of my unequivocal rejection, the more I think about it. What if, when she is eleven, she demands the birthmark come off, only to find she can have it only partially removed? She will be convinced that earlier action could have completely erased it, and she will have yet another reason to hate us for ruining her life.

Or she'll live her entire life not caring about a silly, insignificant birthmark on her arm. And the brilliant, beautiful, self-assured woman she becomes will roll her eyes at all this maternal dithering.

Or she'll be haunted by the constant question "What's that on your arm?" and have it removed out of pure annoyance. In the meantime she'll be uneasy about short sleeves, strapless gowns and bathing suits.

(Right, because all women and girls without birthmarks are extremely confident about bathing suits.)

As you can tell, I'm torn on the issue. Removal is cosmetic, so insurance probably won’t cover it. That’s pretty far down on the list of important factors, but it is a factor. It is likely to cost between $2,000 and $5,000 to have it removed.

Bump and I were told that the way we handle Lula's birthmark will influence her opinion of it more than anything else. The doctor said he’s seen huge birthmarks that don’t bother their wearers at all, and tiny imperceptible ones that emotionally cripple their owners. The bottom line is that if we’re casual about it, she’s not likely to care about it either.

If the birthmark were on her face, we would be more apt to have it blasted. But it's on her arm, for heaven's sake.

There’s no guarantee it can be completely removed, even if we act now.

Technology is advancing at a remarkable pace; the lasers used today weren't even considered five years ago, and in three years they will probably be totally obsolete. When Lula is old enough to make her own decision about it, the "before one year" condition may no longer exist.

Removing the birthmark hurts. She will cry. I will have made a choice that causes her pain.

Or I will have made a choice that causes her pain when some pissy nine-year-old calls her Red Arm.

She will undoubtedly be self-conscious about her body, because all girls are. Wouldn't that phase of life be easier for her without a big ol' birthmark on her arm?

If I think she is going to want it removed eventually, isn't it better to subject her to the procedure now, when she's not likely to remember the discomfort?

Would I want it removed, if it were me? I can't really say, because I wasn't born with a birthmark. I have other obvious physical imperfections that really don't bother me.

Is this like being born near-sighted, which I would fix if I could? Or like being born with brown eyes, which I hated as an adolescent but is not something that needs repair?

For now, I'm still leaning toward not having it removed. But I am scheduling a consultation with the doctors who would remove it - should we decide to go that route - just to gather more information and ask some more questions.

Would you put your baby through a painful procedure for a purely cosmetic reason?

Not that I'm going to do whatever you tell me, but I'm interested in your thoughts. (Because, ooooh, opinions from the internet. . . it's like your bossy cousin, your busybody neighbor, and your annoying colleague wrapped into one, only with less authority and more dumbass.) Just keep this in mind: What if we have her birthmark removed and Lula is the Chosen One to save the world, only the prophecy says the Chosen One has a red right elbow, and she can no longer prove that she’s the True and Rightful One because we went and had her birthmark removed? Well what then, Internet? Huh? What then?


Michele said...

OK, Nosey Neighbor here. I was looking at pictures of my boys at about 5-6 montsh last night and at the thought of their sweet chubby little baby arm being lasered I woudk have decided "Hell No". But then again, I have boys, and boys dont have to worry about strapless dresses like girls do.
This is really gender based and shallow for me to admit, but I think if I had a girl, I might be more likely to do it. But you are right, it's her elbow, not her cheek. Who worries about elbows?

I am so not helping, am I?

E :) said...

When I was 9 months old, I had a cup of boiling water spilled all over my right arm, forming a deep scar. Over time it has faded a bit, but it's still there. And you know what? It doesn't bother me one bit. Not one bit. It's just part of me and part of my story. I also have freckles and they don't bother me.

That's my experience with these things, at least.

I can totally see how you're torn, but the doctor's right. Her reaction will mostly mirror yours. And I'm with you on the thinking that she will be able to remove it in the future if she wants to.

Em said...

Here are my gut feelings:
1. The person who mentioned this to you was a DERMATOLOGIST. Much more likely to notice skin and its related imperfections than the rest of us.

2. Your little baby is perfect the way she is and your family is better off keeping that money in the bank for a real emergency.

3. But if you decide to remove it I won't get all judgey.

Becky said...

I say remove it and have Lasik eye surgery and breast implants done at the same time.

Or not.

Tough call. But I'm with you on the ear-piercing thing.

Auntly H said...

I vote leave it alone. But, I'm with Em, if you decide to go laser, I'll respect your Mom and Dad authority on all things Lula.

Melissa said...

Is the removal likely to leave a scar? Is the birthmark likely to stay the same? (I have a birthmark on my arm that looked much bigger when I was smaller; it didn't grow while the rest of me did. But it's a weird skin thing, not a vascular thing. And it never occurred to me to be bothered by it.)

I don't know, I'd ask a lot of questions and talk about it a lot. But I would be leaning toward leave it be.

Jill said...

First, doesn't this mean she's a wizard or something? Or does that have to be a lightning bolt on your head?

I think you can't make a wrong decision. Either way makes good sense.

I would want to ascertain if it could possibly get worse with age. If not, then I think I would lean against the laser. It seems so light pink and insignificant. I think people will just think she scraped it and nothing more.

Violet said...

I'd probably leave it. It might bother her in her teens - but then just about any "imperfection" could bother her then.

Gidge said...

One twin used to have a terrible birthmark on his head which will still flair a bit when he is angry. It was so bad that we jokingly called him Gorby when he was a newborn. The other one had a small streak of one on his forehead bcse he came out face up instead of face down and apparently mom's pubic bone is hell on your face on the way out. But we were lucky that they weren't vascular.

I guess, if it seemed to me it was disfiguring enough that it might cause her mental stress over being MOCKED, I might have it removed - even if it hurt. Because she wouldn't remember the pain and because mental pain can be forever.

But, if it's JUST a birthmark, like not a bad one.....well, I would probably be right there with you and let her make the call.

I agree with you - I don't think you should change your children's bodies, ear piercing or laser surgery - for cosmetic reasons. This isn't Gattaca.

tammy said...

I'd leave it. It's part of her. It's on her arm. Who cares.

I have a very small birth mark on my neck, when I was in high school many people asked if I had a hickey. It didn't bother me then & doesn't bother me now...

Anyway, that's justmy two cents!

Heather said...

Oh, tough one. I have a small (quarter size) red birthmark on my foot. It is shaped like australia and I always kind of liked it.

Miles is constantly pointing to it and asking "You got a boo-boo mama?"

But a foot is different than an arm. I would probably just wait and let her choose later (and never mention the "more effective before age one" part).

And the first photo - LH kissing Lulu - is so cute.

theotherbear said...

If there was any chance she might get teased as a kid I would get it removed. (But I can see the sense in not doing it too).

laurie said...

i'd bank on the brilliant, beautiful, self-assured woman and just start now laying the groundwork for that. if a pissy 9-year-old doesn't call her red arm, she'll probably make fun of her for something else -- especially if she's brilliant, beautiful and self-assured.

Alison said...

Have you read Every Crooked Pot? I haven't yet - but heard it's a wonderful book & it seems very relavent to this decision.

Teresita said...

I think it is sort of pretty.

But what will Lula think?

At 5 she will be curious.

At 10 she will be shy about it.

At 15 she'll be annoyed by it.

At 20 she'll think its cool.

At 25 she'll be way to busy to think about it.

At 30 she'll feel affection for it. Or maybe she'll think its pretty.

In the Trenches of Mommyhood said...

I have a small circle birthmark (port wine stain) on my forehead. I'm just now (at 34) having laser procedures to have it removed (insurance is paying). My two cents is that you should wait and let her make the decision on her own.

Anonymous said...

I sincerely think you are giving yourself such a hard time at being a young Mother & I do sympathise with you but I can see you are tossing it over one way & then another! "Not a gemini are you?"
I am sure your little Angel is perfect the way she is & I feel she won't be as concerned about it as you are.She looks perfect to me. I agree with 'eE & teresita Totally!
These days there's so much more to think about & that's this Planet & what it look's like in 10 year's.! God Bless You xxx

Jennie Eveleigh Lamond said...

I have a 2 inch by half inch birthmark on my left upper arm. It is raised, and when I was a child, it was red, it has since faded to a sickly yellow colour that doesn't tan in the summer, and remains the only part of my body that is freckle-free. I was only ever aware of it when other children would point it out to me by asking "what's happened to your arm?". I have never avoided tank tops because of it, in fact, for the most part I am still unaware of it in my day to day life until someone else points it out to me. It is my skin, it is a part of me, and always has been. There is really no point in worrying about it, since it has utterly no health impacts on my daily life.
Besides, I read a hokey article about birthmarks being scars from a previous life once, and I kind of like the idea.

Anonymous said...

I was searching for others that had birthmarks. I have a pink birthmark on my upper left arm. People sometimes ask what happened to my arm. Why would anyone want to get rid of a pretty pink beauty mark? How could you even think of hurting your poor innocent daughter in this way? She deserves to love her body just like it is, and hopefully love herself in a bathing suit too.

nginahk said...
This comment has been removed by the author.
John Dudley said...

When you are looking for birthmark removal Delhi, the Internet is an invaluable tool, particularly for seeing before and after photos. For additional information, visit