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?