Congenital hairy nevus or congenital nevomelanocytic nevus is a pigmentary lesion that appears at birth. The treatment of patients with congenital nevi depends on the size of the lesion, location and potential for malignant transformation. An important aspect is of course the aesthetic consideration, especially when the localization of these congenital hairy nevi is at the face level.
Treatments are primarily surgical: serial excision, complete excision accompanied by reconstruction of the area with free skin graft, tissue expansion, local flaps and free tissue transfer.
The adjuvant treatments that can be applied are: chemical peeling, dermoabrasion, laser therapy.
Surgical treatments are the main therapeutic indication, adjuvant treatments not removing the nevi cells completely.The purpose of the treatment is to completely remove the nevus and to rebuild the area preserving the function and maintaining the aesthetic appearance of the respective anatomical unit.
Surgical interventions are often performed in the case of serial excision with local anesthesia, and in the case of TISSUE EXPANSION, treatment involving 2 surgeries, the surgeries are performed with general anesthesia.
TISSUE EXPANSION involves two different surgeries: first intervention involves placing the TISSUE EXPANDER (a special silicone medical device, the shape and dimensions being specific and customized according to the lesion); the second intervention, at least at 2 months after the first surgery of inserting the silicone device, involves removal of the expander, excision of the pigmented hairy nevus and covering of the resulted skin defect with the skin flap expanded during this time.
Between the two surgeries, the tissue expander is filled with physiological saline solution by repeated injections at 2-4 days via the valve connected to the expander. These injections are not painful, they are done without local anesthesia and generally last for 2 months.
Treatment with TISSUE EXPANSION is currently a modern treatment that takes into account the aesthetic and functional aspect of the reconstructed area, being superior from an aesthetic point of view to the other surgical treatments. Of course, the first step in such situations is scheduling a consultative session, where a local examination of the area and the hairy pigmented nevus will be carried out, establishing the personalized treatment options.