Birthmarks: Is It a Nevus or Sebaceous Gland Nevus?

Birthmark on the head?

Hello Doctor: When I was born, I had a flesh-colored mark on my head.
The doctor said it was a birthmark, but after almost 20 years, it has not disappeared, and there is not much hair growing on it.
However, it has not caused any pain so far.
I would like to ask the doctor if this is indeed a birthmark or if it could be a tumor.
I later found information online suggesting it might be a sebaceous gland nevus.
Is treatment necessary? If so, what kind of treatment is available? Currently, there are no unusual symptoms.
I am attaching a photo for clarification: https://www.dropbox.com/s/b0q6ctommmhzk97/IMG_1662.JPG?dl=0 Thank you.

Niming, 10~19 year old female. Ask Date: 2015/08/22

Dr. Wu Yuxin reply Dermatology

It should be a sebaceous gland nevus.
In the past, some experts believed that there was a high risk of future lesions, recommending excision.
However, some experts now argue that the risk of lesions is not particularly high, so there is no definitive conclusion.
It is suggested to first perform a biopsy; if it is confirmed to be a sebaceous gland nevus, excision remains one of the options, as it can improve the appearance of hair loss.
Alternatively, a one-time excision may also be considered.

Reply Date: 2015/08/22

More Info

When it comes to understanding skin lesions such as birthmarks, it is essential to differentiate between various types, including nevi (commonly referred to as moles) and sebaceous gland nevi. Based on your description, it sounds like you have a lesion that has been present since birth, is flesh-colored, and has not changed significantly over the years. This raises the question of whether it is a simple nevus or a sebaceous gland nevus.

A nevus is a benign growth of melanocytes, the cells responsible for producing pigment in the skin. Nevi can vary in appearance, size, and color, and they are generally harmless. However, they should be monitored for any changes in size, shape, or color, as these changes could indicate a potential issue, such as melanoma, a type of skin cancer.

On the other hand, a sebaceous gland nevus is a type of congenital skin lesion that arises from sebaceous glands, which are responsible for producing oil in the skin. These lesions can appear as raised, smooth, and often have a yellowish color. They may also have hair follicles and can sometimes be associated with other skin conditions or syndromes. Sebaceous gland nevi are typically benign but can sometimes develop into more serious conditions, so they may require monitoring or treatment.

In your case, since the lesion has not caused any discomfort or significant changes over the years, it is likely benign. However, it is crucial to have a dermatologist evaluate the lesion to confirm its nature. A thorough examination, possibly including a biopsy, can provide clarity on whether it is a simple nevus or a sebaceous gland nevus.
Regarding treatment, if the lesion is determined to be benign and asymptomatic, treatment may not be necessary. However, if it is causing cosmetic concerns or if there is any uncertainty about its nature, removal may be considered. Surgical excision is the most common method for removing such lesions, and it is typically performed under local anesthesia.
In summary, while your lesion may very well be a benign nevus or a sebaceous gland nevus, it is essential to consult with a dermatologist for a definitive diagnosis. Regular monitoring is crucial, especially for any changes in the lesion. If you have concerns about its appearance or any potential symptoms, discussing these with a healthcare professional will provide you with the best course of action.

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