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Dr. Nair
Dr. Nair, Dermatologist
Category: Dermatology
Satisfied Customers: 8072
Experience:  MBBS, MD (Dermatology, Venereology & Leprology)
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I have a large congenital nevus on my back. Can I get a tattoo

Resolved Question:

I have a large congenital nevus on my back. Can I get a tattoo over it?
Submitted: 3 years ago.
Category: Dermatology
Expert:  Dr. Nair replied 3 years ago.
Hi,

How big is the nevus? Does it look like any of these:

graphic

graphic

Customer: replied 3 years ago.
It covers most of my back. It is much much lighter brown than those the pictures and has faded considerably over the years. I had laser hair removal on it and it's not hairy anymore.
Expert:  Dr. Nair replied 3 years ago.
I hope you find our interaction helpful. If you are satisfied with my response(s) please remember to press the ACCEPT button.

Thank you for the information. I would strongly advise against getting a tattoo on the congenital melanocytic nevus (CMN). The reason is that CMNs are at increased risk of developing melanomas within them, especially if they are larger than 20 cm in diameter. A tattoo will mask the underlying nevus and thus a melanoma may be missed until it has become too big or spread. Secondly tattoo pigment may irritate the melanocytes causing a confusing picture on biopsy of a suspected lesion since it will be hard to differentiate a true melanoma from a nevus with secondary changes. Hence I would advise against getting a tattoo on the CMN.

Hope this information is useful, please feel free to ask if you have any queries.
Customer: replied 3 years ago.

What about a tattoo that was around some of the parts of it and incorporated the birthmark into the design. I have had the birthmark my whole life with no problems....is there still a large chance that it might develop a melanoma. If anything the birthmark has lightened and become less visible over time. Do you have any other suggestions as to what I can do to make this birthmark? It is very embarrassing for me and I am very tired of living with it. Would getting the tattoo over it affect it in any other way, other than masking the look of the nevus?

Expert:  Dr. Nair replied 3 years ago.
I hope you find our interaction helpful. If you are satisfied with my response(s) please remember to press the ACCEPT button.

I understand the nevus is a significant cosmetic problem but the only therapy really effective is staged surgical excision - however for a nevus covering the whole back this might not be technically feasible. Lasers don't remove the nevus completely and are generally not recommended for treating such large lesions. Yes the CMN is at an increased risk of developing melanoma throughout your life, and the incidence is 5-7% by the age of 60 years. Thus the CMN must be under 6-12 monthly follow up with your dermatologist/family physician.

Besides the concerns I voiced regarding the tattoo it is presently not known whether it can increase melanoma risk. Tattoo pigment is usually inert but some people react to it. Theoretically chronic irritation to CMN melanocytes could cause them to proliferate and this could possibly increase the risk of melanoma. However this is conjecture and to the best of my knowledge there is no proof of this yet.

Customer: replied 3 years ago.
But if the tattoo were to incorporate the nevus in some way, that wouldn't cause any problems?
Expert:  Dr. Nair replied 3 years ago.
I hope you find our interaction helpful. If you are satisfied with my response(s) please remember to press the ACCEPT button.

Well right on the margin shouldn't be much of a problem but only as much as absolutely necessary should be included.

Dr. Nair, Dermatologist
Category: Dermatology
Satisfied Customers: 8072
Experience: MBBS, MD (Dermatology, Venereology & Leprology)
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