Not long ago, a woman in her early twenties entered my clinic. She sat down and just smiled brightly. When I asked why she was smiling, she replied, "Don't you recognize me?" and stared at me intently. With a flustered heart, I checked the registration status under 'follow-up visit' and found that she was a patient I had treated in the past. Only after searching through old medical records did I realize she was a child who had been treated for an Ota nevus 15 years ago. Ota nevi are conditions where bluish spots appear around the eyes from birth. She must have visited me frequently as a young child 15 years ago to receive laser treatment. That day, a beautiful face with no trace of the condition sat before my eyes. Honestly, as a doctor, this is exactly what feels like true compensation.
When I was in school, there was always one or two children in each class nicknamed 'fortune teller.' It wasn't because they told fortunes; it was simply because they had spots somewhere on their faces. Nose fortune teller, lip fortune teller... Those who gave the nicknames didn't realize they were teasing, and those who received them surely felt their hearts rotting away for a long time. This was an era when there were no adequate treatment methods.
Congenital spots come in many types: red spots, blue spots, black spots, brown spots... Nevus flammeus, Ota nevus, café-au-lait spots, congenital melanocytic nevi... Since the names differ, so do the causes and treatments. It was only after the advent of lasers targeting pigments in the 1990s that these spots could be removed without scarring. In medical history, this is a very recent development. Today, lasers are known mainly as cosmetic devices for treating wrinkles and blemishes, but in reality, they are the most powerful and almost only treatment tool for congenital nevi.
Congenital nevi do not cause pain nor lead to serious physical abnormalities. Medically, it can be summarized with a single phrase: "It's fine." However, when parents first bring their babies into the clinic, they usually ask two questions: "What did we do wrong?" and "Is it hereditary?" Most congenital nevi are neither due to parental fault nor inherited. They are typically explained as random mutations that occurred in cells during early development. Thus, it is a matter of probability occurring at a certain rate in every newborn child. The cause is so 'futile,' yet parents carry guilt, and as children grow, they accept the spot as a 'defect unique to them.' I know how long a single spot, which isn't even a disease, can gnaw at the hearts of a child and their family.
The problem lies in treatment costs. Laser therapy does not end in one session. It requires multiple sessions spaced several months apart, and if the spots are large, it may take years. However, most of this treatment is classified as cosmetic and is not covered by health insurance. The full cost falls on the parents. In a country that pours out every possible childbirth measure because children are precious, wallets remain closed when it comes to restoring the faces of children born without any fault. On one hand, there are discussions about applying insurance coverage for the suffering of hair loss patients. I have no objection to that. However, if society can show consideration for so many hair loss patients, I hope they would at least consider placing these few children's share on the calculator as well. Considering the number of patients, it is not a scale that finances cannot handle.
Just as I was glad to see that woman appear smiling after 15 years, the faces of children who disappeared without completing their treatment also come to mind. Many children stopped coming after a few visits. Thinking that they may have quit due to the burden of treatment costs makes my heart feel dark even now. I can only hope that in some hospital, these children will recover completely like her.
The woman freed from the Ota nevus left a silly joke as she left the clinic after a simple consultation for another skin issue: "I thought if I removed this spot, I could become Miss Korea, but that won't happen." That child may not have become Miss Korea, but I believe she learned to smile freely with her own face as she grew up. I dream of a country where children born with spots do not feel intimidated. I think it is not such a big wish.
in OPINION
