Conversation: The conversation between human and AI assistant.
[|Human|] I was born with a red, puffy birthmark right at the top of my butt cheeks (has always made me wonder if I was born with a tail, but my parents say no).  It is oddly shaped and roughly the size of a quarter.   The problem is that it itches, on and off, and if I scratch it without thinking, it breaks open and bleeds.  Ive been using hydrocortisone on it, and trying not to touch it, but this problem has been ongoing since I can remember.  Im poor and without insurance, is there anything I can do at home to make this better?
[|AI|]  **1. Birthmarks rarely cause problems, other than cosmetic changes, psychological distress, pain, bleeding, or rapid increase in size which needs to be treated.2. Since you are applying topical steroid [HY Chat Doctor.  The risks of laser surgery include transient hyperpigmentation, hypopigmentation, slight scarring, permanent hyperpigmentation, and recurrence. I would advise that you consult a Dermatologist with Good laser experience in these kinds of lesions. 3.  a health care professional can diagnose a birthmark based on the appearance of the skin, so have an appointment with your doctor. [since problem is ongoing]PS. They can be covered up, but not improved by creams and lotions