Removing a small number of BHD skin lesions by surgery (cutting below the surface of the skin to remove the lesion) has provided some people with a satisfactory solution. However, there can be scarring and there is no guarantee that this solution is permanent. Consultation with an expert dermatologist is highly recommended if you are considering surgical treatment. Some people have consulted plastic surgeons; however, it would be wise to make sure the doctor is aware of the nature of the fibrofolliculomas and their association with Birt-Hogg-Dubé syndrome.