Birthmarks

What are birthmarks?
Birthmarks are a common type of discoloration that appear on your skin at birth or during the first few weeks of life. They’re usually noncancerous.

They can occur anywhere on your face or body. Birthmarks vary in color, size, appearance, and shape. Some are permanent and may get larger over time. Others fade away completely. Most birthmarks are harmless, but some indicate an underlying medical condition. In some instances, birthmarks may be removed for cosmetic reasons.

What causes a birthmark?
You may have heard tales connecting birthmarks to unmet food cravings, but that’s a myth. Birthmarks are not caused by anything that a pregnant woman does or doesn’t do during her pregnancy. The underlying reason why birthmarks form is unknown.

Are birthmarks genetic?
Some birthmarks are hereditary and run in families but most aren’t.

Very occasionally, some are caused by gene mutations. For example, some babies born with port-wine stains have a rare condition called Klippel-Trenaunay syndrome. This condition is caused by a genetic mutation that isn’t generally inherited. Another rare condition, Sturge-Weber syndrome, also appears as port-wine birthmarks and is caused by a different gene mutation. It also doesn’t run in families and can’t be inherited.

Can birthmarks appear later in life?
Birthmarks refer to skin spots that are apparent at birth or shortly afterward. Marks on your skin such as moles may occur later on in life but aren’t considered birthmarks.

Birthmark types
Many birthmarks fall into one of two categories, each of which has a different cause:

Vascular birthmarks occur if blood vessels in a particular area of your skin don’t form the way they should. For example, there may be too many blood vessels clustered in one area or the blood vessels may be wider than they should be.

Pigmented birthmarks occur when there’s an overabundance of pigment cells in one area. Pigment cells are what give your skin its natural color.

Pigmented birthmarks
These birthmarks occur when you have more pigment in one part of your skin than in other parts. Types of pigmented birthmarks include:

Moles (congenital nevi)
Moles range in color from pink to light brown or black. They vary in size and may be flat or raised. They’re typically round in shape. Moles can occur anywhere on your face or body. Some moles fade away but others last for life. A change in a mole may sometimes be linked to skin cancer.

Café au lait spots
These birthmarks are somewhat oval in shape, and translate as “coffee with milk” from French. They’re often pale brown in color. The darker your skin is naturally, the darker your café au lait spot will be. This type of birthmark may occur at any time from birth through early childhood. They may become larger in size but often fade. Some children have more than one café au lait spot. If your child has several, they may also have a rare medical condition, called neurofibromatosis.

Mongolian blue spots
These flat, bluish-gray spots mostly occur in people with naturally dark skin. They’re not harmful but are sometimes mistaken for bruising. Mongolian spots typically occur on the lower back and buttocks. They usually fade away completely by age 4.

Vascular birthmarks
Sometimes a bunch of extra blood vessels will clump together and you can see this cluster in your skin. This is called a vascular birthmark. Vascular birthmarks occur in around 40 percentTrusted Source of newborns.

Salmon patches
These red or pink patches often occur in the area between eyes, on eyelids, or on the back of the neck. They’re sometimes referred to as angel kisses or stork bites. They’re caused by clusters of small blood vessels under the skin. Salmon patches sometimes fade in color and don’t require medical treatment.

Hemangiomas
These birthmarks may appear pink, blue, or bright red in color. They’re often found on the extremities, head, or neck. Hemangiomas may start out small in size and flat in shape. Sometimes they grow during the first few months of a baby’s life, becoming elevated and larger. Many hemangiomas fade away completely by the time a child reaches adolescence. They sometimes leave a pale mark. These marks may be referred to as cherry or strawberry hemangiomas.

Some fast-growing hemangiomas require medical removal to ensure that they don’t interfere with a child’s vision or breathing. Children with multiple hemangiomas on their skin should be checked for internal hemangiomas.

Port-wine stains (nevus flammeus)
Port-wine stains are caused by abnormal formation of small blood vessels under the skin. They can occur anywhere on the body but are often found on the face and neck. Port-wine stains may start out as pink or red and turn dark red or purple. They don’t fade over time and may become darker if left untreated. The skin may also become very dry, thick, or pebbled in texture. Port-wine stains that occur on eyelids may require medical treatment or monitoring. Rarely, these types of birthmarks may be associated with genetic conditions.

Removing birthmarks
Most birthmarks are harmless and don’t require removal. Some birthmarks may cause unease because of their appearance. Other types of birthmarks, such as hemangiomas or moles, may lead to an increased risk for certain medical conditions, such as skin cancer. These birthmarks should be monitored by a dermatologist and may also require removal.

Techniques for removing birthmarks include:

Laser therapy
Laser therapy can remove or significantly lighten port-wine stains, making them less visible. This type of treatment is performed by a dermatologist or surgeon. It uses highly concentrated pulsing beams of light that can be modulated for strength.

Laser therapy may be most successful when it’s started in infancy but can also be used on older children and adults. You’ll usually need several treatments. Laser treatments can be uncomfortable and may require a local anesthetic. They often produce permanent results. Temporary swelling or bruising may occur.

Beta-blockers
Beta-blockers are oral medications used to treat high blood pressure. Propranolol is a type of beta-blocker that may also be used to reduce the size or appearance of hemangiomas. It works by shrinking the blood vessels and reducing blood flow. This causes the hemangioma to soften, fade, and shrink. Another beta-blocker, timolol, can be applied topically and may have similar results.

Corticosteroids
Corticosteroids are anti-inflammatory medications that can be taken orally or injected directly into birthmarks. They work directly in the blood vessels helping to shrink the size of the birthmark.

Surgery
Some birthmarks may be successfully treated via surgical removal. These include very deep hemangiomas which might damage the healthy tissue surrounding them. Some large moles may also be removed.
Birthmark removal is typically done on an outpatient basis and may even be done in a dermatologist’s office rather than a hospital. A doctor uses a small scalpel to remove the birthmark after administering local anesthesia. If the birthmark is large, it may be removed in sections over the course of several appointments.

Tissue expansion is another surgical technique that’s sometimes used to reduce the scarring left by surgical removal of birthmarks. It requires the insertion of a balloon under the healthy skin located next to the birthmark. This causes new, healthy skin to grow as a type of flap. This flap is used to cover the area where the birthmark was previously. The balloon is then removed.

Tips for monitoring birthmarks
Most types of birthmarks are harmless and fade on their own. You should point out any birthmark your baby or child has to their pediatrician. They can help you monitor the birthmark for growth. They can also determine if the birthmark is associated with a genetic condition that requires treatment.

Monitoring your child’s birthmark is important and should be done by both yourself and a doctor. Look for changes, such as size growth, elevation, or a darkening of pigmentation. If you notice rapid growth in a birthmark, let your child’s doctor know.

Moles can sometimes turn into skin cancer. This is rare in children but becomes more of a concern in adults. It’s important that you let your child know the importance of monitoring their moles for changes as they get older. Things to look for include a change in color, size, and shape. Moles that grow irregular borders should also be seen by a dermatologist.

The takeaway
Birthmarks are common in newborns. There are two types: pigmented and vascular. Most birthmarks are harmless and many fades completely over time. Some, such as port-wine stains, are permanent and may even occur on the face. These can be removed using treatment such as laser therapy. Treatments to remove birthmarks are often most effective when started during infancy.