Birthmarks are colored marks on the skin that are
present at birth or develop shortly after birth. They can be many different
sizes, shapes, and colors, including brown, tan, black, blue or blue-gray,
pink, white, red, or purple. Some birthmarks appear on the surface of the skin,
some are raised above the surface of the skin, and some are located under the
skin. Most birthmarks are harmless and do not need treatment. Many birthmarks
change, grow, shrink, or disappear. There are many types of birthmarks, and
some are more common than others.
Salmon patches (also called stork bites, angel kisses, or macular stains) are the most
common type of birthmark. They are found in 40% to 70% of newborns.1 They are thin, flat, light pink or red areas of colored skin
that occur most frequently on the back of the neck (stork bites) and on a
baby's upper eyelids, upper lip, or between the eyebrows (angel kisses). Most
salmon patches on the eyelids fade without treatment within the child's first
year. Most salmon patches on the nape of the neck do not fade. Salmon patches
are more noticeable when a baby is crying or when he or she is hot or
cold.
Congenital moles (nevi) are present
at birth and are usually brown in color. They can appear anywhere on the body
and can be different shapes and sizes. Some
moles appear alone, and some moles appear in groups.
Large moles may need to be closely watched because they can become cancerous
later in life.
Café-au-lait spots are
smooth birthmarks that may be present at birth, but tend to develop in
childhood. They are usually oval in shape and range from light brown to
chocolate brown in color. They are found most commonly on the torso, buttocks,
and legs. Café-au-lait spots do not go away, may increase in number, and
generally do not require treatment. A single café-au-lait spot is not a sign of
a health problem. But six or more spots that are larger than
0.25 in. (6.4 mm) or ones that
occur along with freckles in the armpit can suggest
neurofibromatosis.
Mongolian spots are smooth, blue or blue-gray birthmarks that
usually are found across the lower back and buttocks. They tend to occur in
children of Asian, Southern European, Hispanic, Pacific Island, or African
descent. A child may have one or several Mongolian spots. These types of
birthmarks usually disappear without treatment by age 3 or 4.
Port-wine stains are uncommon birthmarks that are
pink-red at birth and darken to a red-purple color after a few years. Port-wine
stains are caused by blood vessels that do not develop normally. They can be
small or they can cover a large area of the body. They generally are found on
the face but can occur anywhere on the body. Port-wine stains on the face can
be associated with brain problems caused by
Sturge-Weber syndrome.
Port-wine stains
do not fade or go away on their own and most darken, thicken, and form bumps
during adulthood. Port-wine stains may become more obvious when the body's
hormones are changing, such as during puberty or pregnancy. A treatment called
laser therapy may lighten or reduce the bumpiness of port-wine stains. If a
port-wine stain makes you or your child feel shy or self-conscious, ask your
health professional about treatment options, makeup, or hairstyles that can
hide the birthmark, and/or support groups and counseling.
Hemangiomas are formed by a clump of immature blood vessels.
They may be present at birth or may appear when a baby is several weeks old.
Hemangiomas vary in size: they may be a few millimeters to a few centimeters in
diameter. There are three basic types of hemangiomas:
- Superficial or capillary hemangiomas are the most common type. They are thick, raised birthmarks
that are soft, purplish red, smooth, or slightly bumpy. They may be irregular
or round in shape and most often develop on the face, scalp, back, or chest.
These hemangiomas may never grow, grow slowly, or grow rapidly to many times
their original size in just a few months. After they stop growing, they usually
begin to shrink. And most of them go away.
- Deep hemangiomas are thick, deep, raised birthmarks that can be pale,
skin-colored, red, or blue. They often are round in shape and may feel like a
sponge. Deep hemangiomas may not go away, or they may fade and leave a
scar.
- Compound hemangiomas are a combination
of superficial and deep hemangiomas.
As many as 10% to 12% of babies have hemangiomas by the time
they are 1 year old.2 Some hemangiomas disappear
completely by 18 months. Most hemangiomas disappear or fade by age 9. Most
children develop only one hemangioma, but sometimes more than one occurs.
Although hemangiomas can appear to be painful or ugly, few need
treatment. Hemangiomas that cause problems with sight, breathing, hearing,
speech, or movement may need treatment. Hemangiomas that grow on internal
organs such as the stomach, intestines, liver, or kidneys may need treatment.
In rare cases, a hemangioma in the diaper area will become sore
and bleed (ulcerate). Ulceration can be very painful. If this happens, apply
pressure to the area continuously with a clean pad for 10 minutes, and contact
your health professional for more advice and an appointment.
