Birthmarks are very common and often fade over time. They come in all shapes and sizes. Some are hard to find, others are impossible to miss. Some are visible at birth, others appear weeks or months later. They can be flat or raised, and appear in a wide range of colors. But no matter how large or small, seeing a birthmark on your newborn can be a concern for any parent. While most are harmless, your child's doctor should check any birthmarks when they first appear to determine the type and whether further monitoring or treatment is needed.
Vascular birthmarks appear when several blood vessels get twisted together. The most common vascular birthmarks are:
- Mascular stains (also called stork bites & angel kisses) are birthmarks that commonly appear on newborn babies. These marks are small blood vessels (capillaries) that are visible through the skin. They are most common on the forehead, eyelids, upper lip, between the eyebrows, and the back of the neck. These marks usually fade as your baby grows.
- Strawberry hemangiomas usually appear on the face, scalp, back, or chest. They are often absent at birth and begin to develop several weeks later, continuing to grow and forming a red, spongy mass. In most cases, they disappear by the time a child is 10 years old, though a slight discoloration of the skin may remain.
- Port-wine stains are flat purple-to-red birthmarks. They usually occur on the face and are often permanent unless treated.
Pigmented birthmarks are caused by an overgrowth of the cells that produce pigment in skin. They can be found anywhere on the body and can increase in number as a child gets older. The most common pigmented birthmarks are:
- Cafe-au-lait spots are light brown and usually oval-shaped. They are often visible at birth but can also develop in the first few years of your child's life. These birthmarks are generally normal but if you notice several cafe-au-lait spots larger than a quarter, they may be associated with neurofibromatosis (a genetic disorder that causes abnormal cell growth in nerve tissues) and should be checked by your child's doctor.
- Mongolian spots are flat, bluish-gray patches on the lower back or buttocks. They are usually found on darker skinned children, such as on children of Asian, American Indian, African, Hispanic, and Southern European descent. Mongolian spots usually fade by the time a child is 5 years old.
- Moles (nevi) are very common and most people will get one (probably more) at some point in life. Most moles appear on the skin during childhood and adolescence. A mole present at birth is called a congenital nevus and will last a lifetime. Large congenital nevi are more likely to become cancerous (melanoma) later in life. Moles can be tan, brown, or black; flat or raised; and may even have hair growing out of them (hairy nevi).
Pigmented birthmarks are best left alone, with the exception of moles that show potential signs of melanoma (rapid change in color, multi-colored, dome-shaped, bleeding, or 50-plus moles). If a mole needs to be removed, the procedure can usually be performed during an office visit through a surgical excision, where the entire mole is cut out and the skin closed with stitches, or a surgical shave, where a surgical blade is used to remove it.
Vascular birthmarks such as macular stains and strawberry hermangiomas are generally temporary and require no treatment. Port wine stains on the face are often treated at a young age with pulsed dye laser therapy.
No one knows for sure what causes birthmarks. It’s important for parents to know that it wasn’t caused by something they did (or did not do) during pregnancy. Seeing a birthmark on your newborn can be alarming because it’s unexpected. Birthmarks seldom pose a health risk but can damage a child’s self-esteem as they get older, especially if the birthmark is obvious. Talking openly about a birthmark helps kids accept it as simply another part of who they are—green eyes, curly hair, brown mole on cheek. You can help your child manage the stares and questions by arming them with a simple response, i.e., “It’s just a birthmark. It’s been there since I was born.”