- Dr. Sanja
Most Common Birthmarks
Medical name: Dermal melanocytosis
Looks like a bruise, can be light or dark blue or even grey in colour. A baby can have one or multiple spots, mostly at the lower back or buttock. The spots can otherwise show virtually anywhere on the body, more common in Asians and people with darker skin. Most commonly spots start fading and disappear by the age of 3-5 years, rarely stay on.
Image 1: Mongolian spot on buttocks
Medical name: Superficial infantile hemangioma
Commonly visible at birth or in the first few months of baby’s life. Looks like a strawberry, appears in different sizes and shapes, usually one or more lesions, anywhere on the body, but mostly seen on head or neck. In some cases, it is possible to spot them on the skin, as well as moist mucus membranes such as inside the mouth or anus. The hemangioma typically grows larger in the first year, and then spontaneously starts to change its colour, becomes flatter, till it completely disappears, most commonly by the age of 18 months – 2 years. It rarely takes years to fade and disappear. As lesions are accumulations of blood vessels, they can bleed a lot in case of injury or can be infected by bacteria if wounded. The best prevention is covering with plasters.
Image 2: Strawberry hemangioma on baby’s body
Medical name: Cavernous infantile hemangioma
This birthmark is a deep vascular benign tumour, typically bluish or skin colour if deep inside, or with strawberry nevus on top. Usually grows bigger in the first year of life, can be painful if its skin breaks open and bleeds. Its growth can suddenly stop or slow down. It can be found anywhere on the skin, single or multiple locations. In the case of numerous lesions, there is a small chance of also finding it in the internal organs, mostly in the gastrointestinal tract or liver. Most will regress by the age of 5 years and nearly 90% will disappear by the age of 10 years, leaving the light spot or a scar on the skin.
Image 3: Deep hemangioma on baby’s chest
Salmon Patch (stork’s bite)
Medical name: Nevus simplex
These marks are composed of small (capillary) blood vessels that are visible through the skin. It is a flat, pink, red patch. If you press on the mark, it fades and becomes more intense when the baby is irritated or crying. This mark is very common, mostly found on the face or back of the neck, but it can appear anywhere. On the face usually fades away by the age of 1-3 years. In the neck area, it might fade but does not always completely disappear.
Image 4: Salmon Patch (stork’s bite) on baby’s face
Medical name: Nevus flammeus
At birth pink, red, or purple spots or patches can be spotted. They can cover the large part of the face and are usually more intense red or purple in colour. It does not disappear like a stork mark, but rather get thicker and darker with time. Although this could be not related to any other health issues, the presence of the stain can indicate the possibility of very rare neurological diseases called Sturge-Weber Syndrome that causes seizures, developmental delay and learning disabilities. This spot grows with the child, tends to get thicker and darker, and does not disappear spontaneously.
Image 5: Port-wine stain on a child’s arm and upper chest
Image 6: Sturge-Weber syndrome
Café Au Lait Spots
Medical name: Café-au-lait macule
This is a flat mark; the intensity of hyperpigmentation varies from light to very dark brown. The size varies from only a few millimeters to covering large areas of the skin, with one or multiple spots. The presence of multiple spots could be the sign of a condition called neurofibromatosis. Your pediatrician needs to assess the size, number, distribution and explain the meaning of this rare condition. This type of spot never disappears spontaneously. Prominent spots should be treated by a dermatologist.
Image 7: Café-au-lait spot on a Child face
Medical name: Congenital melanocytic nevus
Moles are mostly brown or tan in colour, can be found anywhere on the skin and tend to cover small or large areas, can be flat or warty, with or without hair. Most of them will stay on, few will disappear spontaneously. These lesions need to be regularly checked by your dermatologist, due to the possibility of turn into a malignant tumour called melanoma.
Image 8: Mole on child’s skin
Medical name: Organoid hamartoma
Mostly found on the scalp or face, without hair if found on the scalp, just slightly pronounced. This birthmark changes colour and becomes more palpable or warty. It does not spontaneously disappear.
Image 9: Nevus sebaceous on child’s scalp
Medical name: Hypo pigmented spots white spot
Can be found anywhere on the body and usually fades with time.
Image 10: White spot birthmark
- Careful examination of the lesion by pediatrician or dermatologist.
- Often wooden lamps are used by dermatologists.
- CT or Ultrasound scan is requested if required.
Treatment for Birthmarks
Most of them are harmless and will disappear with no intervention, but need to be observed. Some can grow in very sensitive areas and might require treatment (obstructing the breathing through the nose, eye lesions or cosmetic reasons).
- Laser therapy is an option for port-wine stain birthmarks. It can be tried with limited expectations.
- Propranolol (a beta-blocker drug used for hypertension) this will prevent the growth and shrink the haemangioma; using this drug that requires close monitoring due to possible side effects
- If corticosteroids used, needs close monitoring by a dermatologist for possible side effects
- In the case of interferon, timolol use – require close monitoring for possible side effects
- Plastic surgery – removal of the lesions, if not dangerous, usually done at the age of puberty
- For aesthetic reasons, it can be covered with makeup
Written by – Dr. Sanja Mulabegovic. Pediatrician & Pediatric Infectious Disease Specialist – TCMC.
Images 1, 4 Used with permission of the Journal of the American Academy of Dermatology.
- J Am Acad Dermatol. 2008; 58:S16-22.
- J Am Acad Dermatol. 1999; 40:877-90.
Images 2, 3,5,7,8,9,10 Used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.
American Academy of Dermatology, “Red, white and brown: Defining characteristics of common birthmarks will determine type and timing of treatment.” The news release issued Feb 4, 2011.
Barnhill RG and Rabinovitz H. “Benign melanocytic neoplasms.” In: Bolognia JL, et al. Dermatology. (Second edition). Mosby Elsevier, Spain, 2008:1713, 1720-3.
Enjolras O. “Vascular malformations.” In: Bolognia JL, et al. Dermatology. (Second edition). Mosby Elsevier, Spain, 2008:1582-5.
Garzon MC “Infantile hemangiomas.” In: Bolognia JL, et al. Dermatology. (Second edition). Mosby Elsevier, Spain, 2008:1567-8.
McCalmont TH. “Adnexal neoplasms.” In: Bolognia JL, et al. Dermatology. (Second edition). Mosby Elsevier, Spain, 2008:1695-6.