A Blog For Mums
When welcoming a newborn into your family, you might notice distinctive marks on their skin that you didn’t expect. These unique features, known as birthmarks, are quite common in babies. They appear either at birth or develop shortly afterwards and come in various shapes, sizes, and colours.
Most birthmarks fall into two main categories: those containing extra pigmentation (colour) and those formed by blood vessels that didn’t develop completely. While the majority are harmless and some fade naturally over time, others may require monitoring to ensure they don’t cause complications. This guide aims to help you understand the different types of birthmarks your little one might have and what, if anything, needs to be done about them.
Vascular birthmarks occur when blood vessels cluster or form abnormally beneath the skin’s surface. These marks typically appear pink, red, or bluish in colour and may feel warm to touch due to the increased blood flow in the area.
The appearance and behaviour of vascular birthmarks vary significantly depending on the specific blood vessels involved. Some are flat and barely noticeable, while others might be raised and more prominent. Let’s explore the most frequently encountered vascular birthmarks in newborns.
Occurring in roughly 3 out of every 1,000 children, port wine stains are relatively common vascular birthmarks. Like salmon patches, they appear as flat, pinkish or reddish areas caused by clusters of capillaries. These marks are visible from birth but differ from salmon patches in several important ways.
Port wine stains tend to be larger and may cover more extensive areas of the face and body. Unlike salmon patches, they don’t fade away naturally. Instead, they grow proportionally as your child develops, potentially becoming darker and thicker over time.
Most port wine stains aren’t linked to any health concerns. However, when they affect certain facial regions, particularly around the eyelid and forehead, they might be associated with Sturge-Weber syndrome, a rare neurological condition. Your doctor may recommend additional evaluation if your baby’s birthmark is in these areas.
For cosmetic reasons, some children and teenagers may feel self-conscious about prominent port wine stains. Laser therapy can sometimes lighten these marks and help prevent them from darkening or thickening with age, though complete removal is rarely achievable.
These flat, pink or reddish marks affect up to 80% of newborns, making them extraordinarily common. Medically termed nevus simplex, they consist of small collections of capillaries (tiny blood vessels) near the skin’s surface.
You’ll typically spot these marks on the eyelids, forehead, nape of the neck, crown of the head, beneath the nose, or on the lower back. Depending on their location, they’ve earned affectionate nicknames like “stork bites” (when found on the neck) or “angel kisses” (when positioned between the eyebrows).
The good news for parents is that most salmon patches naturally disappear by the time your child reaches toddlerhood. Don’t be concerned if these marks become more vivid when your baby cries or is active – this temporary deepening of colour is perfectly normal due to increased blood flow to the area.
While generally harmless and requiring no intervention, it’s worth mentioning to your doctor if these marks are particularly large or appear in unusual locations.
These benign growths typically emerge within the first few weeks after birth and affect approximately 5% of infants. Infantile haemangiomas consist of extra blood vessels that form in the skin and undergo a distinctive growth pattern.
When located near the skin’s surface, these marks appear bright red and are sometimes called “strawberry marks” due to their appearance. Deeper haemangiomas may look bluish or purple, resembling bruises beneath the skin.
The most rapid growth phase for infantile haemangiomas occurs during the first 5-7 weeks of life, making early discussion with your paediatrician crucial. While most are harmless, some haemangiomas may be associated with specific health issues requiring additional testing or treatment.
Effective treatments exist for problematic haemangiomas, but they work best when initiated shortly after formation – generally around one month of age. If you suspect your baby has an infantile haemangioma, prompt consultation with your doctor is advisable.
Unlike their infantile counterparts, congenital haemangiomas are fully formed at birth and may even be detected during prenatal ultrasound examinations. These rare vascular growths behave differently from infantile haemangiomas and don’t grow after birth.
Congenital haemangiomas typically appear as large, round or oval bumps. Their colour tends to be purple or blue, sometimes with tiny red blood vessels visible on the surface and a whitish ring surrounding the base.
Some congenital haemangiomas begin to disappear rapidly after birth (known as rapidly involuting congenital haemangiomas), while others (non-involuting congenital haemangiomas) remain permanently. In most instances, these birthmarks pose no danger and don’t require treatment.
If a non-involuting congenital haemangioma doesn’t fade naturally, surgical removal or other treatments can be considered when the child is older.
Venous malformations develop when veins in the skin form improperly during foetal development, creating tangled clusters that give these birthmarks their characteristic blue or purple appearance. Though present at birth, they might not become obvious until adolescence.
These rare vascular anomalies affect approximately 2 in 10,000 children. The affected veins may enlarge during physical activity or in certain positions, sometimes causing discomfort.
While many venous malformations cause no problems whatsoever, treatment might be necessary if the birthmark becomes painful or interferes with your child’s activities. Small clots called phleboliths occasionally form within these veins, creating hard spots that may cause discomfort though they’re generally harmless.
Treatment options might include compression garments, medications, surgical intervention, or other procedures depending on the specific characteristics of the malformation.
Most venous malformations are confined to the skin, but occasionally they extend into muscles, bones, or internal organs. Your doctor might recommend imaging studies to better understand the extent of your child’s birthmark.
Pigmented birthmarks occur when melanocytes—cells responsible for producing skin colour—are concentrated in certain areas. These marks typically appear brown or grey and, like vascular birthmarks, can vary significantly in appearance and implications.
Commonly referred to as moles, congenital melanocytic naevi may be present at birth or develop during a baby’s first year. These birthmarks are quite common, affecting 1-3% of newborns.
The appearance of congenital naevi varies considerably. Most are brown, but they may also display shades of pink, red, or black. Some have a bumpy texture or contain hair, and they might become rougher or more raised over time.
The majority of congenital melanocytic naevi are harmless and don’t require removal or treatment. Dermatologists typically monitor them during regular check-ups and can advise you about changes to watch for in your child’s birthmark.
As your child grows, their naevi will grow proportionally—not rapidly. These moles are classified by size as small, medium, or large/giant naevi. Large and giant naevi carry a somewhat higher risk of developing melanoma (a type of skin cancer) compared to smaller congenital naevi or moles that appear later in life.
Sun protection is important for all children but especially crucial for those with this type of birthmark. A child with multiple congenital melanocytic naevi should always be evaluated by a paediatrician or dermatologist, as this pattern may rarely indicate issues with the brain and spinal cord.
The name “café-au-lait” translates to “coffee with milk,” aptly describing the light brown colour of these common birthmarks. Between 20-30% of people have at least one café-au-lait spot.
These marks are flat with a typically round or oval shape. Most are smaller than a child’s palm and have smooth, well-defined borders. Café-au-lait spots are either visible at birth or develop very early in life.
The vast majority of café-au-lait spots are harmless and unlikely to develop into skin cancer, though they may darken with sun exposure. A large café-au-lait spot with irregular borders might be associated with a rare genetic condition called McCune-Albright syndrome.
Multiple café-au-lait spots can sometimes indicate other conditions, including neurofibromatosis. If your child has a large café-au-lait spot, more than five spots, or spots in the armpits or groin area, discuss this with your paediatrician.
These birthmarks are most prevalent in babies with deeply pigmented skin, appearing in 85% of Asian, 96% of Black, and 46% of Hispanic newborns. They typically appear on the lower back and buttocks, though some babies have them in other areas.
Dermal melanocytosis birthmarks may display a mixture of colours including brown, grey, blue, and black. Their distinctive colouration results from pigment being present in different skin layers.
Most of these birthmarks gradually fade, with many disappearing entirely by the toddler years. The vast majority are harmless and require no treatment. In rare instances, these marks may be associated with genetic conditions, so consult your paediatrician if your baby has multiple spots along with other health concerns.
Mosaicism refers to the presence of two different sets of DNA or genes within the same person. In pigmentary mosaicism, genetic differences affect skin colouration, creating unique patterns including lines and swirls.
Although the genetic changes responsible for pigmentary mosaicism are present at birth, the affected skin might not change colour until later in childhood. Sun exposure can sometimes trigger these changes, creating the impression that the birthmark is spreading.
For most children, pigmentary mosaicism is harmless. A small percentage may experience problems with bones, eyes, or brain, particularly if the birthmark covers a substantial portion of the body. Your paediatrician might recommend certain tests if they have concerns.
While most birthmarks are completely harmless, certain situations warrant prompt medical attention:
Your paediatrician can provide guidance specific to your child’s situation and refer you to specialists if necessary.
Many birthmarks require no treatment at all, particularly those that are likely to fade naturally. For those that might benefit from intervention, several options exist:
The best treatment approach depends on the type of birthmark, its location, potential complications, and your child’s overall health.
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