Skin discolorations that are present at birth or appear shortly thereafter are known as birthmarks. They can develop anywhere on the skin, although some types tend to appear most frequently in particular areas. (Flat vascular malformations or port wine stains, for instance, commonly appear on the face.)
Most birthmarks are harmless, and only a small proportion pose significant cosmetic problems. Furthermore, the most common types of birthmarks are temporary, disappearing before the child reaches school age.
In a few rare cases, a birthmark may suggest the presence of a serious underlying disorder or pose an increased risk of skin cancer. Pediatricians examine babies carefully to identify such birthmarks, many of which can be safely removed.
HOW DO BIRTHMARKS DEVELOP?
Different types develop in different ways. Some are the result of excess pigment cells in a small area, while others develop when tiny blood vessels overgrow or expand in the skin.
TYPES OF BIRTHMARKS
• Cafe au lait Spots . These are small, sharply defined areas of light to dark brown color. They are more common in dark-skinned infants, occuring in 12 percent of black newborns. Numerous cafe au lait spots may indicate the presence of a rare inherited disease called neurofibromatosis.
• Moles . Moles, also known as Pigmented Nevi , are rarely present at birth, developing instead throughout childhood and adolescence. Moles in newborns are typically somewhat larger than in adults, and they have the potential to become cancerous, so removal is usually recommended.
Some infants are born with extremely large moles that may cover large segments of the body. Besides being disfiguring, these moles have a high potential to become cancerous, and they should always be removed.
• Mongolian Spots . These are large, flat, bluish or black patches that as many as 90 percent of black and other dark-skinned infants are born with. They usually are located at the base of the spine or on the buttocks. They are entirely benign and usually disappear without treatment by late childhood.
• Port Wine Stains . Port wine stains are flat, red or purple discolorations caused by overgrowth of tiny blood vessels in the skin. They are present at birth, usually appearing on the face or limbs, and they grow along with the child rather than fading. Prominent or disfiguring port wine stains can be removed with laser treatment.
• Salmon Patches . Also known as Stork Bites and Angel Kisses , these deep pink patches are the most common birthmarks, appearing in about 40 percent of all newborns. Salmon patches are most often found on the nape of the neck, the middle of the forehead and the eyelids. They usually fade and disappear before the first birthday.
• Strawberry Hemangiomas . These raised, bumpy spots appear on a baby's skin in the first two to five weeks of life. They may start out pale, then turn red or purple and grow larger, especially in the first six months. Strawberry hemangiomas are most commonly found on the head, neck or shoulders. In contrast to port wine stains (flat hemangiomas), almost all shrink over the first two or three years and disappear by late childhood.
WHAT TREATMENTS ARE AVAILABLE?
The rare birthmarks that require treatment can sometimes simply be cut out of the skin in a minor surgical procedure. Lasers have been developed that can remove certain red and brown birthmarks.
IS MEDICAL ATTENTION NECESSARY?
A birthmark that is quite large, ulcerated, or located in an area where it interferes with functions such as eating does require medical attention. The rare types of birth marks associated with skin cancer should also be evaluated with special care.
At or soon after birth, the pediatrician will take note of ordinary types of birthmarks, and, if they are large, measure them. In later visits, he will check the birthmarks to see if they are regressing naturally or changing in any unusual ways. If a birthmark is disfiguring or potentially dangerous, the pediatrician may refer you to a dermatologist or plastic surgeon to have it treated or removed.
GETTING HELP
Call your doctor if:
• A birthmark changes in size, color or shape
• A birthmark bleeds or itches
• A birthmark becomes sore or tender
• Any new molelike growths appear, especially if they are irregularly shaped, discolored or large
