About Birthmarks

Overview

"Birthmark" is the common name for any number of pigmented markings that may appear anywhere on a baby's skin at or soon after birth. Birthmarks may be flat or raised and may be tan, brown, blue, pink, red or purple. Most birthmarks are harmless but can be treated for cosmetic reasons if they don't fade with time. Birthmarks that require medical treatment have the best outcome with early intervention and treatment.

Types

Vascular birthmarks such as hemangiomas, port wine stains, salmon patches and other vascular malformations are the result of poorly formed blood vessels clustered together above or below the skin. A port wine stain appears at birth as a flat, dark, often large patch of red or purple skin on one side of the head, face or neck. A salmon patch is a small, irregularly shaped, pink or red patch, often on the face at birth. Hemangiomas can be large or small, flat or raised, red areas that usually appear on the face, head, chest or back. They may be present at birth or become visible up to four weeks after birth.
Non-vascular birthmarks such as moles, Mongolian spots and cafe-au-lait spots are caused by groupings of pigmented skin cells that form brown spots on the skin or, in the case of Mongolian spots, appear as bruises.

Complications

Most non-vascular birthmarks don't cause any symptoms other than their physical appearance. Some moles and other pigmented areas may change in size, shape, color or number, which could be an indication of skin cancer. A few cafe-au-lait spots on the body are not cause for concern, but if more than six appear, see a doctor to rule out a condition called neurofibromatosis.

Some vascular birthmarks, such as strawberry hemangiomas that are located on the face and scalp, may grow deep or too close to an organ such as an eye, ear or windpipe. This can potentially interfere with vital functions such as seeing, hearing or breathing. Hemangiomas can grow on the skin outside of the body and inside, on organs such as the brain and liver. They can sometimes ulcerate or bleed.

Early Intervention

To prevent growth or thickening, some vascular birthmarks--particularly hemangiomas and port wine stains--require early treatment. Infants and children are now treated at much younger ages because early intervention helps ensure better treatment, fewer treatments in the long term and a more acceptable long-term outcome.

Hemangiomas that grow internally and/or interfere with body processes can be life-threatening. Early, aggressive treatment can help minimize medical and cosmetic complications in the future and also help prevent psychological and social problems that often occur as a result of having a visible facial deformity.

When a new mole appears in anyone over 20 years old or an older mold changes its physical form or becomes itchy or painful, see a doctor right away to determine whether there is cause for concern. A biopsy and early diagnosis can prevent more serious complications later.

Treatments

Many dermatologists who specialize in the treatment of vascular birthmarks for children and adults use various types of laser therapy. Although many birthmarks are harmless, they can be treated for cosmetic reasons. Not all birthmarks respond to the same treatments.

Laser therapy, steroids or surgery may be necessary to remove a hemangioma that is interfering with the function of any vital organ. Laser therapy is also very successful for removing port-wine stains--but treatment must be repeated because blood vessels will continue to grow under the skin in the original area, and a new stain will appear. Maintenance treatments help prevent the stain from darkening, thickening and cobbling, or developing a pebbly appearance.

Prognosis

Many non-vascular and many vascular birthmarks fade or disappear on their own with time. Mongolian spots usually disappear completely before puberty. Early treatment of any birthmarks that do require medical intervention usually leads to a better outcome than if the mark is left untreated for any length of time.

Hemangiomas are generally not fully grown when they appear at birth. Most grow quickly during the first year and then slowly start to shrink and disappear completely during early childhood. Port-wine stains continue to grow with a person into adulthood and often get darker, thicker and pebbly to the touch if left untreated.