What Are Baby Birthmarks? Types, Causes, and Treatment

At the first notice of a birthmark, a lot of things may run through the mind of a parent. The worry some parents feel is almost palpable, especially if the birthmark is large or occurred in a prominent area such as the face. However, birthmarks are a common phenomenon in babies and most cases do not pose any danger.

What Is a Baby Birthmark?

A baby birthmark is essentially a blemish on the skin of a baby, which is present at birth or appears soon after birth. The birthmark differs from the surrounding skin in color, texture, shapes, and sometimes even exists as an outgrowth. It is normally noticed at the time of birth or days, weeks, or months afterward. They can appear anywhere on the body, including the face, neck, arms, chest, stomach, buttocks.

Sometimes, they shrink and disappear as the baby grows. Other times they stay put and may even expand. Most often, birthmarks are harmless and should not be a cause for concern except maybe for cosmetics reasons.

What Are the Different Types of Birthmarks?

Birthmarks are broadly divided into two classes: vascular and pigmented.

Pigment Birthmarks

The pigmented birthmarks are caused by an increased number of pigment cells (called melanocytes) in some parts of the skin. By extension, the patch of the skin with a higher density of melanocytes will be darker than the surrounding skin. Some common examples include:

Cafe-au-lait spots

Cafe-au-lait spots are flat, smooth, oval birthmarks that occur commonly on the torso, buttocks, and legs. Its color range typically includes different shades of brown.

It has a tendency of expanding and turning darker with age. Generally speaking, cafe-au-lait spots are not a health concern. However, if you notice that your baby has several spots larger than a coin, it’s best you speak with a pediatrician right away. This is because several large spots may be a sign of several serious, yet rare medical conditions like neurofibromatosis and McCune-Albright syndrome

Congenital moles (nevi)

These are present at birth in about 1 out of every 100 newborns. They may be black or brown, raised or flat. They are usually irregular in shape and range from less than an inch to about nine inches. Nevi can appear anywhere on the body, the back, the face, the neck, or even entire limbs. The larger ones may actually be a sign of a deadly skin cancer, called melanoma. However, this is rare in newborns. Contact a pediatrician if you notice changes in the size, shape, color, or borders of a nevus over time.

Congenital melanocytosis

This flat, smooth birthmark is present at birth and is mostly located around the buttocks, hips, or waist. The colors are mostly light blue, bluish-gray, and bluish-black. This kind of birthmark usually disappears gradually before the child reaches school age.

Vascular Birthmarks

Vascular birthmarks are caused by underlying blood vessel malformation or clustering of blood vessels. The common types include:

Salmon patches

These occur in about one-third of infants. They can present as small red or pink patches or spots on the skin. The salmon patch is usually flat. When they appear on the face they are called ‘angel’s kisses’. They can also appear back of the neck, where they called ‘stork bites’. They usually disappear as the baby gets older.

Port-wine stain

The color is usually reddish-purple like grape. They can also be quite large at times. It is a result of the multiplication of the capillaries under the skin. The patch may expand over time and is permanent. Furthermore, it commonly affects the face, arms, and chest. If they grow on the eyelids, they will require medical intervention as they increase the risk of glaucoma in the baby.　

Strawberry hemangioma (capillary hemangioma)

These are usually strawberry red and may protrude from the skin as a soft bump. They can appear on the chest, scalp, back, and face (near the eyes). Luckily most regress before the age of five.

Cavernous hemangioma

It looks like a light bluish, spongy tissue filled with blood under the skin. If the cavernous hemangioma is quite deep, the overlying skin will be apparently okay. It usually disappears as the child nears puberty.

Venous malformations

This happens when abnormally formed and dilated veins are situated just under the skin. That said, the overlying skin has a bluish-red color. Most remain hidden during childhood and become apparent in adulthood. Common sites are the tongue, lips, cheek, and jaw. Because pain is sometimes an issue here, treatment is required.

What Are the Common Causes of Birthmarks?

By and large, birthmarks are caused by issues in the factors that control the migration and multiplication of pigment cells or blood vessels. Most vascular birthmarks are not hereditary, hence can not be inherited. As such they are mostly caused by other factors like:

• Bits of the placenta lodging in the developing fetus during early pregnancy.
• Damage to nerve cells controlling the change in the caliber of the blood capillaries lumen, leading to blood vessels that are perpetually widened and unable to constrict properly. This increases the blood flow to the affected patch of skin, hence the red color in the vascular birthmark. This can be seen in port-wine stains.
• Some medical researchers believe that certain proteins produced by the placenta can cause certain types of birthmarks.
• On very few occasions, port wine stains have been associated with gene mutations in rare conditions like Sturge-Weber syndrome and Klippel-Trenaunay syndrome. But these mutations are not the kind that can be inherited.

Note: The popular notion that a birthmark is the result of a pregnant woman not satisfying all her food cravings is purely fictional. A pregnant woman can satisfy all her food cravings and still have a baby with a birthmark.

What Are the Possible Complications of Birthmarks?

Many birthmarks shrink and fade with age, even without treatment. Examples of permanent birthmarks include cafe-au-lait spots, moles, and port-wine stains. What could go wrong if you decide not to treat birthmarks at all? Let’s take a look.

• Strawberry hemangiomas can turn into an open sore and can lead to a serious skin infection in your child.
• Strawberry hemangiomas that develop around the nose and mouth can interfere with breathing and feeding respectively. If not addressed promptly and properly, can then lead to malnutrition.
• Strawberry hemangiomas that grow around the eye can cause visual impairment.
• A port-wine stain around the eye can lead to glaucoma
• Congenital nevus has a 5-10% chance of ending up as an aggressive cancer called melanoma.

How Do You Treat a Birthmark?

The treatment employed depends on the birthmark and baby. Here’s are our suggestions on things you could do for your baby.

1. Wait and watch. Though not strictly a “treatment”, direct observation is key to proper management. As you observe, you may notice that the birthmark shrinks or expand; changes color, changes shape, etc. If you notice any of these changes, ring a dermatologist up immediately.

2. Use makeup to help cover up blemishes in older children. Your dermatologist could assist you with recommendations for makeup that is safe and effective.

3. When you meet the doctor about your baby’s birthmark, the doctor makes a diagnosis and maybe offers some treatment options based on the type of birthmark your child has. Below are some of the possible treatment options:

• Laser therapy: This is a very viable option for a port-wine stain, a type of birthmark is permanent
• Corticosteroids: This medication can be used to shrink a baby’s hemangioma. Your baby’s dermatologist may prescribe corticosteroids as pills or injectables
• Propranolol: This medication can effectively halt hemangioma growth and potentially shrink it.
• Timolol: This medication can help shrink hemangiomas. It does this off-label work at a lower dose than the conventional dose used to treat glaucoma. Since it also comes in a liquid form, so you can apply it to your baby’s birthmark.
• Interferon: This is an effective alternative treatment for a child with life-threatening birthmarks, but has several serious side-effects.
• Surgery: Surgery can be used to excise the birthmark. This treatment is used when the birthmark has the potential of becoming cancerous in time like congenital moles. Also, it is used when the birthmark is very large or visible and could adversely affect the child’s self-image.

Note: Most times, surgery on birthmark are carried out when the infant reaches puberty, as the baby may not be fitted to handle the stress of early surgery.

The Bottom Line

Birthmarks are patches of skin with color or growth patterns different from the surrounding skin. Birthmarks are quite common in infants and are not something you should worry about. That’s because a good number shrink and fade as the baby grows into adulthood.

While most birthmarks are innocuous, others are not. You need to know the common birthmarks and which class of safety they fall into. In a situation where you are not sure, contact a dermatologist as soon as you can.

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