A birthmark is a generally harmless irregularity on the skin caused by overgrowth of blood vessels, cells that contain pigment, smooth muscle and fat cells. Birthmarks can be flat or raised, have regular or irregular borders, and have different shades of coloring. Birthmarks earned their name as they appear at or shortly after birth. The two main types of birthmarks are:
Red, vascular birthmarks, such as hemangiomas and port wine stains caused by increased blood vessels clumping together.
Pigmented birthmarks, such as moles, café-au-lait spots, and Mongolian spots, which are large, dark patches that may resemble a bruise and are caused by excess skin pigment cells.
A third type, congenital nevi (congenital moles) are defined as moles that are present at or shortly after birth. Not all moles are birthmarks.
What are the symptoms?
Birthmarks show no symptoms beyond their initial appearance. Nearly all of them pose no physical health risk and many of them disappear or are greatly reduced in size and appearance over time. There are no known preventive measures for birthmarks.
Who gets it?
Contrary to the name, birthmarks do not always appear at birth. Birthmarks may not develop for hours, days, or even weeks after birth. There is no particular subset for susceptibility to birthmarks. Though birthmarks can occur in male and female babies, and in any ethnicity, some subsets are more prone – if even slightly – to get birthmarks. These include:
Hemangiomas are more common in female babies
Hemangiomas are also more common in premature babies
Mongolian spots are more likely to appear among Asian, East Indian, African, Native American, and Hispanic babies.
Café-au-lait spots are more common in African-American babies
Active observation – All hemangiomas should be monitored closely as some can develop complications including skin breakdown and bleeding. In these cases, birthmarks need to be addressed quickly to minimize pain and permanent scarring.
Beta-blockers – These have been shown to be effective treatment options for hemangiomas. Unlike steroids, beta-blockers not only prevent additional growth of the hemangioma, but shrink the existing hemangioma.
Timolol – A beta-blocker that is applied topically to the surface of hemangiomas twice daily. It has been shown to be effective in treating very superficial hemangiomas.
Corticosteroids – Oral corticosteroids are only used during the growth phase and usually do not shrink the existing hemangioma but rather slow further growth.
Pulsed dye laser – The pulsed dye laser treatment is safe and effective in treating infants and young children.
Surgery – Surgical excision is usually reserved for cases in which fibrous, fatty tissue or scarring remains after the hemangioma has resolved or for hemangiomas that are shrinking very slowly and have not resolved by the time the child is about to enter school.