Birthmarks are coloured marks on the skin that are
present at birth or develop shortly after birth. They can be many different
sizes, shapes, and colours, including brown, tan, black, blue or blue-grey,
pink, white, red, or purple. Some birthmarks appear on the surface of the skin,
some are raised above the surface of the skin, and some are located under the
skin. Most birthmarks are harmless and do not need treatment. Many birthmarks
change, grow, shrink, or disappear. There are many types of birthmarks, and
some are more common than others.
Salmon patches (also called stork bites, angel
kisses, or macular stains) are the most common type of birthmark. They
are found in 40% to 70% of newborns.1 They are thin,
flat, light pink or red areas of coloured skin that occur most frequently on
the back of the neck (stork bites) and on a baby's upper eyelids, upper lip, or
between the eyebrows (angel kisses). Most salmon patches on the eyelids fade
without treatment within the child's first year. Most salmon patches on the
nape of the neck do not fade. Salmon patches are more noticeable when a baby is
crying or when he or she is hot or cold.
Congenital moles (nevi) are present at birth
and are usually brown in colour. They can appear anywhere on the body and can
be different shapes and sizes. Some
moles appear alone, and some moles appear in groups.
Large moles may need to be closely watched because they can become cancerous
later in life.
Café-au-lait spots are smooth birthmarks that
may be present at birth, but tend to develop in childhood. They are usually
oval in shape and range from light brown to chocolate brown in colour. They are
found most commonly on the torso, buttocks, and legs. Café-au-lait spots do not
go away, may increase in number, and generally do not require treatment. A
single café-au-lait spot is not a sign of a health problem. But six or more
spots that are larger than
6 mm (0.25 in.) or ones that
occur along with freckles in the armpit can suggest
neurofibromatosis.
Mongolian spots are smooth, blue or blue-grey
birthmarks that usually are found across the lower back and buttocks. They tend
to occur in children of Asian, Southern European, Hispanic, Pacific Island, or
African descent. A child may have one or several Mongolian spots. These types
of birthmarks usually disappear without treatment by age 3 or 4.
Port-wine stains are uncommon birthmarks that
are pink-red at birth and darken to a red-purple colour after a few years.
Port-wine stains are caused by blood vessels that do not develop normally. They
can be small or they can cover a large area of the body. They generally are
found on the face but can occur anywhere on the body. Port-wine stains on the
face can be associated with brain problems caused by
Sturge-Weber syndrome.
Port-wine stains do not fade or go away on their own and most darken,
thicken, and form bumps during adulthood. Port-wine stains may become more
obvious when the body's hormones are changing, such as during puberty or
pregnancy. A treatment called laser therapy may lighten or reduce the bumpiness
of port-wine stains. If a port-wine stain makes you or your child feel shy or
self-conscious, ask your health professional about treatment options, makeup,
or hairstyles that can hide the birthmark, and/or support groups and
counselling.
Hemangiomas are formed by a clump of immature
blood vessels. They may be present at birth or may appear when a baby is
several weeks old. Hemangiomas vary in size: they may be a few millimetres to a
few centimetres in diameter. There are three basic types of hemangiomas:
- Strawberry hemangiomas
(superficial or capillary hemangiomas) are the most common type. Strawberry
hemangiomas are thick, raised birthmarks that are soft, purplish red, smooth,
or slightly bumpy. They may be irregular or round in shape and most often
develop on the face, scalp, back, or chest. Strawberry hemangiomas may never
grow, grow slowly, or grow rapidly to many times their original size in just a
few months. After they stop growing, they usually begin to shrink, and most
strawberry hemangiomas eventually disappear.
- Deep
hemangiomas are thick, deep, raised birthmarks that can be pale,
skin-coloured, red, or blue. They often are round in shape and may feel like a
sponge. Deep hemangiomas may not go away, or they may fade and leave a
scar.
- Compound hemangiomas are a combination
of strawberry and deep hemangiomas.
As many as 10% to 12% of babies have hemangiomas by the time they
are 1 year old.2 Some hemangiomas disappear completely
by 18 months. Most hemangiomas disappear or fade by age 9. Most children
develop only one hemangioma, but sometimes more than one occurs.
Although hemangiomas can appear to be painful or ugly, few need
treatment. Hemangiomas that cause problems with sight, breathing, hearing,
speech, or movement may need treatment. Hemangiomas that grow on internal
organs such as the stomach, intestines, liver, or kidneys may need treatment.
In rare cases, a hemangioma in the diaper area will become sore and
bleed (ulcerate). Ulceration can be very painful. If this happens, apply
pressure to the area continuously with a clean pad for 10 minutes, and contact
your health professional for more advice and an appointment.