Birthmarks

Birthmarks have distinguished many famous faces throughout history, such as Soviet leader Gorbachov's forehead (a port-wine stain) and the corner of Cindy Crawford's mouth (a nevus). More than 80 percent of babies have some sort of birthmark - an area of discolored skin that is present at birth or shows up within a few weeks after birth. Most birthmarks fade in early childhood, but some remain throughout life or even grow larger and darker over time.

Doctors and scientists still don't understand precisely what causes birthmarks, but contrary to popular myth, they are not related to any trauma or stress experienced by the mother during pregnancy. The tendency to have birthmarks may be inherited and some marks may be similar to those on other family members, but most are not.

Birthmarks are categorized into two groups: vascular or pigmented. Vascular birthmarks are made up of malformed blood or lymph vessels just below the skin's surface, and are usually pink, red, or bluish in color and generally do not fade away. Approximately 10 in every 100 babies have vascular birthmarks. Pigmented birthmarks are made up of malformed pigment cells and are usually brown, gray, bluish, or black in color.

Most birthmarks are harmless; however, approximately 40,000 children are born each year with birthmarks that require specialized medical attention according to the Vascular Birthmarks Foundation, so you should have all your child's birthmarks checked out by a health care provider. Certain birthmarks are associated with vision problems and cancer; and others may impede eating, breathing, nerve function, and blood flow. In addition, large or very visible birthmarks can be psychologically damaging to a young child.

Birthmarks present in a variety of sizes, locations, shapes, and colors. The following are among the most common:

Vascular Birthmarks

Stork bites/Angel kisses/Salmon patches

These are the most common birthmarks. As many as 70 percent of babies have one or more of these blotchy pink or purple flat marks that are dilated capillary veins just under the skin's surface. They may increase in color when there's a change in temperature or the baby cries. Stork bites (so called because they were thought to arise where the proverbial stork carried the baby) are found on the back of the neck and usually last into adulthood. Angel kisses are usually found on the forehead or eyelids and many fade by age 2.

Hemangioma

These raised, rough lesions affect approximately 10 percent of babies (more often in girls, preemies, and twins) and can be large and disfiguring, or small and almost unnoticeable. They occur mostly on the head and neck and can grow rapidly. They usually show up during the first six weeks after birth (only 30 percent are present at birth) and continue to grow for about a year. After a year they suddenly stop growing, turn white, and start shrinking - without treatment. This shrinking and fading process can take three to ten years. Twenty percent of babies who have hemangiomas have more than one. A common type of hemangioma is a strawberry hemangioma (so-called because its raised, red appearance resembles a strawberry), which affects about 2 to 5 percent of babies.

Port-wine stains (PWS)

These dark, berry-colored stains are present at birth on less than one percent of babies. They usually show up on the face or head, but they can appear anywhere on a baby's body. If your baby's port-wine stain is initially light-colored, it may fade as your child grows; however, most thicken and grow darker with age. If your baby's port-wine stain is near the eye and cheek, it may cause vision problems such as glaucoma, or seizures and developmental delay (a condition known as Sturge-Weber Syndrome).

Pigmented Birthmarks

Mongolian Spots

These large, flat bluish or grayish areas resemble (and may be mistaken for) bruises, and are usually found on the back or buttocks of dark-skinned babies. In fact, they occur on 95 to 100 percent of Asian, 90 to 95 percent of East African, 85 to 90 percent of Native American, 50 to 70 percent of Hispanic, and 1 to 10 percent of Caucasian babies. Most Mongolian spots fade by school age; however, some never fully fade.

Café au Lait spots

Between 20 and 50 percent of babies have one or two of these tan or light brown flat patches. They usually shrink as the child grows; although they may darken with sun exposure. Groups of six or more café au lait spots may be a sign of a genetic disorder called neurofibromatosis (NF), a genetic disorder that causes abnormal cell growth of nerve tissue.

Nevi

Also known as moles, these are clusters of pigmented skin cells that vary in size and may be flat or raised, black or brown, hairy or not. Most nevi show up later in childhood; however, approximately 1 percent of babies are born with them. These are called congenital nevi, or birthmark moles, and could indicate an increased risk of skin cancer (melanoma), especially if the moles are very large. This type of birthmark should be carefully observed over time by a doctor.

If a birthmark is prominent, threatens your child's health or is disfiguring or psychologically damaging, it may be removed, depending on the type, severity, and location of the birthmark. Treatment options include surgery, laser therapy, and topical, oral, or injected steroids. Unfortunately, almost all birthmark-removal treatments can cause some scarring.

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