Birthmarks are very common and generally appear on the skin at birth or shortly after.

They are mostly harmless and many will fade or get smaller over time. Rarely birthmarks are associated with other medical problems, so it is a good idea to talk about your child's birthmark with your child's doctor to determine if this is an issue.

The cause of birthmarks is unknown. Some large or disfiguring birthmarks can be treated with medicines, lasers or surgery. Talk your child's physician to discuss options. In general, if a birthmark ever bleeds, hurts, or drains fluid, then you should consult your child's doctor. He or she will check to make sure that it is not infected and decide if it needs treatment.

Birthmarks come in various colors, shapes, textures and sizes. Common birthmarks include the following:

Red Ones

Strawberry Hemangiomas or Stork Bites

 

 

A common birthmark is called a strawberry hemangioma, which can be either raised or flat.

The flat ones are usually located near the middle of the forehead between the eyes or on the back of the neck. This type of birthmark is commonly referred to as a stork bite since it is where the stork was holding your baby for delivery! These generally fade by four years of age. The ones on the back of the scalp tend not to fade as much but will be covered by hair as your child grows.

Another common place for this flat, red birthmark is on the eyelids. Again, these will fade over time. When your baby is straining (such as when crying or stooling) or when your baby is warm (such as after a bath), these red marks may appear more prominent as the blood vessels underneath expand.

Raised hemangiomas

     Hemangiomas at birth                                                                  Same baby 7 months on

Raised hemangiomas can be anywhere on the body and tend to rise up into a reddish bump over the first year of life. The hemangiomas can look rather dramatic when they get larger. These are often called strawberry hemangiomas due to their resemblance to strawberries. After about a year, these bumps gradually flatten out and then eventually either disappear or turn faint pink by the time your child is four years of age. Nothing needs to be done about either of these unless they are very large or are located in a place that may cause problems later, such as near the eye or around the mouth. The red color comes from the fact that they are made up of little blood vessels.

If your baby has a lot of hemangiomas, your doctor may refer you to a dermatologist or evaluate your baby further for conditions that may need treatment.

Port-wine stain or naevus flammeus

Another reddish birthmark called a port-wine stain is flat, pink to purple, and looks like an irregular patch. Sometimes it resembles a stain that would result if you spilled a dark red fluid, like wine (thus the name). These can appear anywhere on the body, often on the face and is the result of swollen blood vessels. Many of these can be treated with laser therapy when your baby is older. These can be occasionally associated with medical conditions, so you should consult your child's doctor.

Grey-blue Ones 

Mongolian Spots

Especially if your baby has darker pigmented skin (such as in Asian or African descent), he may have some dark grey-blue marks on the skin that appear almost like bruises. These are most common on the buttocks and can be rather large. These are normal and will usually fade by four to six years of age.

Photo credit http://www.adhb.govt.nz  

Because they can be mistaken for bruises, it is a good idea for your doctor to document their existence so that no one will question you about them later.

Brown Ones

Cafe au Lait Spots

 

A cafe au lait spot appeared on this baby's cheek around 3 weeks of age. The picture on the right shows the same child a few years later.

A common birthmark is light brown in color and is called a cafe au lait spot. It is flat and is a coffee-colored brown (think coffee with cream). This birthmark should grow only as your baby grows. If your child has more than five of these birthmarks, visit your doctor to see if your child may have other findings that may indicate a disorder. If your child has only one to four of these birthmarks, then this it is likely a normal variation and not related to a disorder. Let your doctor know if the color changes or the spots grow faster than your child is growing.

Moles

Usually we develop moles as we get older, due to sun exposure. But some babies are born with moles. These range in size and can be anywhere on the body. Some may have hair growing out of them. Brown moles that are really big (more than 7 inches or 20 cm) are called giant nevi and are at higher risk for developing melanoma, or skin cancer. These need to be evaluated by a dermatologist. Moles that are medium-sized (.5 inches to 7 inches or 1.5cm to 19 cm) may be evaluated and followed. Hairy moles should be checked by a dermatologist as well.

White Ones

Ash Leaf Spots

Some babies have white colored birthmarks. If there is only one, then this can be a normal variation. The birthmark should grow only as your baby grows. If your child has many of these, has neurological problems, or has a spot growing faster than he is growing, see his doctor to rule out more significant medical conditions.

Dealing With Birthmarks

It's always surprising to see a mark on your beautiful baby's skin. It can be frightening if the birthmark grows rapidly in the beginning (like a hemangioma). For the most part, birthmarks improve as your child gets older so that can be reassuring. Do your research and ask questions to help you be best informed about the course of the birthmark. Ask your doctor and look for support groups if needed.

If the birthmark is large and very visible, especially on the face, some people may stare or ask questions about it. While this may feel intrusive or rude, it's a good idea to have an answer to handle these situations. As a parent, your child will be able to sense how you deal with their birthmark. As they get older and are able to talk to others about themselves, teach them to be open with others. Accepting that everyone is different and that each person is special is a great lesson early on. Teach your child how to explain that they have a birthmark and that they were born with it. Focusing on other wonderful aspects of your child's appearance and personality will help to build confidence and self-esteem.

Next:  Newborn skin and common conditions

By Dr Sandy L. Chung - Parts of this article are excerpts from Chung, S. (©2011) Dr. Sandy's Top to Bottom Guide to Your Newborn: Answers to the Questions Every New Parents Asks, Boulder, CO: Sentient Publications.