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Birthmarks are colored marks on the skin that are
present at birth or develop shortly after birth. They can be many different
sizes, shapes, and colors, including brown, tan, black, blue or blue-gray,
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 thin, flat, light pink or red areas of
colored 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 color. 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 color. 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
0.25 in. (6.4 mm) or ones that
occur along with freckles in the armpit can suggest
Mongolian spots are smooth, blue or blue-gray 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 pink-red at birth and darken
to a red-purple color 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
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.
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 doctor about treatment options and/or support groups and counseling.
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 millimeters to a
few centimeters in diameter. There are three basic types of hemangiomas:
Some hemangiomas disappear completely by 18 months. Most
hemangiomas disappear or fade by age 9. Most children who have hemangiomas have
Although hemangiomas can appear to be painful or ugly,
few need treatment. Hemangiomas that grow rapidly or cause problems with sight, breathing,
hearing, speech, or movement may need treatment. For example, babies born with severe hemangiomas that are growing rapidly need to be treated right away. And hemangiomas that grow on
internal organs such as the stomach, intestines, liver, or kidneys may need
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 doctor for more advice and an appointment.
March 8, 2013
Kathleen Romito, MD - Family Medicine & John Pope, MD - Pediatrics
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