About birthmarks
There are two main categories of birthmarks — red birthmarks and
pigmented birthmarks. Red birthmarks are a vascular (blood vessel) type
of birthmark. Pigmented birthmarks are areas in which the color of the
birthmark is different from the color of the rest of the skin.
What are red birthmarks?
Red birthmarks are colored, vascular (blood vessel) skin markings
that develop before or shortly after birth.
What are the types of red birthmarks?
One common kind of vascular birthmark is the hemangioma. It usually
is painless and harmless and its cause is not known. Color from the
birthmark comes from the extensive development of blood vessels at the
site.
Strawberry hemangiomas (strawberry mark, nevus
vascularis, capillary hemangioma, hemangioma simplex) might appear
anywhere on the body, but are most common on the face, scalp, back, or
chest. They consist of small, closely packed blood vessels. They might
be absent at birth, and develop after several weeks. They usually grow
rapidly, remain a fixed size, and then subside. In most cases,
strawberry hemangiomas disappear by the time a child is 9 years old.
Some slight discoloration or puckering of the skin might remain at the
site of the hemangioma.
Cavernous hemangiomas (angioma cavernosum, cavernoma)
are similar to strawberry hemangiomas but are more deeply situated. They
might appear as a red-blue spongy mass of tissue filled with blood. Some
of these lesions disappear on their own, usually as a child approaches
school age.
Port-wine stains are flat, purple-to-red birthmarks made
of dilated blood capillaries. These birthmarks occur most often on the
face and might vary in size. Port-wine stains often are permanent
(unless treated) and might thicken or darken over time, resulting in
emotional distress.
Salmon patches (also called stork bites) appear on 30
percent to 50 percent of newborn babies. These marks are small blood
vessels (capillaries) that are visible through the skin. They are most
common on the forehead, eyelids, upper lip, between the eyebrows, and
the back of the neck. Often, these marks fade as the infant grows.
What are the symptoms of red birthmarks?
Symptoms of red birthmarks include:
- Skin markings that develop before or shortly after birth
- Red skin rashes or lesions
- Skin markings that resemble blood vessels
- Possible bleeding
- Skin that might break open
How are red birthmarks diagnosed?
In most cases, a health care professional can diagnose a red
birthmark based on the appearance of the skin. Deeper birthmarks can be
confirmed with tests such as MRI, ultrasound, CT scans, or biopsies.
What is the treatment for red birthmarks?
Many capillary birthmarks such as salmon patches and strawberry
hemangiomas are temporary and require no treatment. For permanent
lesions, concealing cosmetics might be helpful. Cortisone (oral or
injected) can reduce the size of a hemangioma that is growing rapidly
and obstructing vision or vital structures. Other oral medicines have
been used experimentally with some success in these cases, as well.
Port-wine stains on the face can be treated at a young
age with a yellow-pulsed dye laser for best results. Treatment of the
birthmarks might help prevent psychosocial problems that can result in
individuals who have port-wine stains.
Permanent red birthmarks might be treated with methods including:
- Cryotherapy (freezing)
- Laser surgery
- Surgical removal
In some cases, birthmarks are not treated until a child
reaches school age. However, birthmarks are treated earlier if they
result in unwanted symptoms or if they compromise vital functions such
as vision or breathing.
Can red birthmarks be prevented?
Currently, there is no known way to prevent red birthmarks.
What are pigmented birthmarks?
Pigmented birthmarks are skin markings that are present at birth.
The marks might range from brown or black to bluish, or blue-gray in
color.
What are the types of pigmented birthmarks?
Mongolian spots usually are bluish and look like bruises. They often
appear on the buttocks and/or lower back, but they sometimes also appear
on the trunk or arms. The spots are seen most often in people who have
darker skin.
Pigmented nevi (moles) are growths on the skin that
usually are flesh-colored, brown, or black. Moles can appear anywhere on
the skin, alone or in groups.
Congenital nevi are moles that are present at birth.
These birthmarks have a slightly increased risk of becoming skin cancer,
depending on their size. Larger congenital nevi have a greater risk of
developing into skin cancer than do smaller congenital nevi. All
congenital nevi should be examined by a health care provider, and any
change in the birthmark should be reported.
Cafe-au-lait spots are light tan or light brown spots
that are usually oval in shape. They usually appear at birth but might
develop in the first few years of a child’s life.
What causes pigmented birthmarks?
The cause of pigmented birthmarks is not known. However, the amount
and location of melanin (a substance that determines skin color)
determines the color of pigmented birthmarks. Cafe-au-lait spots might
be a normal type of birthmark, but the presence of several cafe-au-lait
spots larger than a quarter might occur in neurofibromatosis (a genetic
disorder that causes abnormal cell growth of nerve tissues). Moles occur
when cells in the skin grow in a cluster instead of being spread
throughout the skin. These cells are called melanocytes, and they make
the pigment that gives skin its natural color. Moles might darken after
exposure to the sun, during the teen years, and during pregnancy.
What are the symptoms of pigmented birthmarks?
Symptoms of pigmented birthmarks include skin that is abnormally
dark or light, or bluish, brown, black or blue-gray in color.
Discolorations of the skin might vary in size and be smooth, flat,
raised, or wrinkled. Pigmented birthmarks might increase in size, change
colors, become itchy, and might occasionally bleed.
How are pigmented birthmarks diagnosed?
In most cases, health care professionals can diagnose birthmarks
based on the appearance of the skin. If a mole exhibits potentially
cancerous changes, a biopsy might be performed.
How are pigmented birthmarks treated?
In most cases, no treatment is needed for the birthmarks themselves.
When birthmarks do require treatment, however, that treatment varies
based on the kind of birthmark and its related conditions.
Large or prominent nevi that affect the appearance and
self-esteem might be covered with special cosmetics.
Moles might be removed surgically if they affect the
appearance or if they have an increased cancer risk.
What are the complications of pigmented birthmarks?
Some complications of pigmented birthmarks can include psychological
effects in cases in which the birthmark is prominent. Pigmented
birthmarks also can pose an increased skin cancer risk.
A doctor should check any changes that occur in the
color, size, or texture of a nevus or other skin lesion. See a doctor
right away if there is any pain, bleeding, itching, inflammation, or
ulceration of a congenital nevus or other skin lesion.
Can pigmented birthmarks be prevented?
There is no known way to prevent birthmarks. People with birthmarks
should use a good quality sunscreen when outdoors in order to prevent
complications.
© Copyright 1995-2009 The Cleveland Clinic Foundation. All rights reserved.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 4/7/2009...#12159
