A pediatric dermatologist explains what to know about birthmarks
You’re snuggling your sweet new baby and notice a spot on their skin – or you might detect a new discoloration during bathtime. It’s likely a birthmark which, despite the name, can sometimes show up a few weeks to even a year after a baby is born.
“Birthmarks are very common but vary widely in size and color. They can even become more noticeable or disappear over time,” said Dr. Jeff Yu, dual board-certified dermatologist and pediatric dermatologist and chair of the Department of Dermatology at VCU. “They’re typically not harmful and may simply be one of the many things that make your baby unique.”
There are two main types of birthmarks in young children.
Vascular birthmarks
These birthmarks are made of extra blood vessels, giving them red or purplish coloring. The most common types of vascular birthmarks include:
- Hemangiomas
- Raised growths that may look like a strawberry or purple/blue bump
- Many appear within the first few weeks of life, grow the fastest during the first 3 months, then fade and shrink on their own after 1 year of age
- Port wine stains
- Flat birthmarks that are usually pink, red or purplish
- Usually noted at birth
- Often located on the head or neck but can appear anywhere
- Don’t fade and may thicken over time
- May be hard to distinguish from nevus simplex (see below)
- Nevus simplex
- Flat pink or red patches
- Typically found on the forehead, eyelids, upper lip or back of the neck
- More common in infants with light skin tones
- Sometimes called stork bites or salmon patches
- Usually fade in the first year of life
Other common birthmarks
Other birthmarks are also very common in children. The most common non-vascular birthmarks include:
- Congenital melanocytic nevi (birthmark moles)
- Flat or raised birthmarks that are commonly brown or black (like a mole)
- Can range in size
- May have hair growing in them
- Café-au-lait spots
- Light to medium brown (similar to the color of coffee with milk, hence the name) flat birthmarks
- Can appear anywhere on the body
- Can range from very small to quite large
- If your child has multiple café-au-lait spots, please speak with your pediatrician.
- Dermal melanocytosis (previously known as “Mongolian” spots)
- Usually grayish black in color, flat and smooth birthmarks
- Located on the back or buttocks
- More common in babies with darker skin tones
When is it important to have a birthmark checked by a dermatologist?
“It’s a good idea to keep an eye on your child’s birthmarks and mention any concerning signs to their pediatrician,” added Dr. Yu. “They may refer you to a dermatologist for evaluation and treatment.”
Dr. Yu especially wants to see children with:
- Rapidly growing, bleeding or painful birthmarks
- Large brown mole-like birthmarks
- Birthmarks over critical structures such as the lower back midline, scalp, eyes, nose or mouth
A dermatologist will evaluate the birthmark and, if needed, request imaging studies, such as ultrasound or MRI, to help determine the type and treatment options.
Depending on the birthmark, treatment may include:
- Continued observation
- Laser treatment to lighten red/vascular birthmarks
- Genetic studies if there is concern of an underlying genetic condition
- Oral/topical medications to shrink or stop growth of a hemangioma