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Birthmarks

Birthmark; birth; mark; stork; stork bite; Mongolian; blue; spot; strawberry; cafe au lait; port; wine; stain; melanocytic; naevus; congenital; freckle; mole; salmon; patch; telangiectatic; bruise; capillary; haemangioma; nevus; Sturge; Weber; Klippel; Trenaunay; milia; milk spot; Epstein's; pearl; acne;

Any mark that is present on the skin at birth or that develops soon afterwards is called a birthmark. They are very common and most children have a mark of some sort. Most are harmless and some go away as the child grows.

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Alert!

Occasionally a birthmark may be a sign of other problems or diseases. Check with your doctor if you are not sure, especially if the mark changes in a way you were not expecting.

What causes birthmarks?

  • No-one knows why some children have birthmarks and others do not. They are certainly not caused by the mother seeing something strange or having a fright during pregnancy.
  • The tendency to have birthmarks may be inherited and some marks may be similar to marks on other family members, but most are not.
  • Some are caused by an over-growth of fine blood vessels, others by an overgrowth of pigment (colour) cells (called melanocytes).

Stork bite mark (Salmon patch, Telangiectatic naevus)

  • These are pink, flat, irregular shaped marks on the back of the neck and/or on the eyelids, forehead and occasionally on the top lip. The skin is not thickened, and you cannot feel any difference when you touch the mark.
  • Nearly half of all babies have these.
  • They are do not cause any problems and usually disappear by 12 months, or earlier.
  • The mark at the back of the neck may stay for longer, but it is usually covered by hair and out of sight.

Mongolian Blue Spots

Mong-spot.jpg (5733 bytes)

  • These are bluish, irregular flat patches, mainly on the back and buttocks (bottom), but they can be on any part of the body. There is no thickening or change to the feel of the skin.
  • They are very common in babies from ethnic groups who have darker skin colouring (olive or darker skin and black hair).
  • They are harmless and become less obvious as the child grows.
  • It is important not to confuse them with bruising.

Strawberry mark (Capillary haemangioma)

  • These are red, raised, lumpy areas which usually appear around 1 to 4 weeks of age, then get bigger, sometimes quite quickly, for a few months. They can look very worrying.
  • They stop growing between 6-12 months and then gradually disappear over the next few years.
  • It is best to allow them to go away by themselves, as there will be little or no scar left.
  • It is not possible to predict exactly what will happen to a strawberry birthmark, but some will be gone by the age of 2 years, about 60% by 5 years and 90-95% by 9 years.
  • The skin of the birthmark is as strong as skin on other parts of the body. The birthmark area does not need to be covered by any bandage.
  • Rarely one will bleed if knocked hard or scratched, or develop an ulcer on the surface and need to be treated.
  • Sometimes a strawberry birthmark will grow in a place which covers an eye, or blocks one side of the nose. In these cases they can be treated (often with laser treatment).

Cafe au lait spots

  • These are flat, roughly oval shaped light brown (milk coffee coloured) spots that may be present at birth or may appear in early childhood.
  • Many children have one or two of these and they are not a sign of a health problem.
  • If your child has more than three or four, check with your doctor as they can sometimes mean that a child might have a rare disease, such as neurofibromatosis.

Port wine stain

  • These are flat, large areas of skin which are darker (pinker or purplish colour) than the skin around them. They are there from birth and the colour gets darker from pale pink to deep red-purple as the child grows. They may also thicken and get more lumpy.
  • The marks are often on the face, sometimes just on one side and they may have a clear edge along the middle of the face, but they can be anywhere on the body.
  • If they are on the upper eyelid and forehead they may be a sign that there could be a very rare problem called Sturge Weber Syndrome (but usually not). People with this syndrome may also have abnormalities of the brain and sometimes of an eye.
  • Port wine stains on a different part of the body, most often a leg, may be a sign of a different syndrome (Klippel-Trenaunay-Weber syndrome). Bones, muscles and other tissue near the birth mark grow larger than the 'normal' limb.
  • Port wine stains don't go away by themselves so it is best to have expert advice about treatment early, because the appearance can affect children's feelings about themselves.
  • Laser therapy usually gives good results. This may not be available in some places yet. [In South Australia you can get more information about where to get treatment from the Women's and Children's Hospital Dermatology clinic. You will need a referral from your doctor.]

Congenital Melanocytic Naevus

These are dark skin patches that are there when a baby is born. hairy-nev.jpg (6228 bytes)

  • Small moles and freckles are common. They are occasionally seen on babies but more often develop in childhood.
  • Some babies are born with large, dark brown, blue or black birthmarks. These sometimes grow dark hairs.
  • Some are raised and lumpy and some are flat and irregular in shape.
  • With some of these, usually not ones that have hair growing on them, there can be a small risk of cancer developing. This will usually show by the skin on or around the mark changing. In these cases the mark is usually removed. This may involve a skin graft or the skin around may be stretched to cover the area.

Milia

Many newborn babies have tiny spots on their face, especially on the nose, chin and cheeks. These little lumps, which are called milia, or somtimes 'milk spots', are usually no larger than a millimetre across, and are caused by blockages in the tiny pores of the baby's skin.

  • It is thought that they are due to the glands which drain through these pores not being fully mature at birth. Sometimes babies will also have milia on their palate or gums (these are called Epstein's pearls).
  • Most milia will disappear within the first few weeks of life without leaving any scarring, although they can sometimes last for a couple of months. No treatment is needed.
  • Sometimes, if the skin is rubbed (for example the baby's face rubs against a rug), the skin around the tiny lump can become red (the central lump stays white). Although this may look like acne, it is not acne. No treatment is needed for this either, the redness will settle by itself.

References

MedlinePlus (National Library Medicine, USA) 
http://www.nlm.nih.gov/medlineplus/ 

Klippel-Trenaunay Syndrome Support Group
http://www.k-t.org

Better Health Channel (Victoria) 
http://www.betterhealth.vic.gov.au/ 

Sturge-Weber Syndrome Foundation
http://www.sturge-weber.org/

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The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Parent Helpline on 1300 364 100 (local call cost from anywhere in South Australia).

This topic may use 'he' and 'she' in turn - please change to suit your child's sex.

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