Birthmarks are marks on the skin noticeable at birth that are usually completely harmless. We look at the different types of birthmarks and when to be concerned.
Medically reviewed by Dr Juliet McGrattan (MBChB) and words by Claire Lavelle
Worried about a birthmark on your new baby or toddler? Birthmarks are coloured marks on the skin that you will probably spot at birth or soon afterwards. For excited new parents, an unexpected mark on their baby can be cause for concern. In fact, birthmarks are very common, and most are nothing to worry about. Most birthmarks are completely harmless and disappear of their own accord, but some may need to be treated.
We speak to consultant paediatrician Dr Sunit Godambe, from the Royal College of Paediatrics and Child Health about the different types of birthmarks and when to be concerned:
What is a birthmark?
When my daughter was born, she had a little strawberry nevus, or infantile haemangioma, to use the proper medical term, on her tummy. It was very small and not particularly raised: I pointed it out to the midwife, who said they were very common (especially in girls) and that it wasn’t anything to worry about.
I didn’t think much about it after that until my niece, then seven, came to visit her new baby cousin and spied it when I was changing my daughter’s nappy. ‘Oh, my friends got one of those,’ she said, airily. ‘Last year it was tiny but now it’s grown absolutely MASSIVE.’
I don’t normally take medical advice based on the comments of children in year three (advanced though my niece is, naturally) but the cool authority with which she said it made me wonder if a second opinion might be worth it after all.
There are several different types of birthmark, some more common than others. The two main types include:
- Vascular birthmarks
Vascular birthmarks usually appear in the head and neck area (often red, purple and pink, or occasionally blue) and are caused by abnormal blood vessels in or under the skin.
- Pigmented birthmarks
Pigmented birthmarks (typically brown in colour) are caused by clusters of pigment cells. Both vascular and pigmented birthmarks can appear anywhere, including inside the body.
Should you worry about birthmarks?
I wasn’t the only one worrying about birth marks: a couple of my NCT friends had also had babies born with birthmarks (one had a salmon patch, or ‘stork bite’, on her forehead; the other Mongolian spots on her upper thigh) and while there was a feeling that we didn’t want to “make a fuss” you could feel the tension thrumming through us as we debated these mysterious marks. In the end, I opted for quietly keeping an eye on it and sure enough, the mark disappeared before my daughter’s third birthday.
But should you worry if you spot a birthmark on your baby? ‘A strawberry nevus is a collection of blood vessels at the surface of the skin, and although one small one is nothing to worry about, they can rub against clothing or experience constant irritation which can cause them to rupture and bleed or become ulcerated,’ says Dr Godambe.
Most birthmarks will completely disappear by the age of five.
‘If they are deeper within the body, they may not be apparent at first and appear as a lump as the haemangioma grows,’ he adds. ‘They can also grow on organs inside the body, such as the liver. If your child has more than one noticeable haemangioma, you may be offered an ultrasound or MRI scan to rule this out.’
More commonly, however, the course of action is to treat troublesome haemangiomas with a beta blocker medication called propranolol to shrink them, or simply wait it out. Occasionally steroids, other more potent medications or laser treatment may be used. ‘Most will completely disappear by the age of five,’ says Dr Godambe.
Salmon patch, or stork bite birthmarks
Stork bite birthmarks are tiny red marks that appear on the upper eyelid, forehead or in the centre of the nape of the neck.
‘Around 30 per cent of babies are born with this type of birthmark,’ says Dr Godambe. ‘Typically, the mark behind the neck stays while marks on the forehead and eyelids fade.’
Port wine stain birthmarks
Around three in 1000 children are born with a port wine stain, which is a flat red or purple mark on the skin apparent from birth. Over time, it can thicken and become raised.
‘Port wine stains develop due to an abnormal collection of blood vessels under the skin,’ explains Dr Godambe. ‘The worry is there might be a similar structure in the brain, which can cause fits or convulsions – this is known as Sturge-Webber syndrome.
‘If there is any suspicion that your child has this, they will be seen by a neurologist and given a brain scan, but the condition is rare.’
✔️ Port wine stain birthmark treatment
Laser treatment is successful at physically treating a port wine stain, and can be started when children are very small. It lightens the birthmark making it less obvious. Multiple laser treatment sessions are required.
Port wine stains are less likely to grow in adulthood (they can become bumpy and ‘cobbled’) if laser treatment has been carried out.
‘Because port wine stains are usually visible, a clinical psychologist may be involved with the family early on to advise the parents – and later, the child – on dealing psychologically with a birthmark that singles a child out as ‘different’.
Mongolian blue spot birthmarks
Doctors think Mongolian blue spot birthmarks are caused by early skin cells that develop during pregnancy getting trapped deep in the layers of the skin, so they’re not due to anything the mother did or didn’t do.
‘These are common in Mediterranean and Asian children and most frequently appear on the lower back or legs,’ says Dr Godambe. ‘They’re blue-grey in colour and usually measure a few centimetres across. The can look like bruising but they’re not painful to the touch, and generally get lighter and fade by the time a child reaches puberty.’
Café au lait spot birthmarks
These are coffee-coloured pigmented patches on the skin that are generally no cause for concern, although if your child develops more than six spots, or they measure more than 5cm in diameter, you should see your doctor.
‘This is because they are associated with a condition called neurofibromatosis, which causes tumours to grow on nerve tissue later on in life,’ says Dr Godambe. ‘Your GP will refer you to a paediatrician or dermatologist for monitoring and, if necessary, treatment.’
Don’t be afraid to ask about birthmarks
When your baby is born he or she will be checked over by a midwife and doctor. Some birthmarks will be visible then and the staff will be able to answer your questions and concerns. You will have another opportunity for this when your baby attends for their six week check and subsequent first vaccinations. Birthmarks are usually nothing to worry about but if at any point you have concerns then do ask for reassurance.
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