Are birthmarks a cause for worry? When baby arrives, a mom’s most immediate concern is most likely related to the health of her new baby. Fingers and toes are accounted for, lungs are checked and a multitude of other tests reveal any possible health issues. So, what about that spot on baby’s skin?
Birthmarks are collections of normal components of the skin, and any of these elements can produce a birthmark: skin cells, pigment cells, blood and lymphatic vessels, oil glands, hair follicles, collagen, etc. Despite of their name, some birthmarks are not apparent at birth, and they can rarely appear as far as during the early adolescent years.
The most common birthmark is the “salmon patch” or “angel kiss” or “stork bite,” named depending on its location. This is a benign malformation of the small blood vessels (capillaries) of the skin, most commonly located on the nape of the neck or the forehead as a red patch.
Vascular birthmarks are made up of a cluster of blood vessels in the skin, in a red, pink or bluish color. There are different types of vascular birthmarks: Hemangiomas of infancy, port wine stains, Mongolian spots and café-au-lait spots. Hemangiomas of infancy typically appear shortly after birth or at birth and tend to grow fast during the first six months, fading away slowly after the first year of age. When hemangiomas are located on the face or neck they may signal more serious eye problems or internal hemangiomas (such as in the liver or in the larynx).
Port wine stains are a capillary malformation. They are present at birth and do not go away. When they are large and on the face, they may signal a syndrome called Sturge Weber which consists of seizures, developmental problems and glaucoma, among other symptoms.
About 80 to 90 percent of Asian- and African-American babies have “Mongolian spots,” which are blue-gray or blue-black spots usually located over the low back or buttocks area, although they can also be located on other areas. Their color is due to pigment cells located deep in the skin. It typically fades during childhood.
Café-au-lait spots are light brown spots, present in up to 18 percent of newborns. Most children with these lesions have no other abnormalities. However, if there are many large spots, they can be associated with a disease called Neurofibromatosis–a condition that causes tumors to grow on nerve tissue, producing skin and bone abnormalities. A very large café-au-lait spot on one side of the body can be related to McCune-Albright syndrome, a genetic disorder of the bones, skin pigmentation and hormonal problems along with premature puberty.
Congenital Melanocytic Nevus (nevus = mole) is a proliferation of pigment cells (melanocytes) that is present at birth or may appear in the first few months of life. It may range in size from small to giant (greater than eight inches). The large ones carry a higher risk for melanoma. They may have hair, and this has no impact on the development of skin cancer. When they overlie the spine, and when they have multiple satellite lesions it can be associated with neurological malformations of the spine (meningocele, etc), hydrocephalus, and brain malformation.
Your child’s pediatrician can identify when a birth mark needs special attention. Rest assured, most birthmarks are harmless and will not need further attention.
Adriana Brune, MD, is a dermatologist at Samaritan Dermatology in Corvallis. She can be reached by calling 541-753-5700.
Healthy MOM™ is brought to you courtesy of Samaritan Health Services and MOM Magazine.