Birthmarks

What are Birthmarks?

Birthmarks refer to patches or spots on the skin that differ in appearance from the surrounding areas. They are extremely common and can manifest in various sizes and shapes. The majority of these birthmarks are usually present at birth, hence the name. While some marks tend to fade away with age, others remain forever unless you remove them.

Typically, birthmarks are painless and harmless. However, certain birthmarks,such as some kinds of moles (congenital nevi),can contribute to skin cancer. It is thus important to talk to your doctor if you notice any changes in these marks.

Types of Birthmarks

The two primary types of birthmarks are:

• Vascular birthmarks: These are composed of blood vessels that fail to form properly during fetal growth. Also referred to as a red birthmark, the color is a result of the blood vessels in the skin. Vascular birthmarks may exist from birth or could appear shortly afterwards.
• Pigmented birthmarks: These consist of clusters of melanocyte cells, which give the skin its color. Pigmented birthmarks have a different color from the rest of the skin, ranging from brown or black to bluish.

Types of vascular birthmarks

• Strawberry hemangiomas: Also known as strawberry birthmark, capillary hemangioma, nevus vascularis, or hemangioma simplex, these can occur on any area of the body but commonly on the face, back, chest, or scalp. They are made up of tiny blood vessels that are closely packed and may exist at birth or appear after some weeks. Usually, they grow quickly, remain at a certain fixed size, and eventually disappear. Many strawberry hemangiomas fade away by age 9, though slight skin discoloration or puckering may remain.
• Cavernous hemangiomas: Also known as angioma cavernosum or cavernoma, these are equivalent to strawberry hemangiomas, though they stretch deeper underneath the skin surface. They may range from red to blue spongey pile of blood-filled tissue. Portions of these lesions fade away on their own often by the time the child reaches school age.
• Port-wine stain birthmarks: These are flat, purple to red marks composed of dilated blood capillaries. Commonly occurring on the face, port-wine stain birthmarks can vary in size. Unless treated, they are permanent and can darken or thicken with time, leading to self-esteem issues, especially if located on a prominent body area.
• Salmon patches: Also referred to as stork bite or angel kiss birthmarks, they occur in 30%-50% of newborns in the United States. The marks are made up of capillaries (tiny blood vessels) noticeable through a child’s skin. Mostly, they appear on the forehead, upper lip, eyelids, behind the neck, and between the eyebrows. However, these salmon patches fade out with age as the child grows.

Types of pigmented birthmarks

• Dermal melanocytosis: Previously known as Mongolian spots, these are bluish marks that resemble bruises. Usually, they occur on the lower back and buttocks and can sometimes appear on the arms or trunk.
• Pigment nevi or moles: These elevated growths on the skin have similar color as the natural skin tone or black or brown. Moles can develop either singly or in groups in any part of the skin.
• Congenital nevi: These are moles present at birth, occurring in 1 out of 100 individuals. Based on the size, these marks have a relatively greater risk of being skin cancer. The possibility of bigger congenital nevi that are over 20 centimetres to develop into cancer is higher compared to smaller ones. As such, examination of all cases of congenital nevi is important, especially if there are any changes.
• Café-au-lait spots: These light brown or light tan patches are often oval-shaped and can appear at birth or develop during the early years of a child. Although café-au-lait spots are generally harmless, several spots bigger than a quarter might indicate an underlying disorder known as neurofibromatosis.

What do birthmarks look like?

Birthmarks appearances are unique from one person to another and vary widely in terms of shape, size, and color. The common features are:

• Flat or elevated mark on the skin
• Marks ranging from the size of a pinhead to the size of a fist
• Colors that differ from the surrounding skin, including red, pink, purple, black, tan, or brown

The size of pigmented birthmarks may increase with age and change in color, particularly with sun exposure and during hormonal changes periods. They can also itch and sometimes bleed if injured.

Does everyone have a birthmark?

While birthmarks are highly common, not all people have one. About 10% of all infants born worldwide have a certain birthmark known as hemangioma.

What causes birthmarks?

The actual cause of birthmarks is unknown, but in some cases, they can form due to:

• Blood vessels not forming properly as expected during fetal growth (vascular birthmarks).
• Melanocyte cells giving the skin its color, growing in groups (pigmented birthmarks).
• A kind of birthmark running in the family or bloodline (genetic predisposition).
• An underlying health problem, such as skin cancer, nevus sebaceous syndrome, or neurofibromatosis, which can lead to birthmark development.

Complications of birthmarks

Pigmented birthmark complications can involve psychological impacts if the mark is on a prominent region like the face. For some, this could lower self-esteem and how one feels about their appearance.

In addition, birthmarks can increase the risk of developing skin cancer. It is thus important to have your provider check for any changes occurring in the size, color or mole texture. Also, you should immediately seek medical attention if you experience pain, itching, bleeding or swelling on the mark.

Birthmark Diagnosis

A birthmark can be diagnosed through a physical examination by closely looking at the mark on the skin. If it is deep in the skin, your provider can use a magnetic resonance imaging (MRI) test, computed tomography (CT) scan, or an ultrasound to confirm it. A skin biopsy may also be done if the birthmark changes in shape or size and might indicate skin cancer.

How can I get rid of a birthmark?

You can consult your medical practitioner concerning birthmark removal if you are unhappy with its appearance on your skin. Do not try to remove the mark at home. For specific birthmarks that pose increased risks of skin cancer, the doctor will recommend removing them.

The treatment method for birthmark removal may include:

• Cryotherapy
• Surgical removal
• Laser removal
• Cortisone injections

The medical practitioner will first asses your birthmarks and suggest the ideal treatment option for you. Childhood birthmarks are usually treated after the child turns six. However, if the marks affect the organs function of the child, including breathing or vision, early intervention may be necessary.

Birthmarks Prevention

There are no definitive ways to prevent birthmarks development. However, it is possible to lower the risks of the marks changing colors or becoming skin cancer by shielding the skin from the ultraviolet rays of the sun.

Consider the following measures to reduce sun exposure risks:

• Applying sunscreen
• Wearing a protective outfit when outside in the sun
• Avoiding sun exposure at daytime when it’s very hot (10am to 4pm)

What can I expect if I have birthmarks?

Typically, birthmarks are harmless and are simply cosmetic that sometimes complement to general look, hence considered beauty marks. Treating birthmarks is not always necessary, and cases like strawberry hemangiomas and salmon patches tend to fade away with time. Some birthmarks will permanently remain with you unless you opt to have them removed. In other instances, larger birthmarks can affect a person’s self-esteem, particularly if they are in a prominent area of the body. You can, therefore, consider the following if you are uncomfortable with your skin:

• Consult a mental health expert regarding your concerns.
• Talk to your doctor about birthmark removal
• Put on makeup to conceal your birthmark

When should I see a healthcare provider?

You should visit your practitioner if you notice changes in your birthmarks or if new marks appear on the skin. The changes to watch out for are:

• Bleeding
• Itchiness
• Pain
• Infection
• Increase in size
• Uneven appearance

What questions should I ask my doctor?

• When visiting your doctor, consider asking the following questions:
• What type of birthmark do I have?
• What options are available for my birthmark removal?
• What are the side effects of birthmark removal?
• Will my birthmark fade and disappear on its own?