Birthmark

  • Medical Author:
    Gary W. Cole, MD, FAAD

    Dr. Cole is board certified in dermatology. He obtained his BA degree in bacteriology, his MA degree in microbiology, and his MD at the University of California, Los Angeles. He trained in dermatology at the University of Oregon, where he completed his residency.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Birthmark facts

  • Birthmarks are composed of various types of normal tissue or pigment that have lost their way to their normal destination during fetal development.
  • Most birthmarks are small and do not produce medical problems.
  • The most common birthmarks are composed of either pigment-producing cells (melanocytes) or blood vessels.
  • Rarely, certain birthmarks can be a clue to a more serious medical problem.

What is a birthmark?

Any mark, spot, or bump that is present in or around the time of birth on the skin of an infant is a birthmark. Mothers are fond of giving these rather romantic names such as angel's kisses, stork bites, or beauty marks. Most of these lesions are not particularly esthetically desirable.

Quick GuideIdentify Birthmarks: Angel's Kiss, Strawberry Mark (Hemangiomas), Others

Identify Birthmarks: Angel's Kiss, Strawberry Mark (Hemangiomas), Others

Birthmark Causes

Klippel-Trènaunay-Weber (KTW) syndrome

What is a port-wine stain?

A port-wine stain is a certain type of hemangioma. This capillary hemangioma has a recognizable appearance. It is usually a deep violet ("port-wine") colored lesion with fairly linear borders.

What are the different types of birthmarks?

Birthmarks can be categorized according to their composition. Marks as a result of excessive accumulations of melanin are called pigmented birthmarks, since the great majority of them are brown to black. Other birthmarks appear lighter than the rest of the skin due to a relative lack of melanin.

Some birthmarks are composed of blood vessels and are called vascular birthmarks. They are generally red, blue, or purple. Other birthmarks are composed of lymphatic tissue (cystic hygroma), breast tissue, and epidermal tissue, which are often yellow to flesh-colored.

What are the characteristics of pigmented birthmarks?

Pigmented birthmarks can be flat or elevated. They may simply be due to excessive deposition of melanin pigment in the deeper layers of the skin called dermal melanosis. This is particularly common in more heavily pigmented infants and is commonly called a Mongolian spot. More frequently, there are accumulations of melanin produced by and contained in pigment cells called melanocytes. The medical term for such a concentration of melanin-producing cells is a nevus. These nevi are generally small, no larger than ¼ inch diameter, however, they can be quite large, covering a significant portion the infant's skin.

What are the characteristics of vascular birthmarks?

The color of vascular birthmarks ranges from light pink to dark purple, and they can be either flat or elevated. Their size is quite variable, as well. Certain types of vascular birthmarks can evolve and change after birth.

What causes birthmarks?

Most birthmarks are probably due to defective migration of cells during fetal development. Once these cells start to multiply, they produce tissue with the characteristics of their cell type though they are not where those cells typically are located.

Are any symptoms and signs associated with birthmarks?

Pigmented birthmarks, aside from their coloration, cause no symptoms. Vascular birthmarks of certain types can produce significant symptoms. The identification of the type of vascular birthmarks may be difficult and require certain advanced imaging techniques as well pathological examination of samples of the birthmark. Certain vascular birthmarks called hemangiomas can begin as flat lesions at birth but enlarge rapidly during the first few months of life. They may ulcerate and disappear slowly, leaving only a scar. If this type of lesion is situated adjacent to an important anatomical structure like an eye or mouth, it may need to be treated to hasten the natural resolution.

What disorders are associated with birthmarks?

There are a number of rare serious disorders that are associated with both pigmented (café au lait mark, for example) and vascular birthmarks. It would be appropriate that any infant with a birthmark is examined by a pediatrician to detect any of these uncommon conditions. Some of these disorders can be inherited, so affected families need to be educated as to their significance.

Can skin damage during delivery produce a birthmark?

It is possible for birth trauma to produce sufficient damage to leave a scar. This scarring could be interpreted as a birthmark.

Quick GuideIdentify Birthmarks: Angel's Kiss, Strawberry Mark (Hemangiomas), Others

Identify Birthmarks: Angel's Kiss, Strawberry Mark (Hemangiomas), Others

Is it possible to remove or fade birthmarks?

It is now possible to treat many kinds of both pigmented and vascular birthmarks. The approach depends on the type of tissue involved and the risks versus the benefits of treatment. The pediatrician is an excellent source of information as to potential treatment options.

Does insurance cover the cost of birthmark removal?

As with all such questions about insurance coverage, each company may be different. Most birthmarks that are small and not visually unpleasant are unlikely to require treatment and are rarely covered. Any birthmark that is likely to impair either the physical or mental health of the child is much more likely to be covered.

What is the treatment for birthmarks?

The treatment of birthmarks depends on the nature of the tissue involved. Medical treatment can hasten the resolution of certain kinds of vascular birthmarks. Generally, measures that destroy the involved cells of the birthmark are required for both pigmented or vascular birthmarks. Either scalpel surgery, lasers, and rarely radiation can be helpful.

What is the prognosis of birthmarks?

A few small pigmented birthmarks are quite common and do not need to be treated. This is also true for vascular birthmarks. Smaller hemangiomas will disappear spontaneously, leaving a small insignificant scar depending on the sites involved. Dermal melanosis eventually fades.

REFERENCES:

Benjamin, Latanya T. "Birthmarks of Medical Significance in the Neonate." Seminars in Perinatology 37 (2013): 16-19.

Margolin, Judith F., Heather Mills Soni, and Sheena Pimpalwar. "Medical Therapy for Pediatric Vascular Anomalies." Semin Plast Surg 2014: 79-86.

McLaughlin, Maura R., Nina O'Connor, and Peter Ham. "Newborn Skin: Part II. Birthmarks." American Family Physician 77.1 Jan. 1, 2008.

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Reviewed on 8/26/2016
References
REFERENCES:

Benjamin, Latanya T. "Birthmarks of Medical Significance in the Neonate." Seminars in Perinatology 37 (2013): 16-19.

Margolin, Judith F., Heather Mills Soni, and Sheena Pimpalwar. "Medical Therapy for Pediatric Vascular Anomalies." Semin Plast Surg 2014: 79-86.

McLaughlin, Maura R., Nina O'Connor, and Peter Ham. "Newborn Skin: Part II. Birthmarks." American Family Physician 77.1 Jan. 1, 2008.

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