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Birthmarks

Birthmarks are coloured markings on your skin. You’re either born with them or they develop very soon afterwards. The medical name for a birthmark is naevus (the plural is naevi).

Birthmarks are very common in newborn babies. They appear where skin cells or blood vessels don’t develop as they should. There are many different types of birthmark and they all vary in size and colour, and where they appear on your child’s body.

Some birthmarks fade as your child gets older but others will be permanent. Many birthmarks are harmless and don't need any treatment. However, if your child’s birthmark is significantly affecting his or her appearance or causing health problems, it may need to be treated.

Types of birthmark

There are many different types of birthmark. They can develop on the surface of your child’s skin or in the deeper layers of the skin. Birthmarks are caused by a problem with the development of some of the structures in the skin and soft tissues. These include tiny blood vessels (capillaries) and cells that produce the dark pigment (melanin) that gives your skin its colour.

We’ve described some of the most common types of birthmark below.

Salmon patch or stork mark

These are one of the most common types of birthmark. They’re caused by excess or abnormal capillaries (blood vessels) in the skin. Around two out of every five babies are born with a salmon patch or stork mark. They are flat red marks usually found on your baby's eyelids, top of the nose, top lip, back or neck. Frequently, the red colour is pale and difficult to see, but when your baby is crying they can become more noticeable.

Most salmon patches on the face fade as your baby gets older. However, around half of all babies with a patch on their neck (usually under the scalp hair) will still have them when they become adults.

Strawberry mark

Strawberry marks usually develop in the first month after your baby is born. They are soft and raised in appearance and are the colour of strawberries, which is where they get their name. They’re also known as strawberry naevi, or infantile haemangiomas.

Strawberry marks are more common in girls and in babies born early (premature babies). They can appear anywhere on your baby’s skin, but around six out of 10 appear on the face or neck.

A strawberry mark starts off as small, red patch, which then grows quickly and becomes a bright, red lump. Most marks stop growing by the time your baby is three months old. It then slowly shrinks and fades. In most children, the strawberry mark will have faded by the age of seven. Only one in 10 babies with a strawberry mark will still have it when they are 10 years old.

Sometimes strawberry marks can grow to be quite large and this can significantly affect your baby’s appearance, particularly if the mark is on his or her face. Occasionally they can become ulcerated, where the skin over the birthmark breaks down, and if this happens they are at risk of bleeding. Some strawberry marks on the face around the eyes, nose or mouth can occasionally affect your baby’s vision, breathing or feeding. If this happens, your baby will need treatment.

Port wine stain

Port wine stains are present when your baby is born. They are caused by dilated blood vessels in the skin. About three in every 1000 babies will have one. Medically they are called capillary vascular malformations.

Port wine stains are flat dark red or purple marks that vary in size and shape. As your child gets older they may get bigger and sometimes become lumpy or a darker red. Your baby is most likely to have a port wine stain on his or her face or upper trunk, though they can be anywhere on the body. Port wine stains usually only affect one side of the body.

Port wine stains don’t shrink or fade naturally. They tend to grow as your baby gets older. Very occasionally port wine stains are linked to other conditions. A port wine stain near your eye may be associated with raised pressure within your eye, called glaucoma. In a rare condition called Sturge-Weber syndrome a port wine stain on your face may be linked to abnormalities of the blood vessels within your brain.

Moles

Some babies are born with moles. The medical term for moles that babies are born with is congenital melanocytic naevi. They are areas of skin where large numbers of cells called melanocytes have grouped together. Melanocytes produce a pigment called melanin, which gives skin a brown colour. Where melanocytes group together the skin is darker and called a ‘mole’.

Moles vary in colour from mid-brown to black and can be raised or flat and of all different sizes. Some have hairs growing out of them. Most moles don’t need treatment.

Mongolian blue spot

Mongolian blue spots are blue or grey areas of skin that appear most often on your child's buttocks and lower back. They are caused by melanocytes being trapped deep in the skin. They can be mistaken for bruises. Mongolian blue spots are more common in babies with darker skin and babies of East Asian origin. If your child has this type of birthmark, it will probably have disappeared by the time he or she is about two.

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Details

  • Diagnosis Diagnosis of birthmarks

    If your child has a birthmark that you're worried about, talk to your GP. He or she will examine your child and ask you questions about how the birthmark developed and whether it has grown. Usually your GP will recognise the birthmark and no further tests are needed. However, your GP may refer your child to see a specialist for further tests and any treatment.

    If you or your child has a mole that has changed in appearance, your GP may refer you to a specialist clinic to have it checked and, if needed, removed. This is to check for signs of cancer.

  • Treatment Treatment of birthmarks

    Salmon patches, Mongolian blue spots and many moles never need treatment. They are either harmless or shrink and fade over time. However, port wine stains, strawberry marks and some moles may need treatment. This is usually if the birthmark causes problems or if it significantly affects your child’s appearance. The main treatments are listed below.

    Strawberry marks

    Most strawberry marks don’t need treatment. Treatment to shrink the birthmark is used for large, quick growing marks that might cause problems. These include those that affect your child’s breathing, feeding or vision, or his or her ability to pass urine or faeces.

    Recently doctors have discovered that a medicine called propanolol can stop strawberry marks growing and make them smaller. This is a type of medicine called a beta-blocker which is usually used for treating high blood pressure. Propanolol is now the main treatment for strawberry marks but occasionally your doctor may prescribe corticosteroids or recommend laser treatment. Laser treatment may be used if the birthmark becomes ulcerated.

    Port wine stains

    Treatment for port wine stains can help the mark to fade, but may not be able to remove it completely. The main treatment involves using a laser. This is done over a number of sessions, spaced two to three months apart. The younger your child is when he or she starts treatment the better the results. Young children will need a general anaesthetic to have this treatment. See our FAQs for more information.

    If your child’s port wine stain is small then he or she can also use cosmetic camouflage cream. This covers the birthmark rather than treating it.

    Moles

    If you have a very large mole or a number of moles, you may need to monitor them because there is a small risk of melanoma (skin cancer). Signs to look for include moles that get bigger, change shape or become uneven in colour and moles that itch, develop a crust or bleed. Practise safe sun care to make sure you don’t get sunburnt. If you do need treatment, your mole may be removed.

  • Private GP appointments

    With our GP services, we aim to give you an appointment the next day, subject to availability. Find out more today.

  • Causes Causes of birthmarks

    The reasons why some babies are born with birthmarks, or develop them in the first few months of life, aren't fully understood. However, birthmarks can’t be prevented.

    Having moles may be something that is inherited, which means that if you have moles your child may also have them. Other birthmarks, such as port wine stains and strawberry marks, aren’t thought to be inherited.

  • Complications Complications of birthmarks

    Most birthmarks are harmless and some will fade as your child grows older. However, if the birthmark significantly affects your child’s appearance, or if it’s on the face or neck, it can sometimes cause problems.

    If a strawberry mark grows quickly and it’s on your baby’s face, then depending on where it is, it can affect his or her sight, breathing or feeding. If this happens, the birthmark may need treatment to shrink it or slow down its growth. Strawberry marks on your baby’s nappy area can also affect how well he or she passes urine or faeces (stool) and therefore may also need treatment.

    Sometimes a strawberry mark can become ulcerated or develop into an open sore, which can be painful for your child. If a birthmark looks infected, for example if it’s painful and swollen and there is discharge (pus), see your GP.

    Some birthmarks can be very distressing because of the way they look, for example if they are large or on your child’s face or neck. This can affect your child’s social development, their relationships with others and how they feel about themselves. If you’re worried about the effect of a birthmark on your child, talk to your GP.

  • Living with birthmarks Living with birthmarks

    Some people use cosmetic camouflage cream to cover birthmarks, especially port wine stains. This can help to improve your child’s confidence and self-esteem. These are special creams that can make a significant difference to how a birthmark looks and keep it covered for long periods of time.

    There are a number of different types of cosmetic camouflage and different shades of colour available. As it’s important to match your child’s skin tone exactly, it’s a good idea to seek help from someone trained to apply it. Two organisations that can help are the British Association of Skin Camouflage and Changing Faces. See our FAQs for more information about camouflage.

    If your child has a very visible birthmark, you may sometimes find other people's reactions difficult to deal with. Your child may also have questions or find that other children make comments about their birthmark. This can affect your child’s social development, their confidence and how they feel about themselves. It's important to be prepared for this and to help your child to be confident in coping with situations they may find difficult.

    There are support groups that can offer you information and advice and put you in touch with other parents or children with birthmarks. See our Resources for more details.

  • FAQs FAQs

    Are birthmarks painful?

    Answer

    Most birthmarks aren’t painful. However, sometimes strawberry marks can bleed or become ulcerated (this is where the skin over the birthmark breaks down). If this happens they can become painful.

    Explanation

    If you think your child’s birthmark may be ulcerated or it’s painful, see your GP. If your child needs pain relief, he or she can take over-the-counter painkillers such as paracetamol or ibuprofen. Your GP may prescribe antibiotics if the birthmark has become infected. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.

    Can laser treatment help to reduce my child's port wine stain?

    Answer

    Yes, although laser treatment doesn’t work for everyone.

    Explanation

    The main treatment for a port wine stain is laser treatment. The light from the laser lasts just long enough to heat up the abnormal blood vessels causing the port wine stain. These are then destroyed without harming the tissues around them. Laser treatment doesn’t work for everyone. However, around half of all people treated using a laser find their port wine stain has faded a lot when the treatment finishes. Treatment for port wine stains on the face is usually more successful than treatment on the arms or legs.

    Laser treatment for port wine stains can be carried out at any age. However, treatment may work particularly well when your child is young, as the skin on the port wine stain is thinner than in an older child.

    Your child will usually have to go to a specialist centre in hospital to have laser treatment. Older children can have treatment using local anaesthesia. This completely blocks pain from the area and your child will stay awake during the procedure. Younger children and those having treatment over large areas of skin, or near the eyes, may have a general anaesthetic. This means your child will be asleep during the procedure.

    Laser treatment can cause bruising and a change in skin colour but these are only temporary.

    How do camouflage cosmetics work?

    Answer

    Camouflage cosmetics are specially designed creams that can cover birthmarks and blend in with your natural skin tone. There are organisations and specially trained people that can recommend the right cream for you and show you how to apply it properly.

    Explanation

    Camouflage cosmetics aren’t the same as ordinary make-up. They are creams that are specially designed to blend in with your natural skin colour and help disguise your birthmark. However, they don’t work as a treatment because they won’t change the structure of your skin underneath the camouflage.

    There is a wide range of different creams and brands that come in pre-mixed colours to match different skin tones. You may need to wear a complementary coloured cream as well. This acts as foundation to cover up very red or dark skin before you put on a natural skin matching colour. Once you have put camouflage cream on you then cover it with loose powder. You can take the creams off using soap and water or cleanser.

    Camouflage cosmetics are different from other beauty products because they:

    • are water resistant, which means you can go swimming with them on 
    • last for between eight and 16 hours before they need touching up or reapplying 
    • have sun protection cream in them 
    • can be used with other creams such as medicines

    It’s important to match your child’s skin tone with the cosmetic camouflage. So it’s a good idea to seek help from someone trained to apply it, or a specialist organisation.

  • Resources Resources

    Further information

    Sources

    • Haemangioma. BMJ Best Practice. www.bestpractice.bmj.com, published 17 January 2014
    • Port-wine stain. PatientPlus. www.patient.co.uk/patientplus.asp, published 28 April 2014
    • Vascular birthmarks: salmon patches, port wine stains and strawberry naevi. British Association of Dermatologists. www.bad.org.uk, published January 2014
    • Melanocytic naevi (moles). British Association of Dermatologists. www.bad.org.uk, published October 2013
    • Haemangioma of infancy. British Association of Dermatologists. www.bad.org.uk, published December 2013
    • Hogeling M, Adams S, Wargon O. A randomized controlled trial of propranolol for infantile haemangiomas. Pediatrics 2011;128(2):e259–66 doi:10.1542/peds.2010-0029
    • Skin camouflage. British Association of Dermatologists. www.bad.org.uk, published September 2014
    • Port wine stain. British Association of Dermatologists. www.bad.org.uk, published August 2013
    • Naevi (birthmarks). DermNet (New Zealand Dermatological Society). www.dermnetnz.org, published 29 December 2013
    • Capillary vascular malformation. DermNet (New Zealand Dermatological Society). www.dermnetnz.org, published 23 September 2014
    • Different kinds of birthmarks. American Academy of Dermatology. www.aad.org, accessed 30 September 2014
    • Melanocytic nevi. Medscape. www.emedicine.medscape.com, published 3 June 2013
    • Infantile hemangioma. Medscape. www.emedicine.medscape.com, published 31 March 2014
    • McLaughlin M, O’Connor N, Hamm P. Newborn Skin: part II. Birthmarks. Am Fam Physician 2008;77(1):56–60. www.aafp.org
    • Getting help. Birthmark support group. www.birthmarksupportgroup.org.uk, accessed 2 October 2014
    • Anaesthesia explained – 3rd edition. The Royal College of Anaesthetists, 2008. www.rcoa.ac.uk
    • Product information. British Association of Skin Camouflage. www.skin-camouflage.net, accessed 2 October 2014
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