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Birthmarks


Expert reviewer, Dr Anton Alexandroff, Consultant Dermatologist, May 2017
Next review due April 2020

Birthmarks are markings on your skin, which can vary in size and colour, depending on the type of birthmark you have. You’re either born with them or they can develop very soon afterwards. The medical name for a birthmark is naevus (the plural is naevi).

A woman with her hand on her bare arm

Overview of birthmarks

Birthmarks are very common in newborn babies, and more so in white people. Around one in three babies are born with a type of birthmark. There are many different types of birthmarks and they all vary in size and colour, and where they appear on your child’s body.

Most birthmarks are caused when skin cells or blood vessels don’t develop as they should – these are known as vascular birthmarks. Pigmented birthmarks are caused by the ‘clustering’ of cells that produce the dark pigment (melanin) that gives your skin its colour. These are often brown or tan in colour and harmless.

Some birthmarks fade as your child gets older but others will be permanent. Most 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.

We’ve gone into more detail about some of the most common types of birthmarks below.

Types of birthmarks

Salmon patch or stork bite

These are one of the most common types of birthmark. They’re caused by excess or abnormal capillaries (blood vessels) in the skin. They are flat red marks usually found on your baby's eyelids, top of the nose, top lip, back or neck (often referred to here as ‘stork bites’). Around two out of every five babies are born with a salmon patch or stork mark. They are usually more noticeable when your baby is crying.

Most salmon patches on the face fade as your baby gets older. However, around half of all babies with a patch on the back of 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, babies born early (premature babies) and multiple births (twins or triplets). They can appear anywhere on your baby’s body, but around six out of 10 appear on the face or neck. They can be more troublesome if they are on your baby’s face or nappy area.

A strawberry mark starts off as a 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 over a few years.

Most strawberry marks won’t need treatment, but some might. This may be because :

  • it becomes ulcerated, which is where the skin over the birthmark breaks down and it may bleed
  • it’s on your baby’s face and affects your baby’s vision, breathing or feeding

See our treatment section for more information on how strawberry marks are treated.

Port wine stain

Most port wine stains are present when your baby is born, although there are a few reported cases where they develop later in life. A port wine stain appears when blood vessels don’t form properly. Experts aren’t sure what causes this to happen. They are caused by dilated blood vessels in the skin. About one in every 300 babies will have one.

Port wine stains are flat, dark red or purple marks that vary in size and shape. As your child gets older, these stains 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, though they can be anywhere on the body.

Port wine stains don’t shrink or fade naturally. They don’t get larger, but will grow in proportion with your child. Port wine stains don’t usually cause any physical symptoms but they can be upsetting to the person who has them or to the parents.

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.

See our treatment section for more information on how a port wine stain can be treated.

Moles

Some babies are born with moles, but most appear during childhood or young adulthood. Most people have moles, and it’s not uncommon to have between 30 and 50.

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. However, if you have a raised mole, it may catch on things or you may not like the appearance. In this case, you may be able to have it removed, but most moles are best left alone.

Mongolian blue spot

Mongolian blue spots are blue or grey areas of skin that appear most often on your baby’s buttocks and lower back. They are usually present at birth or may appear within the first weeks of your baby’s life. 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 disappear by the time he or she is about four.

Diagnosis of birthmarks

If your child has a birthmark that you're worried about, book an appointment to see your GP. They will examine your child and ask you questions about how and when the birthmark developed and whether it has grown. Usually, your GP will recognise the birthmark and if they think it won’t cause any problems, no further tests are needed. However, your GP may refer your child to see a paediatrician, dermatologist or a birthmark specialist for further tests and any 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, in some cases, port wine stains, strawberry marks and moles may need treatment. This is usually if the birthmark causes problems or if it significantly affects your child’s appearance.

Your doctor will talk you through why your child’s birthmark or mole may need treatment, and the risks and benefits of any treatments. 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.

A type of medicine called beta-blockers, especially propanolol, can be very effective at stopping the growth of strawberry marks and making them smaller. Propanolol is usually the main treatment for strawberry marks. However, occasionally your doctor may prescribe corticosteroids or recommend laser treatment.


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. Laser treatment is usually given every two to four weeks until no more improvement is seen. 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. Camouflage cream is a special type of make-up, available on prescription, which is matched to the colour of your child’s skin. This helps to cover 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 suncare to make sure you don’t get sunburnt. If you do need treatment, your mole may be removed.

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. You may also have more moles if you’re exposed to the sun a lot as a child. Moles are most common in people with fair skin, especially those who have been sunburnt a number of times.

Other birthmarks, such as port wine stains and strawberry marks, aren’t thought to be inherited.

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 (stools) 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.

Birthmarks may also become irritated or inflamed by hair brushing, or if they are somewhere on the body where clothing may rub.

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

Some people use cosmetic camouflage cream to cover their 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.

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 information under Other helpful websites for more details.

Frequently asked questions

  • 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.

    More information

    Some birthmarks can bleed if they are scratched. This is because the blood vessels are very close to the surface of the skin. Keep your child’s nails short to help prevent damage if they scratch it.

    If your child’s birthmark starts to bleed:

    • apply pressure to it with a clean cloth or tissue for at least five minutes
    • don’t take the cloth off to look at it as this can restart the bleeding

    If the bleeding doesn’t stop, seek medical attention. Contact your GP surgery for advice or go to your nearest accident and emergency department.

    If you think your child’s birthmark may be ulcerated or it’s painful, see your GP. 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.

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

    More information

    The main treatment for a port wine stain is laser treatment. It works by reducing the widened blood vessels and therefore making the colour of the birthmark lighter. Laser treatment is usually given every two to four weeks until no more improvement is seen (it reaches a plateau). Most people will see at least a 50 percent lightening in the colour of their port wine stain.

    However, laser treatment doesn’t work for everyone, and some people won’t see any improvement. Treatment is often more successful in younger children, 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 redness, swelling or bruising, and a change in skin colour. There may also be some blistering and crusting but these side-effects are only temporary.


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Related information

    • Types of birthmark. Birthmark Support Group. www.birthmarksupportgroup.org.uk, accessed 28 March 2017
    • Nevi. BMJ Best Practice. bestpractice.bmj.com, published May 2016
    • Vascular birthmarks: salmon patches, port wine stains and strawberry naevi. British Association of Dermatologists. www.bad.org.uk, published January 2014
    • Port wine stain. British Association of Dermatologists. www.bad.org.uk, published December 2016
    • Melanocytic Naevi. British Association of Dermatologists. www.bad.org.uk, published October 2016
    • Congenital dermal melanocytosis (mongolian spot). Medscape. www.emedicine.medscape.com, published May 2016
    • Getting a referral. Birthmark Support Group. www.birthmarksupportgroup.org.uk, accessed 6 April 2017
    • Strawberry Naevus. Patient Plus. patient.info/patientplus, published March 2016
    • Brightman LA, Geronemus RG, Reddy KK. Laser treatment of port-wine stains. Clin Cosmet Investig Dermatol 2015; 8:27–33. doi:10.2147/CCID.S53118
    • Coping. Birthmark Support Group. www.birthmarksupportgroup.org.uk, accessed 6 April 2017
    • Camouflage. Birthmark Support Group. www.birthmarksupportgroup.org.uk, accessed 6 April 2017
    • Skin camouflage. British Association of Dermatologists. www.bad.org.uk, updated April 2017
    • Homepage. The British Association of Skin Camouflage. British www.skin-camouflage.net, accessed 6 April 2017
    • Homepage. Changing Faces. www.changingfaces.org.uk, accessed 6 April 2017
    • Haemangioma. Birthmark Support Group. http://www.birthmarksupportgroup.org.uk, accessed 6 April 2017
    • Capillary malformation (port wine stain/PWS). Birthmark Support Group. www.birthmarksupportgroup.org.uk, accessed April 2017
  • Reviewed by Alice Rossiter, Specialist Health Editor, Bupa Health Content team, May 2017
    Expert reviewer, Dr Anton Alexandroff, Consultant Dermatologist, May 2017
    Next review due April 2020



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