Birthmarks are very common and come in all shapes and sizes. The good news is they are not usually dangerous and seldom need treatment. But if they change shape or cause concern, see your doctor.
What are birthmarks?
They are coloured skin spots that are present at birth or can develop later on. There are two main types.
Vascular birthmarks are associated with blood vessels and tend to be pink, purple or red coloured. They may also be raised above the skin’s surface.
Pigmented birthmarks are on the surface of the skin and usually brown, black or bluish-gray in colour.
What causes birthmarks?
Nobody knows. It is thought that they result from an overgrowth of a structure present in the skin, but it is not known why this happens. In many cases, there seems to be a genetic factor – you’re more likely to get them if other family members have them.
There have been lots of theories over the years about what causes them – such as something marking the skin during the birth process – but these haven’t been proven.
Are birthmarks dangerous?
Usually, no. Most birthmarks are completely harmless. But if you are concerned about your child’s birthmarks or any you have, especially if they change shape, size or colour, see your doctor. Also get a birthmark checked out if it bleeds, becomes inflamed or is extremely itchy.
Some types of pigmented birthmarks, called congenital nevi, have a slightly increased risk of becoming skin cancer, depending on their size (the bigger they are, the greater the risk). They should all be regularly examined by a doctor and any changes reported.
There is also a type of pigmented birthmark called café-au-lait. These are light brown in colour and appear at birth or in the first few years of a child’s life. They are usually harmless but ones that grow larger than a 20 cent piece could be a sign of conditions such as neurofibromatosis, a genetic disorder that causes the abnormal growth of cells in nerve tissues.
In some cases, what looks like a raised, red birthmark could in fact be a haemangioma, or blood vessel tumour. These are common, and usually painless and harmless. Many of these (often called strawberry haemangiomas because of their colour) disappear by the time the child is around 10. All that is left is slight discolouration or slightly puckered skin.
Port-wine stains are flat red or purple birthmarks consisting of dilated blood capillaries. These often occur on the face and don’t fade. In fact, they can become darker and raised.
The most common vascular birthmark is the salmon patch or stork bite. They can occur in as many as 50 per cent of all children and are flat, pale red or pink marks usually found on the forehead, upper eyelid, upper lip or at the back of the neck.They tend to vanish within two to five years, other than those on the back of the neck, which usually don’t fade. Vascular lasers can be used to lighten their colour if necessary.
Do birthmarks need to be treated?
Not usually. In some cases, your doctor may recommend removing a haemangioma depending on its location.
For example, one close to an eye might be removed with laser therapy in case it interferes with the ability to see.
Sometimes a haemangioma can become ulcerated, in which case it will need treatment. Oral corticosteroids or a drug called propranolol can also reduce the size of a haemangioma.
If a port wine stain on the face is unsightly or causing psychological distress, it may be treated using pulsed dye laser, cryotherapy (freezing), laser surgery or, in some cases, plastic surgery.