Birthmarks: Causes and Treatment

What are birthmarks?

Birthmarks are colored marks that appear on the skin. They can be present at birth or develop shortly after birth. Birthmarks can vary in size, shape, and color, and they are typically harmless. There are two main types of birthmarks:

Vascular birthmarks: These are caused by abnormal blood vessels in or under the skin. They can be pink, red, or purple in color. Examples include port-wine stains and hemangiomas.
Pigmented birthmarks: These are caused by clusters of pigment cells. They can be brown, black, or blue in color. Examples include moles and café-au-lait spots.

Most birthmarks do not require treatment, but some may be treated for cosmetic reasons or if they pose a health risk.

What types of vascular birthmarks are there?

There are several types of vascular birthmarks, including:

Salmon patches (angel kisses or stork bites): These are flat, pink, or red marks that often appear on the back of the neck, eyelids, or forehead. They are very common and usually fade over time.
Hemangiomas: These are raised, red, or purple marks caused by an overgrowth of blood vessels. They can appear anywhere on the body and often grow rapidly in the first few months of life before shrinking and fading over time.
Port-wine stains: These are flat, purple or red marks that often appear on the face and do not fade over time. They can darken and thicken with age.
Macular stains (salmon patches): These are flat, pink, or red marks that often appear on the back of the neck, eyelids, or forehead. They are very common and usually fade over time.
Venous malformations: These are blue, soft, and sometimes raised marks caused by malformed veins. They can vary in size and may be present at birth or develop later in life.

Treatment options for vascular birthmarks depend on the type, size, and location of the birthmark, as well as the age and health of the individual. Options may include laser therapy, medication, or surgery.

What types of pigmented birthmarks are there?

There are several types of pigmented birthmarks, including:

Mongolian spots: These are flat, bluish-gray marks that are usually found on the lower back or buttocks. They are more common in people with darker skin tones and often fade by school age.
Café-au-lait spots: These are flat, light brown marks that can vary in size and shape. They are usually harmless but may be associated with certain genetic conditions if they are numerous or large.
Congenital nevi: These are moles that are present at birth. They can vary in size and color and may be raised or flat. Larger congenital nevi have a slightly higher risk of developing into skin cancer.
Becker’s nevus: This is a pigmented birthmark that is usually larger and darker than a typical mole. It often appears on the shoulder, chest, or back and is more common in males.
Dermal melanocytosis: This refers to blue or gray patches of skin that are caused by an accumulation of melanocytes, the cells that produce pigment in the skin. These patches are more common in people with darker skin tones and are often found on the lower back and buttocks.
Epidermal nevus: This is a raised, rough, and often hairy patch of skin that is present at birth. It is caused by an overgrowth of the outer layer of skin cells and can vary in size and appearance.

Treatment for pigmented birthmarks is usually only considered if the birthmark is causing cosmetic or health concerns. Options may include laser therapy, surgery, or other medical procedures.

What causes birthmarks?

The exact causes of birthmarks are not always known, but they are generally believed to be the result of a variety of factors, including:

Genetics: Some birthmarks, such as port-wine stains and congenital nevi, can run in families, suggesting a genetic component.
Vascular abnormalities: Vascular birthmarks, like hemangiomas and port-wine stains, are caused by abnormalities in the blood vessels.
Increased melanin: Pigmented birthmarks, such as café-au-lait spots and moles, are caused by an overgrowth of pigment cells (melanocytes) in the skin.
Embryological factors: Some birthmarks may be the result of errors or disruptions during fetal development.
Environmental factors: Some researchers believe that certain environmental factors, such as exposure to chemicals or radiation, may play a role in the development of birthmarks, but more research is needed to understand these potential links.

Many birthmarks are harmless and do not require treatment. However, some birthmarks may be associated with underlying health conditions or may cause cosmetic concerns, in which case treatment options may be considered.

When should I see a healthcare provider about my birthmark?

You should consider seeing a healthcare provider about your birthmark if:

Change in appearance: If your birthmark changes in size, color, shape, or texture, it’s important to have it evaluated by a healthcare provider.
Pain or discomfort: If your birthmark becomes painful, itchy, or tender, or if it bleeds or oozes, you should seek medical attention.
Cosmetic concerns: If you are concerned about the appearance of your birthmark and it is affecting your self-esteem or quality of life, you may want to discuss treatment options with a healthcare provider.
Associated symptoms: If your birthmark is associated with other symptoms, such as headaches, dizziness, or vision problems, it’s important to have a healthcare provider evaluate these symptoms.
Family history of skin cancer: If you have a family history of skin cancer or if your birthmark has features that are concerning for skin cancer, such as irregular borders or changes in color, you should see a healthcare provider for an evaluation.

In general, most birthmarks are harmless and do not require treatment. However, it’s important to have any new or changing birthmarks evaluated by a healthcare provider to rule out any underlying health concerns.