A birthmark is a benign irregularity on the skin caused by overgrowth of blood vessels, melanocytes, smooth muscle, fat, fibroblasts or keratinocytes. Birthmarks can be flat or raised, have regular or irregular borders, and have different shades of coloring.
Contrary to the name, birthmarks do not always appear at birth. Most birthmarks are permanent, but there are several types of birthmarks that fade as a child grows. Birthmarks can be flat or raised, have regular or irregular borders, and have different shades of coloring. The two main types of birthmarks are red, vascular birthmarks, such as hemangiomas and port wine stains, and pigmented birthmarks, such as moles, café-au-lait spots, and Mongolian spots.
Contrary to the name, birthmarks do not always appear at birth. Birthmarks may not develop for hours, days, or even weeks after birth. Most birthmarks are permanent, but there are several types of birthmarks that fade as a child grows. Some types of birthmarks run in families, but not always. Nobody really knows why babies get birthmarks or why some kids have small birthmarks and others have big ones. They just seem to happen.
The two main types of birthmarks are red, vascular birthmarks, such as hemangiomas and port wine stains, and pigmented birthmarks, such as moles, café-au-lait spots, and Mongolian spots. Pigmented birthmarks are caused by excess skin pigment cells while Vascular birthmarks are caused by increased blood vessels. The third type, congenital nevi (congenital moles) are defined as moles that are present at or shortly after birth.Birthmarks are most commonly harmless; however, in some cases birthmarks are associated with other health problems. It is important to find out if this is the case for you or your child. At Dermatology Associates of Wisconsin, we offer pediatric dermatology services and specialize in the care and treatment of skin, hair, and nail problems that affect infants and small children.
Port wine stains are birthmarks composed of dilated small blood vessels in the skin that occur in 1 in 200 newborns. They are most often located on the face, neck, arms or legs but can occur anywhere on the body. These lesions present at birth as pink patches. Over time, portwine stains become darker red to purple in color and may thicken. Port wine stains do not go away, but treatment is available to dramatically improve the appearance of the stain and prevent darkening and thickening of the birthmark.
For most children, port wine stains are not associated with any other health concerns. Port wine stains of the face, however, can occasionally be associated with eye problems (glaucoma) and neurologic problems such as seizures (Sturge-Weber syndrome). Similarly, large port wine stains of the arms or legs can be associated with enlargement of the affected extremity. As a result, it is important to be evaluated early by a pediatric dermatologist to determine if treatment is needed.
Hemangiomas are birthmarks composed of extra blood vessels. They are one of the most common skin conditions in the first year of life affecting up to 10% of infants. Hemangiomas may be present at birth, but more frequently appear during the first month of life. Hemangiomas have different appearances, depending upon the depth of the blood vessels.
Superficial hemangiomas tend to be bright red and elevated from the surface of the skin. Deeper hemangiomas are blue in color. Most hemangiomas are found on the head or neck, although they can be found anywhere on the body. Hemangiomas grow for the first 6 to 8 months of life, and then stabilize in size for several months before gradually resolving. Approximately 50% of hemangiomas resolve by 5 years of age and 90% by 9 years of age.
Treatment of hemangiomas is not always necessary, however, hemangiomas that cause skin breakdown, disfigurement, and interfere with feeding, sight, breathing, and other vital functions require treatment. There are some other rare situations that also require immediate intervention. It is very important that a child be seen early by a pediatric dermatologist to minimize complications in cases where the hemangioma bleeds, forms a sore or bruise, appears infected, involves the nose, lips, eyelids, ears or diaper area, or grows suddenly over a matter of days.
Congenital moles are defined as moles that are present at or shortly after birth. They are classified by size: small, medium, large, or giant. Small congenital moles are present in approximately 1 percent of all newborns, whereas giant congenital moles are much less common with an incidence of 1 in 20,000 newborns.
Congenital moles are important due to their increased lifetime risk of developing into a type of skin cancer known as malignant melanoma. The exact risk of a small or medium-sized congenital mole changing into a melanoma is controversial with an estimated lifetime risk less than 3 to 5%. The risk of developing a melanoma in a small or medium congenital mole is greatest after puberty. As a result, removal can be delayed until the child is older, however, the mole will grow as the child grows thereby resulting in a larger scar.
It is important to inspect congenital moles on a regular basis at home. We often recommend that a dermatologist observe small and medium congenital moles once a year and larger congenital moles more frequently. Some early warning signs of malignant melanoma include asymmetry (one half of the mole does not match the other); an irregular border (ragged or blurred edges); multiple shades or colors within a mole (such as varying shades of brown, black, red, white, or blue); or a mole that is larger than a pencil eraser in size.