Any mark, spot, or bump that is present in or around the time of birth on the skin of an infant is a birthmark. Mothers are fond of giving these rather romantic names such as angel’s kisses, stork bites, or beauty marks. Most of these lesions are not particularly esthetically desirable.
Birthmarks are areas of discolored and/or raised skin that are apparent at birth or within a few weeks of birth. Birthmarks are made up of malformed pigment cells or blood vessels.
About 10 in every 100 babies have vascular birthmarks (birthmarks made up of blood vessels).
Although the cause of birthmarks is not known, most of them are benign (non-cancerous) and do not require treatment. Babies with birthmarks should be examined and diagnosed by a dermatologist.
The following are the most common types of vascular birthmarks:
flat, unelevated stains (known as “angel’s kisses” or “stork bites”) – These are the most common type of vascular birthmark, characterized by pink to red marks that may appear anywhere on the body. Some of these disappear after about age 2, but others may last into adulthood.
hemangioma – a common vascular birthmark that becomes visible within the first few weeks of life and continues to grow rapidly for about six to nine months. Then, they gradually lose this red color and also shrink.
port-wine stains – a port-wine stain, also called a nevus flammeus, is a flat, pink, red, or purple mark that appears at birth, often on the face, arms, and legs, and continues to grow as the child grows. Port-wine stains do not go away and often require treatment if located on the eyelid or forehead.
Port-wine stains involving the face may cause eye problems.
What are the different types of birthmarks?
Birthmarks can be categorized according to their composition. Marks as a result of excessive accumulations of melanin are called pigmented birthmarks, since the great majority of them are brown to black.
Other birthmarks appear lighter than the rest of the skin due to a relative lack of melanin.
Some birthmarks are composed of blood vessels and are called vascular birthmarks. They are generally red, blue, or purple. Other birthmarks are composed of lymphatic tissue (cystic hygroma), breast tissue, mast cells, and epidermal tissue, which are often yellow to flesh-colored or even hairy.
What are skin pigment disorders?
Skin color is determined by a pigment (melanin) made by specialized cells in the skin (melanocytes). The amount and type of melanin determines a person’s skin color. Melanin gives color to the skin, hair, and iris of the eyes. Levels of melanin depend on race and amount of sunlight exposure.
Sun exposure increases melanin production. In addition, hormonal changes can affect melanin production. The following chart describes various skin pigment disorders.
What are the characteristics of pigmented birthmarks?
Pigmented birthmarks can be flat or elevated. They may simply be due to excessive deposition of melanin pigment in the deeper layers of the skin called dermal melanosis.
This is particularly common in more heavily pigmented infants and is commonly called a Mongolian spot.
More frequently, there are accumulations of melanin produced by and contained in pigment cells called melanocytes. The medical term for such a concentration of melanin-producing cells is a nevus.
These nevi are generally small, no larger than ¼ inch diameter, however, they can be quite large, covering a significant portion the infant’s skin.
What are the characteristics of vascular birthmarks?
The color of vascular birthmarks ranges from light pink to dark purple, and they can be either flat or elevated. Their size is quite variable, as well. Certain types of vascular birthmarks can evolve and change after birth.
What causes birthmarks?
Most birthmarks are probably due to defective migration of cells during fetal development. Once these cells start to multiply, they produce tissue with the characteristics of their cell type though they are not located where those cells typically are.
Are any symptoms and signs associated with birthmarks?
Pigmented birthmarks, aside from their coloration, cause no symptoms. Vascular birthmarks of certain types can produce significant symptoms.
The identification of the type of vascular birthmarks may be difficult and require certain advanced imaging techniques as well pathological examination of samples of the birthmark.
Certain vascular birthmarks called hemangiomas can begin as flat lesions at birth but enlarge rapidly during the first few months of life. They often then ulcerate and disappear slowly, leaving only a scar.
If this type of lesion is situated adjacent to an important anatomical structure like an eye or mouth, it may need to be treated to hasten the natural resolution. Birthmarks composed of mast cells can produce a hive over their surface if they are rubbed.
What disorders are associated with birthmarks?
There are a number of serious disorders that are associated with both pigmented (café au lait mark, for example) and vascular birthmarks. Fortunately, they all are extremely rare.
It would be appropriate that any infant with a birthmark is examined by a pediatrician to detect any of these uncommon conditions. Some of these disorders can be inherited, so affected families need to be educated as to their significance.
Can skin damage during delivery produce a birthmark?
It is possible for birth trauma to produce sufficient damage to leave a scar. This scarring could be interpreted as a birthmark.
Is it possible to remove or fade birthmarks?
It is now possible to treat many kinds of both pigmented and vascular birthmarks. The approach depends on the type of tissue involved and the risks versus the benefits of treatment.
The pediatrician is an excellent source of information as to potential treatment options.
Does insurance cover the cost of birthmark removal?
As with all such questions about insurance coverage, each company may be different. Most birthmarks that are small and not visually unpleasant are unlikely to require treatment and are probably rarely covered.
Any birthmark that is likely to impair either the physical or mental health of the child is much more likely to be covered.
What is the treatment for birthmarks?
The treatment of birthmarks depends on the nature of the tissue involved. Medical treatment can hasten the resolution of certain kinds of vascular birthmarks.
Generally, measures that destroy the involved cells of the birthmark are required for both pigmented or vascular birthmarks. Either scalpel surgery, lasers, and rarely radiation can be helpful.
What is the prognosis of birthmarks?
A few small pigmented birthmarks are quite common and do not need to be treated. This is also true for vascular birthmarks.
Smaller hemangiomas will disappear spontaneously, leaving a small insignificant scar depending on the sites involved. Dermal melanosis eventually seems to fade.