Birthmarks are very common and usually are nothing to worry about. Birthmarks are basically just collections of skin color pigment if brown / black or collections of blood vessels if red. Most red birthmarks may not actually become visible until your baby is a few days old. The most common types are flat, light red, irregularly shaped patches on the nape of the neck or on the eyelids. These are sometimes called stork bites, angel kisses, salmon patches or nevus simplex. These almost always fade in a short time. Another common type in blacks or people of Asian ancestry are bluish-black patches on the back or buttocks called Mongolian spots. These are often mistaken for bruises. These may remain for extended periods of time, but usually they blend in with the child's natural skin color during childhood.
Some red birthmarks may be raised or deep. The thickness is due to more or thicker blood vessels. Some of these get larger until a year of age or so, then slowly regress and may even disappear. Some may also have thin overlying skin and bleed easily. PAY PARTICULAR ATTENTION TO THESE AS AN INFECTION IS EASILY CAUGHT WITH A SKIN BREAK AND CAN DRAMATICALLY WORSEN IN A SHORT TIME. (Despite being taught this in my education, I have only seen one of these bleed badly and have never seen one get infected). Some red birthmarks may not fade with time. You will then have to decide whether you want the birthmark removed. Some birthmarks may be painlessly and almost entirely removed with a laser, while others may require surgical removal, while others may not be removable. Unless the birthmark interferes with some bodily function or is hindering your child's normal growth and development, then wait a few years before considering any treatment as most will fade considerably in time. About the time your child will enter school is a good time to consult me or your surgeon regarding treatment, but please feel free to discuss the matter with me during our regular office visits. Should the birthmark grow rapidly or bleed often please call the office for an appointment. There are some centers that recently have started treating the red birthmarks very early with the laser. Since the treatment of the red birthmarks is changing over the last few years, please ask me about treatment options.
Mongolian spot: To the right is a picture of a mongolian spot. While it initially looks like a bruise, when you look closer you will see that the color is quite different from a bruise, also the margins are not the same and the pattern does not look like a bruise.
Cavernous Hemangioma: To the right is a picture of one of these. They never look like this at birth. Often there is no sign of this until several weeks of age (they typically appear or raise up between the 2 week and 2 month checkup). Occasionally you will see a patch of pale skin with visible squiggly blood vessels in the middle in the area where one of these is going to appear.
Copyright 2005, Joe Matusic, MD, FAAP, MD