What Causes Birthmarks In Babies And How To Remove Them?

In this article, MomJunction acquaints you to the interesting world of birthmarks! Keep reading to know what causes birthmarks in babies, and how to identify the dangerous ones. Posted by Rohit Garoo. MomJunction is your friend, philosopher, and guide – all rolled into one. We are a place to stop for a while and hang out with likeminded people, a place to learn and to teach. Image courtesy of chuckstock via Bigstockphoto.

Birthmarks come in all shapes and sizes and are often considered as unique identification marks of a person. While some seem in place and part of the baby’s skin, others look abnormal. Are these birthmarks harmful? Can they indicate some health condition?

What Causes Birthmarks?

A birthmark is an anomaly in the skin, present right from the birth, although some of them could spontaneously develop soon afterward. Birthmarks are usually colored and are spontaneous anomalies that are not inherited or genetic, according to the experts.

Birthmarks are broadly classified into two categories:

  • Vascular birthmarks: The heart and blood vessels make the vascular system, also called the circulatory system. Vascular birthmarks occur when a group of blood vessels under the skin do not form correctly. They also appear when the blood vessels abnormally clump together under the skin. Vascular birthmarks are purple, pink, or red.
  • Pigmented birthmarks: The skin contains cells called melanocytes or pigment cells, which produce the skin pigment melanin. When a bunch of melanocytes group together in a cluster, they lead to the formation of pigmented birthmarks. These birthmarks are light to dark brown.

There are six types of birthmarks, and each of them falls under one of the two categories.

What Types Of Birthmarks Can A Baby Have?

There are three types of vascular and pigmented birthmarks each, which can occur anywhere on the body:

Vascular Birthmarks

1. Salmon Patches:

  • These are pink, dark pink, or red, flat patches that can appear anywhere on the face but mostly on the forehead, neck, or the eyelids. They are called salmon patches since the color of the birthmark is usually a shade of pink that resembles the color of the salmon fish.
  • The patches do not have a defined border but could become prominent due to increased blood circulation when the baby cries, sweats, or feels flushed.
  • Medically referred to as Nevus Simplex, Salmon patches are colloquially called “angel’s kiss” when they appear on the forehead, and “stork bites” when they are on the neck.
  • Salmon patches are the most common vascular birthmarks and occur in one out of three infants. In some cases, they may fade away as the baby grows older.

2. Hemangioma:

  • These appear as bright reddish-pink bulges from the skin. Since the color resembles that of strawberry, this birthmark is also called strawberry hemangioma.
  • A hemangioma bulge is soft and compressible, and doesn’t hurt when you press gently with a finger.
  • Sometimes, the hemangioma may occur right below the skin, causing a smaller, bluish-purple bulge on the skin.
  • Hemangioma could be deep, superficial or mixed hemangioma.
  • Hemangiomas may grow initially but start to shrinks as the baby grows older. It eventually disappears by the time the child is 7-10 years and could leave only a faint mark on the skin once where it existed.

3. Port Wine Stain:

  • Clinically called nevus flammeus, this type of birthmark appears as a flat, purple, reddish-pink to dark pink patch.
  • The marks are in the color of wine or grape juice, which gives them their name. Port wine stains could resemble salmon patches but have a well-defined border. They are also constant in all situations, unlike salmon patches that become prominent mostly when the baby is crying or flushed.
  • These birthmarks stay for a lifetime and may grow larger as the baby grows. They become more noticeable after the baby attains puberty. Port wine stains are extremely rare and happen in less than 1% of babies.

Pigmented Birthmarks

 1. Moles:

  • These are perhaps the most common types of birthmarks you encounter among infants. The medical term for a mole is congenital melanocytic nevi.
  • Moles come in several shapes, sizes, and colors. A mole can be large and flat or small or raised. They can be brown, black, tan, or pink.
  • Existing moles may disappear as the baby grows older, while new ones may appear anywhere later. Moles can grow big and can have a diameter ranging between 1.5cm (0.6in) to more than 20cm (7.9in).
  • Moles could become darker and bumpier during puberty.

2. Café-Au-Lait Spot:

  • Pronounced “cafay oh lay”, which is French for “coffee with milk,”. These marks get the name from their color, which is light brown like that of milk coffee. The color is more prominent when the mark appears on a lighter area of the skin. On darker skin, the color could be deep dark brown resembling black coffee.
  • These spots can appear anywhere on the body and could fade away as the baby grows older.

3. Mongolian Spots:

  • These are grayish-blue spots that look like bruises. They are called Mongolian spots since the Mongols were considered to have them initially. Nevertheless, these birthmarks are most common among Asians, Hispanics, Native Americans, and Africans.
  • The Mongolian spots usually emerge on the lower back, buttocks, and limbs.
  • The birthmark may disappear by the age of four years, although in some it may persist for longer, perhaps growing darker as the baby ages.

Can Birthmarks Be Dangerous For A Baby?

Birthmarks are usually not harmful. But in some instances, a birthmark could be a cause for concern:

  • More than six café-au-lait spots: A baby should usually have a couple or more of café-au-lait spots, but never more than six. More than six spots could be a symptom of neurofibromatosis, which is a benign tumor of the nerve cells. If you discover a growing number of such spots, take the baby to a doctor.
  • Hemangioma near the eye, ear, or the throat: A strawberry hemangioma near the eye can cause vision problems while the one around the ear can cause hearing problems. Since hemangioma can exist within the skin, they can cause severe discomfort if present right above the trachea. The hemangioma will have to be removed if it affects the baby’s breathing.
  • Port wine stain on the eyelid: Some infants with a port wine stain could have a genetic condition called Sturge-Weber syndrome, in which these birthmarks are a symptom. The congenital condition is characterized by an abnormality in the blood vessels and can cause several neurological disorders and problems in vision.
  • Rapidly growing mole: If the mole grows rapidly and becomes darker, then it could be a symptom of skin cancer. Although such a scenario is quite rare in the case of birthmark moles, it is still vital for parents to keep an eye on the size of the baby’s mole.
    If you notice any of the symptoms mentioned above or if a birthmark itches, bleeds, or become sore, then take your baby to a doctor right away.

How Are Dangerous Birthmarks Diagnosed?

Clinical examination of the baby can determine whether or not a birthmark is harmful. Birthmarks are usually looked at during regular pediatric visits and any problems because of them can be detected by looking for symptoms such as pain, rapid enlargement, difficulty in feeding or breathing, and the presence of seizures or convulsions. If the doctor suspects complications, then an X-ray and MRI may be done to detect the underlying problem.

How Are A Baby’s Birthmarks Removed?

A doctor may remove the baby’s birthmarks in two cases: if the marks affect the baby’s health and if parents wish to remove the birthmark for cosmetic reasons. In either case, the following procedures would be employed to get rid of the birthmark:

  • Surgical removal: Birthmarks like hemangioma, which compress against internal organs and cause discomfort, are surgically removed. Surgery is done only after assessing how the birthmark impacts the health of the baby.
  • Laser treatment: A laser treatment is used to reduce the intensity of the birthmark’s color and is not recommended if the mark is harmless. This procedure can be useful for lightening port wine stains and Mongolian spots. Laser treatment requires adequate preparation, and the baby will have to be admitted to the hospital as the surgery is performed under general anesthesia.Laser surgery also poses risks and possible side effects such as the onset of pain, scarring, discoloration, and infection at the site of the operation. The treated area will also be sore for up to eight hours after the therapy and would require extensive post-operative care.
  • Steroid treatment: Oral or injected steroids can help bring down the intensity of the birthmark. This treatment is usually suggested in the case of hemangioma. However, steroids can have side effects and studies shown that 40% of hemangioma treated with steroid often rebound and reappear. Steroids can be used as a last resort or as part of a systemic birthmark treatment that encompasses other treatment methods.
  • Beta-Blockers: A group of medicines called beta-blockers is found to be effective against hemangioma birthmarks. The beta-blocker propranolol can normalize the abnormal blood vessels of a strawberry hemangioma in the baby. The medicine has fewer side effects than steroids and can be chosen as a method to get rid of the birthmark without surgery. A doctor may prescribe the medicine if steroids are not an option or if the birthmark cannot be surgically removed.
  • Radiation therapy: If a mole or café-au-lait is cancerous, then the doctor may suggest radiation to subdue it.

Birthmarks seldom interfere with healthy living, and your baby can go about his or her routine even with evident marks on the skin. If the birthmark does not pose a problem to the baby or cause any discomfort, then its removal would be purely for cosmetic reasons. Your baby’s doctor can let you know about the pros and cons of doing the surgery in such a case.