What’s that? Chances are you will ask this question at least once when you examine your baby’s skin. Of all the possible little skin imperfections birthmarks are often most worrisome to parents.
The good news? Birthmarks are common, most of them are not a medical problem and when they are, there are effective treatments available. Your baby’s doctor should examine any birthmark carefully and may want to monitor certain birthmarks for changes.
Call the doctor if when looking at your baby’s birthmark you notice: Bleeding, ulceration, swelling or redness; change in color, texture, or size; or if the birthmark seems to cause itching or pain. Here is what you need to know about four common types of birthmarks:
1. Port-wine stains
These are bright or deep red marks caused by small malformations of blood vessels that can look like splashes of red wine. About 3 out of every 1,000 babies are born with a port wine stain usually on the face, head, arms or legs. The marks may grow, darken, and thicken as a child grows up. If port wine stains are a cosmetic concern (especially if they are on the face) treatment with a pulsed dye laser can lighten the birthmark significantly. “Occasionally port wine stains on the top or central part of the face can signify other problems with the eye or central nervous system,” says Dawn Davis, M.D., pediatric dermatologist at the Mayo Clinic in Rochester, Minnesota. “Your baby’s doctor may want to do further tests to check for those.”
2. Stork bites
These birthmarks, also known as “angel kisses,” “salmon patches” or by the medical term “nevus simplex,” occur in about one third to one half of all babies, usually on the face or back of the neck. The cause is dilated blood vessels. Sometimes confused with port wine stains, stork bites tend to be much lighter in color, and usually fade away completely by the time your child is 18 months old. Stork bites that are still present by the time a child is age three can often be eliminated through laser treatments.
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These red or purplish lesions are caused by a build-up of blood vessels in certain parts of the skin. (In some cases, they can also occur on internal organs.) About one third of hemangiomas are present at birth, while others form in the first few months of life, grow for a while, then start to shrink on their own (involute) and ultimately disappear. Most hemangiomas need no treatment other than monitoring their progression. “Once a hemangioma resorbs often there is nothing left, no sign that your child ever had one,” says Dr. Davis. “Some hemangiomas can leave behind a ‘footprint’ — a little residual of where it once was — or a little bit of scar tissue, which can be repaired by a plastic surgeon if necessary.” Most hemangiomas are not medical problems. However, large hemangiomas may need treatment with laser removal or steroid medications, especially if the hemangioma obstructs an eye, nose, mouth, genitals or fingers or toes. “Babies who have five or more hemangiomas on the body, regardless of their size, are more likely to have hemangiomas or extra blood vessel growths within the body, such as on the liver and the gut, and sometimes those can cause obstructive problems,” says Dr. Davis. “An ultrasound or other body scan may reveal if there is an internal problem.”
Doctors call these “nevi.” They are lesions that are brown or black, flat or raised. Small (less than three inches in diameter) congenital nevi occur in about one percent of babies at birth, grow with your child, and usually cause no problems, according to the American Academy of Pediatrics (AAP). Many children also develop more moles as they grow up, usually after age five; doctors call these “acquired nevi,” and these, too, are usually harmless. But both types of moles should be monitored and checked regularly by a doctor to make sure that there are no changes in the moles that could signal skin cancer. Large congenital nevi (ranging in size from three inches to covering an entire arm or larger) are much more serious because they have a higher risk of becoming cancerous. Fortunately they are also much less common, affecting about one out of every 20,000 newborns, according to the AAP. “The moles that we worry about in infants are very large moles, especially if they occur along the spine or encompass a generous amount of the scalp or face,” says Dr. Davis. “Also babies who are born with 15 or more moles are at increased risk of growths on internal organs as well, and so need to be monitored closely.”
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Laura Flynn McCarthy is a New Hampshire-based writer who specializes in health and parenting topics.