Baby skin has a reputation for being soft and sweet — but it’s not always a blank canvas. Your sweetie might make her grand entrance with a distinguishing birthmark.
Baby birthmarks can come in a range of shapes, sizes and colors. Some birthmarks will disappear over time, while others stick around or even become more noticeable. The one thing they often have in common? They’re not usually harmful.
What are the main types of birthmarks?
Baby birthmarks can be vascular or pigmented,[1] and you can tell the difference simply by looking at them.
- Vascular birthmarks, like stork bites, port-wine stains, hemangiomas and venous malformations are all made up of extra blood vessels, so they have a reddish or purplish color.
- Pigmented birthmarks like moles, café-au-lait spots, dermal melanocytosis (also known as Mongolian spots) and pigmentary mosaicism are made up of extra pigment-producing skin cells, so they look brownish or grayish.
In most cases, a vascular or pigmented birthmark will turn out to be harmless, but some pigmented birthmarks (like congenital nevi) can be at risk for melanoma, especially if they’re very large. Both types are worth bringing up with your baby’s pediatrician to see if a mark needs to be monitored or if it poses any potential health risks.[2]
Vascular birthmarks
These growths can be flat or raised, but you can usually spot them by their reddish or purplish color.
Stork bites
What are stork bites? Stork bites, sometimes called angel kisses, are common newborn birthmarks that usually have a red or pink color and smooth, flat texture. They often show up on the nape of the neck or the face. Around 80 percent of newborns have them, and they’re more likely to occur in lighter skin tones.
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What causes stork bites? Stork bites can occur when clusters of blood vessels dilate, causing increased blood flow that’s easy to see under a newborn’s thin, delicate skin.
Do stork bites need treatment? The marks are harmless and usually fade on their own by 18 months. But if a stork bite hasn’t gone away by age 3 and you or your child are bothered by it, you can opt to have it removed with a laser treatment.
Port-wine stains
What are port-wine stains? Port-wine stains are flat, purplish-reddish birthmarks that get their name from their resemblance to spilled red wine. Officially called nevus flammeus, port-wine stains affect around 3 in 1,000 children and seem to occur in all skin tones equally. They’re visible at birth — often appearing on the face, neck, arms or legs — and tend to get darker and bigger with age.
What causes port-wine stains? Port-wine stains are caused by blood vessels that form abnormally within the skin.
Do port-wine stains need treatment? Port-wine stains are usually harmless, but they’re permanent and can be prone to dryness and irritation. In rare cases, they’re tied to an increased risk of neurological and vision problems. Laser treatments can help induce fading, especially when done before your baby’s first birthday, though the mark won’t necessarily go away completely and could come back over time.
Strawberry hemangiomas
What are strawberry hemangiomas? Strawberry hemangiomas, or infantile hemangiomas, are benign growths made of extra blood vessels around the skin. The name comes from their bright red color and raised, bumpy (or cluster-like) texture, which looks a little like a berry. But hemangiomas can also be smooth and bluish purple, like a bruise. They affect around 5 percent of infants — with girls, twins and preemies at higher risk — and often show up on the face, scalp, back or chest.
What causes strawberry hemangiomas? Strawberry hemangiomas form when lots of small, immature blood vessels clump together, though experts don’t know what causes the vessels to cluster in the first place.
Do strawberry hemangiomas need treatment? Most strawberry hemangiomas aren’t problematic and will gradually shrink and fade on their own by the time your child is preschool-aged. Your baby’s pediatrician might opt to remove the growth if it’s very large or growing near your little one’s eyes, nose or mouth, which can make it harder for her to see, breathe or eat. For infants, oral medications, topical treatments or injections are preferred over surgery or lasers.
Congenital hemangiomas
What are congenital hemangiomas? Congenital hemangiomas are round, bump-like growths with a pink, purple or blue color that look swollen and feel warm to the touch. They’re rarer than strawberry hemangiomas, are more common in girls, preemies and twins, and are always present at birth. Most often, congenital hemangiomas will form on the arms, legs, head or neck, but they can also occur in the liver (though they’re rarely dangerous).
Where do congenital hemangiomas come from? These marks form when blood vessels grow more than they should and become clumped or tangled, though experts don’t understand why this happens in the first place.
Do congenital hemangiomas need treatment? Some congenital hemangiomas shrink and fade on their own between 12 and 24 months, but others are permanent and could lead to health issues. During your baby’s first year, her doctor will likely opt to keep an eye on the growth and decide if it should be treated. Hemangiomas with bleeding or broken skin, or ones that interfere with your baby’s breathing, vision or heart rate should be removed surgically, usually between ages 2 and 5.
Venous malformations
What are venous malformations? These are bluish or purplish birthmarks that might bulge out, especially when your child is exerting herself. Children with venous malformations are born with them, but they sometimes don’t become noticeable until puberty. They can form anywhere on the skin (and in some cases, inside muscles, bones or organs) but are rare overall, affecting just 2 in 10,000 kids.
Where do venous malformations come from? Venous malformations happen when blood vessels don’t develop normally and become tangled. Experts don’t understand why that happens, but a genetic component might be involved.
Do venous malformations need treatment? Most venous malformations aren’t problematic and will usually not be treated, since they’re difficult to remove and have a tendency to grow back. But if it hurts your baby, your pediatrician may recommend trying to get rid of the growth with surgery, injections or lasers, especially if it affects her breathing or vision, causes bleeding or touches an internal organ.
Pigmented birthmarks
These marks are often flat and brownish, but they can sometimes look gray or blue too.
Café-au-lait spots
What are café-au-lait spots? These spots, which affect up to 30 percent of people, look a lot like their name suggests: Café-au-lait in French means “coffee with milk,” and café-au-lait spots usually have a beige to brown color. They tend to be flat and round with smooth edges, and occur more often in darker skin tones.
What causes café-au-lait spots? Café-au-lait spots can form when pigment-producing cells called melanocytes group together under the skin. Some babies have them at birth, but they can also develop during early infanthood.
Do café-au-lait spots need treatment? Most café-au-lait spots aren’t harmful, but they do tend to grow and darken with age. Very large or prominent ones can be removed with laser treatments, but most kids just live with them. In some cases a very large spot or multiple spots could be linked to certain rare genetic health conditions. The pediatrician can examine your baby’s mark or marks to decide if they might pose a health risk.
Moles
What are moles? Moles are freckle-like marks that range from light brown to black, and can also have shades of pink or red. They can be small or large, flat or bumpy, and even have hair. Moles that are present at birth are called congenital pigmented nevi.
What causes moles? Both congenital and acquired moles are simply clusters of pigment-producing cells called melanocytes. Experts don’t fully understand why moles sometimes form before a baby is born or very early in life, but it’s thought to have to do with a random genetic mutation.
Do moles need treatment? WWhile some moles can harbor a higher risk for skin cancers like melanoma, the vast majority of congenital moles, especially small ones, are likely harmless and don’t need treatment. That said, they rarely go away and tend to get bigger or darker with age. It’s a good idea to monitor moles for any changes in size, shape, color and borders. Your child’s doctor can help you get a sense for what kinds of changes are normal and which ones might mean the mole needs to be examined.
Dermal melanocytosis
What is dermal melanocytosis? Previously called Mongolian spots, these birthmarks have a blue or blue-gray color, round or irregular shape, and flat texture that looks similar to a bruise. (But don’t worry — they don’t hurt!) Dermal melanocytosis often shows up on a baby’s buttocks, lower back or shoulders and is more common in Black, Asian and Hispanic babies.
Where does dermal melanocytosis come from? Dermal melanocytosis occurs when skin pigment cells, called melanocytes, cluster together in the deeper layers of your baby’s skin. These pigments appear blue or bluish gray when light is reflected off of them, resulting in a blue or gray spot.
Do dermal melanocytosis need treatment? These birthmarks tend to be harmless and short-lived, fading away by the time your little one reaches her second birthday. Laser treatments can help get rid of the spot if it sticks around longer or if you or your child are bothered by it. In rare instances, the marks are tied to certain congenital and metabolic disorders. Your child’s doctor can examine her spot and assess her risk for any related health issues.
Pigmentary mosaicism
What is pigmentary mosaicism? Pigmentary mosaicism is a rare condition where different genes in skin cells cause marks that are lighter or darker than the surrounding skin. The marks are flat and can have unique patterns, including waves or lines. They’re often spotted at birth but can also become more noticeable with time in the sun. It’s equally common in light and dark skin tones, but often looks more prominent in darker skin.
What causes pigmentary mosaicism? “Mosaicism” is a word that means two sets of DNA, or genes, are present in the same person. In pigmentary mosaicism, different genes might affect the color of the skin, causing it to have different skin colors.
Does pigmentary mosaicism need treatment? Pigmentary mosaicism itself isn’t dangerous and doesn’t require treatment. But it’s worth having it checked out, since in rare cases the marks have been associated with changes found in the bones, eyes and central nervous system. While the spots or streaks are permanent and can’t be removed, limiting your child’s sun exposure can keep them from getting darker.
When to speak to your baby’s pediatrician about a birthmark
Luckily, the majority of birthmarks won’t affect your baby’s health — most of the time, they’re just one more thing that makes your sweetie unique. But it’s always important to contact your child's doctor if a mark or growth seems to change or get bigger, bleeds or becomes irritated, or seems to make your little one uncomfortable.
And even if a birthmark doesn’t seem worrisome or bothersome, it’s still worth having the doctor take a look. Your pediatrician can diagnose the mark so you know exactly what you’re dealing with and whether it needs to be monitored, as well as if it poses the potential for any possible risks down the road.
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