Skin ExpertsSkin ConditionsBirthmarks

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Learn more about treatment options for birthmarks

Birthmarks

Many people are born with birthmarks. For others, they appear within the first few weeks of life. Birthmarks can be brown, tan, blue, pink or red. Vascular birthmarks are made up of blood vessels bunched together in the skin. They can be flat or raised, pink, red or bluish discolorations. Pigmented birthmarks are flat, light brown patches on the skin that can occur anywhere on the body. The exact cause of birthmarks is unknown.

Eric Bernstein, MD, MSE, discusses port wine stain birthmark treatment options.

What you should know

There are several types of birthmarks. The most common are:

  • Macular stains: These faint, red marks are sometimes called “angel’s kisses” when found on the brow and eyelids, and “stork bites” when found on the back of the neck. They may also occur on the tip of the nose, upper lip and other parts of the body. They are pink and flat. These birthmarks are harmless and require no treatment.
  • Hemangiomas: These birthmarks generally appear during the first year of life, and can grow very rapidly for about one year. Most never get bigger than two or three inches in diameter, but some may be larger. After the first year, most stop growing, turn white and slowly shrink. Half of all hemangiomas are flat by age 5; nine out of 10 are flat by age 9. Many disappear completely; others leave a faint mark. There are two main types of hemangiomas:
    • Strawberry hemangioma: These birthmarks are slightly raised and bright red because the abnormal blood vessels are very close to the surface of the skin.
    • Cavernous hemangiomas: These marks have a blue color because the abnormal vessels are deeper under the skin. Hemangiomas are more common in females and in premature babies. They can be anywhere on the face or body.
  • Port-wine stains: Sometimes called a nevusflammeus, or capillary hemangioma, these uncommon birthmarks appear at birth. They are flat, pink, red or purple, found most often on the face, neck, arms or legs. They can be any size. They grow only as the child grows. Over time, they may become thick and develop small bumps or ridges. Port wine stains do not go away by themselves and last a lifetime.
  • Cafe-au-lait spots: Café-au-lait spots are flat and light brown patches that can occur anywhere on the body. Though they don't usually require treatment, the spots should be checked at birth to determine if they are a result of the genetic disease neurofibromatosis.
  • Moles: Moles are the most common type of pigmented birthmarks. They can be flat or raised, any size and any color.
  • Mongolian spots: Mongolian spots are bluish, bruise-like spots usually located around the lower back, buttocks and upper legs. They require no treatment and usually vanish with age.

Do's and Don'ts

Most birthmarks, such as moles, should be checked occasionally by a doctor as a person ages to determine if the mark is still harmless. A person also should visit a doctor if any birthmark undergoes unexplained bleeding, oozing, itching, rapid growth or dramatic color change.

Do:

Have a baby’s birthmarks checked by a doctor at birth to determine if they are harmless or a symptom of a problem.Have birthmarks checked occasionally by a doctor to determine if they are still harmless.See a doctor if any birthmark undergoes unexplained bleeding, oozing, itching, rapid growth or dramatic color change. 

Don't
  • Allow excessive sun exposure. The darker pigmentation absorbs more sunlight, making birthmarks more susceptible to becoming cancerous.

Why treat birthmarks?

  • Birthmarks – especially port wine stains on the face – can create emotional, social and economic burdens.
  • Sometimes a birthmark that grows or shrinks rapidly can form an open sore or ulcer. These sores can be painful and can become infected. It's very important to see a dermatologist and keep this sore clean and covered with antibiotic ointment and a dressing.
  • Birthmarks located near bodily orifices can cause special problems and should be monitored closely by a dermatologist.

General questions to ask before the procedure

  1. Is a doctor on site?
  2. Is the doctor board-certified in dermatology or in another specialty with equivalent training and experience?
  3. Was my medical history taken?
  4. Was I given an initial evaluation to determine if the technique or procedure is appropriate for my skin type?
  5. Did the doctor show me before-and-after photos?

Questions to ask the dermatological surgeon

Birthmarks Questionaire

  1. Which birthmark procedure is the correct one for me? (What are the options?)
  2. What is the estimated cost of the procedure?
  3. How long is one appointment?
  4. How often will I need to receive treatment to remove my birthmarks?
  5. How far apart are the treatments?
  6. What are the common side effects or complications associated with the procedure?
  7. How can I prepare for the treatment/procedure?
  8. Does the treatment hurt?
  9. What are my pain management and anesthesia options?
  10. How long is the recovery time associated with my procedure?
  11. Do you have before-and-after patient images to help to prepare me for what to expect?
  12. Will someone walk me through the process before going in for treatment?
  13. What are the risks?
  14. What should I expect after the procedure is performed? (i.e., short-term and long-term effects; activity restrictions; expected recovery period)