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Birthmarks: Types, Causes, Treatment, and Prevention | Easy Guide

Alan Lucks | MD

Medically reviewed by Alan Lucks | MD, Alan Lucks MDPC Private Practice - New York on September 14th, 2023.

Key Takeaways

  • Vascular birthmarks like port-wine stains appear in 3-5 per 1,000 births and darken with age, while pigmented types including café-au-lait spots affect up to 30% of newborns.
  • Congenital melanocytosis (formerly Mongolian spots) appears blue-gray on the lower back or buttocks in 80-90% of Asian and African American babies, typically fading by age 4.
  • Large congenital nevi covering more than 20cm carry a 5-15% lifetime risk of melanoma transformation and require dermatological monitoring every 6-12 months.
  • Laser therapy works best on red vascular marks before age 1 when blood vessels are smaller, often requiring 3-8 sessions spaced 6-8 weeks apart for optimal results.
  • Any birthmark showing asymmetry, irregular borders, color changes, diameter growth beyond 6mm, or new symptoms warrants immediate evaluation using the ABCDE criteria.

Birthmarks are colored skin spots that are either present at birth or develop shortly after. They come in many colors, including brown, tan, black, blue, pink, white, red, or purple. Some birthmarks are flat, while others are raised or go into the skin's deeper layers. This guide will help you understand the types, causes, treatment, and prevention of birthmarks.

Types of Birthmarks

There are two main categories of birthmarks:

  1. Red birthmarks: These vascular skin markings are related to blood vessels and develop before or shortly after birth.

  2. Pigmented birthmarks: These skin markings are present at birth and range in color from brown or black to bluish or blue-gray.

Common Pigmented Birthmarks

  • Congenital melanocytosis (previously called Mongolian spots): These bluish marks resemble bruises and often appear on the buttocks, lower back, trunk, or arms. They are more common in people with darker skin.

  • Pigmented nevi (moles): These flesh-colored, brown, or black growths can appear anywhere on the skin, alone or in groups. Moles form when skin cells grow in clusters instead of spreading evenly.

  • Congenital nevi: These are moles present at birth, which have a slightly higher risk of turning into skin cancer. Larger congenital nevi have a greater risk than smaller ones.

  • Cafe-au-lait spots: These light tan or brown oval-shaped spots usually appear at birth or in the first few years of life. Multiple large cafe-au-lait spots may indicate neurofibromatosis or other conditions.

Birthmarks: Types, Causes, Treatment, and Prevention | Easy Guide

Causes and Symptoms of Birthmarks

The exact cause of most birthmarks is unknown, and they are not usually inherited. Pigmented birthmarks are determined by the amount and location of melanin in the skin. Symptoms include abnormally dark, light, or colored skin that may be smooth, flat, raised, or wrinkled. Birthmarks may change in size or color, become itchy, or bleed.

Diagnosis and Treatment of Birthmarks

In most cases, healthcare professionals can diagnose birthmarks based on their appearance. If a mole shows signs of potential skin cancer, a biopsy may be performed. Treatment is usually not necessary for birthmarks unless they interfere with vision or are associated with other health issues. Large or prominent moles that affect self-esteem can be covered with cosmetics or removed surgically.

Preventing Birthmark Complications

While there is no known way to prevent birthmarks, people with birthmarks should use sunscreen with an SPF of 30 or higher when outdoors to prevent complications. If you notice any changes in color, size, texture, or experience pain, bleeding, itching, inflammation, or ulceration of a mole or skin lesion, see a doctor right away as these may be warning signs of skin cancer.

For more information on birthmarks, visit:

The Bottom Line

Most birthmarks are harmless cosmetic variations that require only sun protection and routine monitoring for changes. Large or evolving marks need professional assessment to rule out malignant potential. If you notice concerning changes in existing birthmarks or have questions about new markings, Doctronic can connect you with dermatology expertise quickly.

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