Vascular birthmarks like angel kisses and pigmented birthmarks like Mongolian blue spots can both be treated to reduce their appearance. There are a variety of treatment options available from surgical excision to noninvasive light treatments. Have a consultation with a dermatologist to determine the best treatment option for your individual needs.
Published: January 27, 2021
Last updated: December 23, 2021
Content Reviewed by AEDIT Medical Advisory Board
Various types of birthmarks can impact a child’s self-image as they grow up. While some birthmarks are looked at favorably as referred to as “beauty marks”, like Cindy Crawford’s cute mole, others can detract from the physical appearance, like Mikhail Gorbachev's prominent port wine stain. Most birthmarks are noncancerous and harmless in medical terms, but many people still want to have theirs removed for aesthetic reasons.
This article looks at the most common types of birthmarks and their causes. It also reviews tips for managing birthmarks and procedures that are available for removing them. Some natural remedies for fading birthmarks are also reviewed.
What are Birthmarks?
Birthmarks are skin discolorations that are present at the time of birth or within a few weeks afterward. Although they are often confused with moles, the two are not the same. A mole can be present at birth and therefore be considered a birthmark. However, most people develop 10-40 moles throughout life that weren’t present at birth. Therefore, a mole can be but is not necessarily a birthmark.
Birthmarks occur in all parts of the body, head, or face. They vary significantly in shape, size, and color. Some birthmarks grow larger and become more noticeable over time. Others fade away completely.
While birthmarks are generally harmless, they can indicate some uncommon medical conditions including Sturge-Weber syndrome and Klippel-Trenaunay syndrome.
There are two primary classifications of birthmarks: vascular and pigmented. Vascular birthmarks are pink/red/purple and are caused by alterations of the blood vessels beneath the skin. Pigmented birthmarks are typically brown and caused by aggregations of pigmented skin cells called melanocytes.
Signs and Symptoms
Birthmarks can be various colors, sizes, and shapes. They can be black, dark brown, tan, flesh-toned, red, purple, pink, and even blue. They can be smooth and flat to the surface of the skin or raised and rough to touch.
The majority of birthmarks cause no pain or discomfort. If you have a birthmark, mole, or another skin lesion that is oozing, bleeding, growing in size, changing in shape or color, or causing you pain, then it will be best to make an appointment with your dermatologist as soon as possible to ensure there are no underlying medical conditions present.
Birthmarks in Babies
Birthmarks in babies are not uncommon. The American Academy of Dermatology reports that more than 10% of newborns have some type of vascular birthmark. Some birthmarks are difficult to even notice while others demand the eyes of anyone in the vicinity. Some birthmarks naturally fade away with time. Others are permanent without medical or surgical intervention.
Red, Strawberry, and Vascular Birthmarks
As the name implies, vascular birthmarks are caused by excess blood vessels that accumulate under the skin. The most common types of vascular birthmarks are:
Angel Kisses Also called stork bites and salmon patches, this type of vascular birthmark is marked by small pink/red spots that typically manifest on the eyelids, on the back of the neck, or between the eyes. However, they can occur anywhere on the face, head, body, or limbs. Angel kisses are harmless and often fade away with age.
Port-wine Stains Also called nevus flammeus, this type of vascular birthmark is marked by abnormal growth patterns of subcutaneous red blood cells. They are most common on the face and neck but can occur anywhere on the person. They are typically pink or red initially, but then, often turn a dark shade of purple. They do not fade over time and often grow more prominent.
Strawberry Hemangiomas This type of birthmark is typically bright red and feels rubbery when touched. It often develops within the first few weeks of life and is not seen at the time of birth. A hemangioma will commonly start as a flat pink/red spot on the skin, and then, grow quickly during the first year.
Fortunately, many hemangiomas fade away progressively with age. Many children have lost theirs completely by age 10. They are most common on the face, head, neck, hands, and feet. They are most often harmless and do not require monitoring or intervention.
Having too much of the skin pigment called melanin causes pigmented birthmarks. Melanin is the dark brown/black pigment that causes the skin to become darker with increased exposure to sunlight. These types of birthmarks include:
Congenital Melanocytic Nevus (CMN) Being congenital means being present at birth. Melanocytic has to do with cells that produce melanin. Nevus is a medical term for a mole. Congenital melanocytic nevus is simply a mole present at birth; a true birthmark. They can be temporary or permanent. Most nevi are harmless but you should see a dermatologist if you have one that bleeds, oozes, changes color, or is painful.
Mongolian Blue Spots This type of pigmented birthmark is typically flat and blue-grey. They occur most commonly on the lower back or buttocks in young children. In many cases, these harmless skin spots fade away by the child’s 4th birthday.
Café au Lait Spots The light brown color of cafe au lait spots is the reason behind its name, which means “milk with coffee” in French. They typically have irregular borders and grow darker with exposure to sunlight. Harmless and considered normal, these skin decolorations can be as small as ½ cm. Multiple cafe au lait spots can indicate neurofibromatosis, a rare genetic disorder.
Birthmarks with Hair: Reason for Concern?
A popular myth about birthmarks is that if they have hair growing out of them, they are more likely to be cancerous. It is a myth because it is not true. There is no scientific evidence to back up the assertion.
It is common that healthy birthmarks and moles have:
- Hair growing from them, which indicates that cells are healthy and noncancerous.
- One or more hairs growing from it.
- Hair that grows through the birthmarks or mole, that may be thick and dark.
- It is safe to remove hair that grows from a birthmark or mole.
The Myth of a Mother Causing a “Birth Stain”
There’s an old wives tale about birthmarks being caused by the mother failing to succumb to food cravings during pregnancy. For instance, a strawberry hemangioma could be caused by the mother not eating strawberries when she craved them. This too is just a myth with no scientific foundation. Birthmarks are not caused by anything the mother eats or drinks during pregnancy. The causes of birthmarks remain largely unknown.
The majority of birthmarks cause no harm and have no medical reason to be removed. However, when they increase the risk for disease or detract from the physical appearance, then birthmark removal options are available. The most commonly used treatments are:
- Light Therapy
- Laser Resurfacing
- Surgical Removal
Light Therapy Intense Pulsed Light (IPL) therapy degrades abnormal blood vessels and pigment cells that cause some birthmarks to be noticeable. It helps some patients to feel better about the appearance of both vascular and pigmented birthmarks. However, it isn’t effective for everyone and may not be enough to make large or very prominent birthmarks less noticeable.
Laser Resurfacing Both vascular and pigmented birthmarks can be diminished by laser resurfacing procedures. An ablative laser or non-ablative fractional laser can be used. The ablative type produces greater results but is also more invasive and requires a longer recovery period. This is a stronger option than IPL for breaking apart the pigment cells or blood vessels that are causing a birthmark.
Surgical Birthmark Removal Surgical birthmark removal procedures include shave excision, punch excision, and true surgical excision. In each case, the tissue that makes up the birthmark or mole is completely removed from the body. Surgical removal is the only known permanent treatment for vascular and pigmented skin lesions.
Vascular and pigmented birthmarks are normally harmless in a medical sense but commonly cause cosmetic concerns. While there are various DIY products available that are claimed to diminish the appearance of these skin lesions, most of them produce marginal results at best. Further, attempting to treat a birthmark or mole by yourself can be dangerous, especially if it is already in a precancerous state.
The only proven way to safely and effectively remove a birthmark is via surgical excision of the tissue that makes it up. Shave, punch, and traditional surgical excision procedures are enhanced today with laser technology and increased dermatological knowledge.
For larger or vascular birthmarks, satisfactory results can be achieved from procedures like IPL and laser resurfacing. However, these techniques may not be enough to correct the birthmark to the point desired and multiple treatments are likely necessary. Speak to a doctor or dermatologist about your options for birthmark removal.
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