Birthmarks in Children: All that parents need to know!
The child gives birth to a Mother! I read this daily while I cross Bandra junction (Mumbai) daily for work. The phrase indicates the strong influence childbirth has on society.
When a child is born, the care given by the parents is one of the strongest bonds that mankind has ever seen. The questions that come in the parent’s minds regarding the influence of chemicals, foods, dust exposure, and many others stress the parents to a high extent. If a parent sees a birthmark or a mole or a red growth on the skin of the child, it breaks them down emotionally.
The worry and stress experienced by the parents need to be addressed by pediatricians, pediatric dermatologists, and other healthcare workers. Birthmarks range from hardly noticeable to disfiguring, but no matter how large or small they are, they can be upsetting.
Birthmarks can be flat or raised, have regular or irregular borders, and have different shades of colour. They’re mostly harmless and many even go away on their own or shrink over time.
Birthmarks in children can be broadly divided into two types for ease of reference. One of those is vascular (blood outgrowths) and ones that are pigmented (moles).
Vascular (blood vessel) birthmarks happen when blood vessels don’t form correctly — either there are too many of them or they’re wider than usual. Pigmented birthmarks are caused by an overgrowth of the cells that create pigment (colour) in the skin.
Vascular Birthmarks
The most common vascular birthmarks are macular stains, haemangiomas, and port-wine stains:
Macular stains: Also called salmon patches, angel kisses, or stork bites, these faint red marks are the most common type of vascular birthmark. They’re often on the forehead or eyelids, the back of the neck, or on the nose, upper lip, or on the back of the head. These do not need any further investigations. Most often they fade on their own by the time a child is 1 to 2 years old, although some last into adulthood.
Haemangiomas are classified as superficial when they appear on the surface of the skin (“strawberry marks”) and deep when found deeper below the skin’s surface. They can be slightly raised and bright red and sometimes aren’t visible until a few days or weeks after a baby is born. Deep haemangiomas may be bluish because they involve blood vessels in deeper layers of the skin.
Haemangiomas grow rapidly during the first 6 months or so of life, but usually, shrink back and disappear by the time a child is 5 to 10 years old. Some, particularly larger ones, may leave a scar as they regress that can be corrected by minor plastic surgery. These might need MRI or CT scans to check for deeper components.
Port-wine stains are discolorations that look like wine was spilled on an area of the body, most often on the face, neck, arms, or legs. Port-wine stains can be any size but grow only as the child grows. They tend to darken over time and can thicken and feel like pebbles in midlife adulthood unless treated. They never go away on their own. Ones near the eye must be assessed for possible problems involving the eye.
Pigmented Birthmarks
The most common pigmented birthmarks are café-au-lait spots, Mongolian spots, and moles:
Café-au-lait spots. These very common spots are the colour of coffee with milk, which explains the name. They can be anywhere on the body and sometimes increase in number as a child gets older. One alone is not a problem. If there are many spots, then the child might need investigations. They can be an indication of genetic disorders of the skin like the Neurofibromatosis clinic. We have specialised in the Neurofibromatosis clinic at the hospital to scan for changes.
Mongolian spots. These flat, bluish-grey patches are often found on the lower back or buttocks. They are most common on darker skin, such as on children of Asian, American Indian, African, Hispanic, and Southern European descent. They usually fade — often completely — by school age without treatment.
Moles (congenital nevi, hairy nevus). Mole is a general term for brown nevi (one is called a “nevus”). Most people get moles at some point in life. One present at birth is called a congenital nevus and will last a lifetime. Large or giant congenital nevi are more likely to develop into skin cancer (melanoma) later in life, although the risk is low in both. Smaller congenital nevi may have a slight increase in risk. Moles can be tan, brown, or black; flat or raised and may have hair growing out of them.
The information written in this article is related to certain marks that appear at childbirth. The parents need to seek their doctor’s opinion for further information.
Dr. Pravin Banodkar, Consultant Dermatology & Cosmetology, NH SRCC Children’s Hospital, Mumbai