Last updated on Feb 17th, 2021 at 10:15 am

One in 10 babies is born with, or quickly develops, a birthmark. Only one in 100 cases require medical intervention.
Birthmarks can be flat or raised and range in colour from brown, tan, black or pale blue to pink, red or purple. They are present at birth or soon after birth.

About birthmarks

Gauteng-based dermatologist Dr Muhanyisi Mukansi says the two main types of birthmarks are differentiated by their causes. Vascular (blood vessel) birthmarks happen when blood vessels don’t form correctly – there are either too many of them or they’re wider than usual. “Pigmented birthmarks are caused by an overgrowth of the cells that create pigment in skin,” he explains.

Vascular birthmarks

The most common vascular birthmarks are macular stains, haemangioma and port-wine stains:

Haemangioma:
Haemangioma are abnormal clusters of blood vessels beneath the surface of the skin. Nearly one-third of babies are born with light-pink patches at the back of their necks, commonly referred to as stork bites. Other babies have a splash of pink in the middle of their foreheads or eyelids. These mild haemangioma often turn bright red, but usually fade before the baby’s first birthday. Strawberry haemangioma are bright red birthmarks of various sizes and shapes that usually appear on the head or neck. They tend to start out as small bumps, but gradually become larger and redder for the first year to 18 months. After this, they usually begin a process called involution where the birthmark slowly shrinks or fades until it’s gone. This can take anything from one to 10 years. Consult a doctor if any strawberry marks appear around your baby’s eyes, nose or mouth.

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Port wine stains:

These are red or purple birthmarks that appear flat on the skin. Caused by a deficiency in the nerve supply to blood vessels under the skin, they usually appear on the face. They are almost always visible at birth and don’t fade on their own.

Pigmented birthmarks

The most common pigmented birthmarks are café-au-lait and and Mongolian spots, and moles.

Café-au-lait spots:

These birthmarks appear as areas of darkened skin ranging from tan to dark brown. They are permanent, very common,
and can occur anywhere on the body. While the size of the birthmarks can increase as the child grows, they are usually harmless and will not need treatment. You should ask your paediatrician’s opinion if your child has six or more of these marks, according to the Mayo Clinic in the US.

Mongolian spots:

Mongolian spots are bluish grey patches typically found on children’s backs, buttocks and upper legs. They are caused by excess pigmentation and usually fade by the time the child enters preschool.
Moles (congenital nevi):
Moles can be brown or black, flat or raised, and may have hair growing on them. Large or giant moles are more likely to develop into skin cancer later in life, says Dr Mukansi. “See a doctor right away if you notice a change in the colour, size or texture of a mole. If there is any pain, bleeding, itching, inflammation or ulceration of a mole or other skin lesion, you should consult a doctor.”

Treating birthmarks

Most birthmarks are harmless and don’t need treatment, but some may require treatment for cosmetic reasons or due to rapid growth.
In some cases, they will need to be treated for medical reasons. For example, haemangioma could impair function around the eyes, nose and mouth. Dr Mukansi recommends that treatment options should be discussed with a paediatric dermatologist or plastic surgeon who has expert experience in treating vascular birthmarks.

Meaning and myths

According to an African cultural belief, the haemangioma or stork bite birthmark can kill a baby if it is left untreated. However, the mark is not deadly or harmful, says paediatrician Dr Dewald Buitendag. “This mark is reddish or pinkish and comes in various shapes and sizes. A stork bite birthmark is also known as a ‘salmon patch’ or an ‘angel’s kiss’. Babies of all races and backgrounds can be born with this mark. Babies can also have this mark on their foreheads, eyelids and faces,” he explains.
When this mark appears on the back of the head and neck, it does not always fade away, but it is covered by hair so is not visible anyway. Dr Buitendagh stresses that the mark will not kill your baby, so it is unnecessary to take him to a traditional healer or doctor to have it treated. Dr Mukansi agrees: “The majority of birthmarks are harmless and the most common vascular birthmarks fade within the first year of life.”