Birthmarks – the different types and when to see a doctor

Birthmarks are often harmless and fade as you age. But sometimes they need to be treated. Find out more and when to see a doctor.

Common types of birthmarks

What causes them and who’s most affected?

When to see a doctor 

How are birthmarks diagnosed?

Treatment for birthmarks

Where to get support

Whether it’s on your leg, the back of the neck, or your face, a birthmark is common and usually nothing to worry about. But sometimes it may need to be treated for health reasons, or removed for its appearance. Discover when to get a birthmark checked and the treatments that can help, if needed.

Have you had a mark on your skin for as long as you can remember? Maybe it’s raised, flat, brown, pink or blue-ish gray in color. 

These are typical signs of a birthmark, but no 2 will look the same. There are countless types, coming in all different shapes, colors and sizes. Depending on where yours is, you might feel self-conscious and embarrassed about it, but birthmarks are really common. 

A birthmark appears at birth (or shortly after) and either disappears over time or lies harmlessly on your skin throughout life. But sometimes you may need to get it treated. 


## Common types of birthmarks

There are many different forms, but the most common fit into 2 categories – vascular and pigmented. 

Some types of vascular birthmarks include: 

- __salmon patch or stork mark__ – flat, red or pink areas, whether on black, brown or white skin. They’re often found on the face, head or neck and may take longer to fade if they’re on the back of the head or neck 
- __strawberry mark or hemangioma__ – raised red lumps on black, brown and white skin. They’re common in girls, premature babies and twins, usually feel firm and are found on the head or neck. They might appear under the skin and look purple, but usually disappear in children by the age of 10
- __port wine stains__ – red, purple or dark marks (or dark patches on brown or black skin), often found on your face or neck. They usually appear on one side of your body and can sometimes be a symptom of another condition, such as Sturge-Weber syndrome, although this is rare. Typically they don’t fade and may need treatment. 

Pigmented birthmarks include: 

- __cafe-au-lait spots__ – flat, light or dark brown patches (they look darker on brown or black skin) found anywhere on your body. They come in many different shapes and sizes but having many spots could be a sign of a condition called neurofibromatosis type 1 (a usually non-cancerous condition that causes tumors to grow along your nerves)
- __blue-gray spots (Mongolian spots)__ – look like a bruise and are most likely to be found on the bottom, lower back, arms or legs. It’s most likely to develop on brown or black skin and usually fades by the age of 4 
- __congenital moles__ – brown or black moles that look darker on darker skin and may feel smooth or wart-like. They can be raised, hairy or darker in color. Larger moles may develop into skin cancer, so [if there’s a risk](https://www.livehealthily.com/health-library/conditions/birthmarks#when-to-see-a-doctor) they may need treatment. 


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## What causes them and who’s most affected?

Anyone can develop a birthmark and the cause isn’t always known. But it’s thought the majority come about because of changes in a baby’s genes during pregnancy when skin and blood vessels are forming.

There’s no evidence to suggest that birthmarks have anything to do with what you eat, do, or don’t do, during pregnancy. 

Most pigmented birthmarks contain melanin, which is a different color (usually brown or black) to the rest of your skin. These birthmarks tend to appear when cells, known as melanocytes, clump together.

Vascular birthmarks (red or blue in color) are blood vessels that have not fully formed. 

There’s no way to tell whether a baby will be born with a birthmark or not, but certain groups might be more likely to develop one. These include: 

- __baby girls, twins, premature babies and babies born with white skin or a low weight__ – may be more likely to develop strawberry marks or hemangiomas 
- __babies born within families that have an underlying condition__ – such as Sturge-Weber syndrome and Klippel-Trenaunay syndrome, or macrocephaly-capillary malformation. A port wine stain birthmark may be a sign of these conditions, but it’s rare 
- __babies with brown or black skin__ – African American or Asian babies may be more likely to develop blue-gray spots (Mongolian spots). 

## When to see a doctor 

It’s a good idea to book an appointment with a doctor if: 

- you’re worried about a birthmark
- you have a large congenital mole
- your birthmark is sore or painful, bleeding, itchy or swollen
- you have more than 6 cafe-au-lait spots
- a birthmark is close to your eye, nose or mouth
- a birthmark has got bigger, darker or lumpier. 


## How are birthmarks diagnosed?

Your doctor will check your birthmark for specific characteristics, or refer you to a dermatologist. In both cases, a diagnosis is usually made from here, but you might need further tests.

These may include: 
- __an ultrasound or a magnetic resonance imaging (MRI)__ – imaging scans to check birthmarks that are deep enough to involve areas of your body other than your skin
- __a skin biopsy__ – when a tiny sample of skin is taken and examined. This may be recommended if your birthmark has changed in size and shape and your doctor wants to check it for skin cancer.


## Treatment for birthmarks

A birthmark doesn’t usually need to be treated, but occasionally it does. So it’s important to get it seen by a doctor as soon as you can if you're worried about it. 

You might also want a birthmark removed because of the way it looks, even if it’s lying harmlessly on your skin. 

Whatever the reason, there are 3 main ways to treat a birthmark, which include: 

- __laser removal__ – when heat and a narrow beam of light make the birthmark appear smaller and less noticeable 
- __medicines__ – used to reduce blood flow to the birthmark, making it lighter and grow slower over time
- __surgery__ – used to fully remove a birthmark, but it may lead to scarring.

## Where to get support

Whether you need a birthmark removed because it’s affecting your eyesight, there’s a risk of skin cancer, or it’s making you feel self-conscious, there are lots of support groups and resources out there to help.

These include:

- [Birthmark Support Group ](https://birthmarksupportgroup.org.uk/)
- [A Birthmark Support Group on Facebook](https://www.facebook.com/BirthmarkSupportGroup/?locale=en_GB)
- [The Vascular Birthmarks Foundation](https://birthmark.org/programs/vbf-support-group-list/)


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References

Amelia Glean

Jo Wheatley

Dr Tamer T Malak

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Birthmarks are often harmless and fade as you age. But sometimes they need to be treated. Find out more and when to see a doctor.
