birthmarks

Birthmarks are localized skin alterations present at birth or appearing in infancy. Most are benign and harmless, though some may be cosmetically distressing or, rarely, associated with medical conditions. Birthmarks are broadly categorized as pigmented birthmarks and vascular birthmarks.

Pigmented birthmarks result from abnormal pigment production or distribution. Examples include café-au-lait spots, congenital melanocytic nevi (moles present at birth or developing in early life), and Mongolian spots (bluish patches often on the lower back or buttocks). These marks vary in size, color, and shape and may persist for life. Larger congenital nevi carry a higher risk of skin cancer later in life.

Vascular birthmarks involve blood vessels. Infantile hemangiomas (strawberry marks) usually appear a few weeks after birth, grow rapidly during infancy, then gradually involute over years. Port-wine stains are flat, pink to red capillary malformations present at birth and tend to persist. Salmon patches (nevus simplex) are pale patches most often seen on the eyelids, between the eyebrows, or at the back of the neck and commonly fade with age.

Diagnosis is typically clinical. In uncertain cases, a dermatologist may use dermoscopy or imaging; biopsy is rarely needed. Management ranges from observation to treatment for cosmetic or functional reasons. Treatments include laser therapy or surgical removal for selected pigmented lesions; propranolol is used for problematic infantile hemangiomas under medical supervision.

Seek medical advice for sudden changes in a birthmark, lesions that ulcerate, or multiple large or unusual marks, or if there are other signs suggesting a syndrome.