# Birthmark

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Benign skin irregularity which appears near the time of birth

For other uses, see [Birthmark (disambiguation)](/source/Birthmark_(disambiguation)).

Medical condition

Birthmark Port-wine stain birthmark visible on the head of Mikhail Gorbachev, one of the most famous individuals with such a birthmark Specialty Dermatology

A **birthmark** is a [congenital](/source/Congenital), [benign](/source/Benignity) irregularity on the skin which is present at birth or appears shortly after birth—usually in the first month. Birthmarks can occur anywhere on the skin.[1] They are caused by overgrowth of [blood vessels](/source/Blood_vessel), [melanocytes](/source/Melanocyte), [smooth muscle](/source/Smooth_muscle), [fat](/source/Fat), [fibroblasts](/source/Fibroblast), or [keratinocytes](/source/Keratinocyte).

[Dermatologists](/source/Dermatologist) divide birthmarks into two types: pigmented birthmarks and vascular birthmarks. Pigmented birthmarks caused by excess [skin pigment](/source/Skin_pigment) cells include: [moles](/source/Melanocytic_nevus), [café au lait spots](/source/Caf%C3%A9_au_lait_spot), and [Mongolian spots](/source/Mongolian_spots). Vascular birthmarks, also called red birthmarks, are caused by increased blood vessels and include [macular stains](/source/Macular_stain) (salmon patches), [hemangiomas](/source/Hemangioma), and [port-wine stains](/source/Port-wine_stain). A little over 1 in 10 babies have a [vascular](/source/Blood_vessel) birthmark present by age 1.[2] Several birthmark types are part of the group of skin [lesions](/source/Lesion) known as [nevi](/source/Nevus) or naevi, which is [Latin](/source/Latin) for "birthmarks".

Birthmarks occur as a result of a localized imbalance in factors controlling the development and [migration](/source/Cell_migration) of [skin cells](/source/Skin_cell). In addition, it is known that most vascular birthmarks are not [hereditary](/source/Hereditary).[2][3]

## Pigmented types

### Mole

Main article: [Congenital melanocytic nevus](/source/Congenital_melanocytic_nevus)

[Congenital melanocytic nevus](/source/Congenital_melanocytic_nevus) is a type of [melanocytic nevus](/source/Melanocytic_nevus), the medical term for what is colloquially called a "mole", found in [infants](/source/Infant) at birth. Occurring in about 1% of infants in the [United States](/source/United_States), it is located in the area of the [head](/source/Human_head) and [neck](/source/Neck) 15% of the time, but may occur anywhere on the body. It may appear as light brown in fair-skinned people, to almost black in people with darker skin. Coming in a variety of sizes and appearances, they may be irregular in shape and flat, or raised and lumpy in appearance and feel. Such naevi can also manifest themselves as [beauty marks](/source/Beauty_marks), which most commonly appear on the [face](/source/Face), [neck](/source/Neck) or [arms](/source/Arm).

### Café au lait spot

Main article: [Café au lait spot](/source/Caf%C3%A9_au_lait_spot)

Café au lait spot [macules](/source/Macule) may occur anywhere on the body. They are most commonly oval in shape and light brown, or milk coffee, in color. These birthmarks may be present at birth, or appear in early childhood, and do not fade much with age.[4] One or two on an individual is common;[4] however, four or more may be an indicator of [neurofibromatosis](/source/Neurofibromatosis).[4] In the event of weight gain, the birthmark can stretch with the skin and become larger.

### Mongolian spot

Main article: [Mongolian spot](/source/Mongolian_spot)

A Mongolian blue spot (dermal melanocytosis) is a [benign](/source/Benign) flat [congenital](/source/Congenital_disorder) birthmark with wavy borders and irregular shape, most common among [East Asians](/source/East_Asia) and [Turkic](/source/Turkic_peoples) people (excluding [Turks](/source/Turkish_people) of [Asia Minor](/source/Asia_Minor)), and named after [Mongolians](/source/Mongols). It is also extremely prevalent among [East Africans](/source/East_Africa) and [Native Americans](/source/Indigenous_peoples_of_the_Americas).[5][6] It normally disappears three to five years after birth and almost always by [puberty](/source/Puberty). The most common color is blue, although they can be blue-gray, blue-black or even deep brown.

The Mongolian spot is a [congenital](/source/Congenital_disorder) developmental condition exclusively involving the [skin](/source/Human_skin). The blue colour is caused by [melanocytes](/source/Melanocyte), [melanin](/source/Melanin)-containing cells, that are deep under the skin.[6] Usually, as multiple spots or one large patch, it covers one or more of the lumbosacral area (lower [back](/source/Human_back)), the [buttocks](/source/Buttock), sides, and [shoulders](/source/Shoulder).[6] It results from the entrapment of melanocytes in the [dermis](/source/Dermis) during their migration from the [neural crest](/source/Neural_crest) to the [epidermis](/source/Epidermis_(skin)) during [embryonic](/source/Embryo) development.[6]

Among those who are not aware of the background of the Mongolian spots, it may sometimes be mistaken for a bruise indicative of child abuse.[7]

## Vascular types

### Stork bite

Main article: [Nevus flammeus nuchae](/source/Nevus_flammeus_nuchae)

Stork bite

Colloquially called a "[stork](/source/Stork) bite", "[angel](/source/Angel)'s kiss" or "[salmon](/source/Salmon) patch", [telangiectatic nevus](/source/Telangiectatic_nevus) appears as a pink or tanned, flat, irregularly shaped mark on the [knee](/source/Knee), back of the neck, and/or the [forehead](/source/Forehead), [eyelids](/source/Eyelid) and, sometimes, the top [lip](/source/Lip). The skin is not thickened and feels no different from anywhere else on the body; the only difference is in appearance. Nearly half of all babies have such a birthmark.[4]

### Strawberry mark

Main article: [Hemangioma](/source/Hemangioma)

An [infantile hemangioma](/source/Infantile_hemangioma), colloquially called a [strawberry](/source/Strawberry) mark, is a [benign](/source/Benign) self-[involuting](/source/Involution_(medicine)) [tumor](/source/Tumor) (swelling or growth) of [endothelial](/source/Endothelium) cells, the cells that line [blood vessels](/source/Blood_vessel). It usually appears during the first weeks of life and resolves by age 10. It is the most common [tumor](/source/Tumor) of [infancy](/source/Infancy).[8]

[PHACES Syndrome](/source/PHACES_Syndrome), a rare condition that often involves [brain](/source/Human_brain), [heart](/source/Heart), and [arterial](/source/Artery) abnormalities, is generally accompanied by the presence of large facial hemangiomas. In such cases, what appears to be a small [bruise](/source/Bruise) or birthmark may grow rapidly and take on a puffy appearance in the first days or weeks of life.

### Port-wine stain

Main article: [Nevus flammeus](/source/Port-wine_stain)

The back of a hand with prominent port-wine staining

[Port-wine](/source/Port_wine) stains, also known as nevus flammeus and sometimes mistaken for strawberry marks, are present at birth and range from a pale pink in color, to a deep wine-red. Irregular in appearance, they are usually quite large, and caused by a deficiency or absence in the [nerve](/source/Nerve) supply to [blood vessels](/source/Blood_vessel). This causes [vasodilation](/source/Vasodilation), the dilation of blood vessels, causing blood to pool or collect in the affected area.[9] Over time, port-wine stains may become thick or develop small ridges or bumps, and do not fade with age.[2] Such birthmarks may have emotional or social repercussions.[2] Port-wine stains occur in 0.3% of the population, equally among males and females.[2][9] They frequently express unilaterally, i.e., on only one side, not crossing the midline of the body. Often on the face, marks on the upper eyelid or forehead may be indicative of a condition called [Sturge–Weber syndrome](/source/Sturge%E2%80%93Weber_syndrome). Additionally, port-wine stains in these locations may be associated with [glaucoma](/source/Glaucoma) and [seizures](/source/Seizure).[2]

## Treatment

Most birthmarks are harmless and do not require treatment. Pigmented marks can resolve on their own over time in some cases. Vascular birthmarks may require reduction or removal for [cosmetic](/source/Cosmesis) reasons. Treatments include administering oral or injected [steroids](/source/Steroid), [dermatological lasers](/source/Laser_medicine) to reduce size and/or color, or [dermatologic surgery](/source/Dermatologic_surgery).[10]

## Historical explanations

Many explanations were given to explain the origin of birthmarks. Occasionally, it was said that children could be 'marked' or 'imprinted' upon by scares or frights given to the mother during the pregnancy, which draws on the outdated theory of [maternal impression](/source/Maternal_impression):

Children are also said to be marked by some sudden fright or unpleasant experience of the mother, and I have myself seen a pop-eyed, big-mouthed idiot whose condition is ascribed to the fact that his mother stepped on a toad several months before his birth. In another case, a large red mark on a baby's cheek was caused by the mother seeing a man shot down at her side, when the discharge of the gun threw some of the blood and brains into her face.[11]

Other explanations claimed that birthmarks shaped like food were the direct result of the mother's [pregnancy cravings](/source/Pregnancy_cravings), or the mother touching a certain part of her body during a [solar eclipse](/source/Solar_eclipse) – her child's birthmark will be in the same location.[12]

## References

1. **[^](#cite_ref-1)** ["birthmark"](https://web.archive.org/web/20090628224336/http://www.mercksource.com/pp/us/cns/cns_hl_dorlands_split.jsp?pg=/ppdocs/us/common/dorlands/dorland/one/000012925.htm) at *[Dorland's Medical Dictionary](/source/Dorland's_medical_reference_works)*

1. ^ [***a***](#cite_ref-add.org_2-0) [***b***](#cite_ref-add.org_2-1) [***c***](#cite_ref-add.org_2-2) [***d***](#cite_ref-add.org_2-3) [***e***](#cite_ref-add.org_2-4) [***f***](#cite_ref-add.org_2-5) ["Birthmarks"](https://web.archive.org/web/20091108165023/http://www.kidsskinhealth.org/GrownUps/birthmarks.html). [American Academy of Dermatology](/source/American_Academy_of_Dermatology). Archived from [the original](http://www.kidsskinhealth.org/GrownUps/birthmarks.html) on 2009-11-08. Retrieved 2011-06-20.

1. **[^](#cite_ref-seattle_children_3-0)** ["Birthmarks"](https://web.archive.org/web/20170202081602/http://www.seattlechildrens.org/medical-conditions/common-childhood-conditions/birthmarks/). [Seattle Children's Hospital and Regional Medical Center](https://en.wikipedia.org/w/index.php?title=Seattle_Children%27s_Hospital_and_Regional_Medical_Center&action=edit&redlink=1). Archived from [the original](http://www.seattlechildrens.org/medical-conditions/common-childhood-conditions/birthmarks/) on 2017-02-02. Retrieved 2008-08-02.

1. ^ [***a***](#cite_ref-parenting_child_health_4-0) [***b***](#cite_ref-parenting_child_health_4-1) [***c***](#cite_ref-parenting_child_health_4-2) [***d***](#cite_ref-parenting_child_health_4-3) ["Parenting and Child Health - Health Topics - Birthmarks"](https://web.archive.org/web/20080723123659/http://www.cyh.com/HealthTopics/HealthTopicDetails.aspx?p=114&np=304&id=1589). Archived from [the original](http://www.cyh.com/HealthTopics/HealthTopicDetails.aspx?p=114&np=304&id=1589) on 2008-07-23.

1. **[^](#cite_ref-tokyo_5-0)** [About Mongolian Spot](http://www.tokyo-med.ac.jp/genet/msp/about.htm)

1. ^ [***a***](#cite_ref-skin_6-0) [***b***](#cite_ref-skin_6-1) [***c***](#cite_ref-skin_6-2) [***d***](#cite_ref-skin_6-3) [Mongolian blue spots](http://skin-care.health-cares.net/Mongolian-blue-spots.php) [Archived](https://web.archive.org/web/20170119081851/http://skin-care.health-cares.net/Mongolian-blue-spots.php) 2017-01-19 at the [Wayback Machine](/source/Wayback_Machine) - Health care guide discussing the Mongolian blue spot.

1. **[^](#cite_ref-7)** [Mongolian Spot](http://www.tokyo-med.ac.jp/genet/msp/index.htm) - English information of Mongolian spot, written by Hironao NUMABE, M.D., Tokyo Medical University.

1. **[^](#cite_ref-pmid16950977_8-0)** Haggstrom AN, Drolet BA, Baselga E, et al. (September 2006). ["Prospective study of infantile hemangiomas: clinical characteristics predicting complications and treatment"](http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=16950977). *Pediatrics*. **118** (3): 882–7. [doi](/source/Doi_(identifier)):[10.1542/peds.2006-0413](https://doi.org/10.1542%2Fpeds.2006-0413). [PMID](/source/PMID_(identifier)) [16950977](https://pubmed.ncbi.nlm.nih.gov/16950977). [S2CID](/source/S2CID_(identifier)) [31052666](https://api.semanticscholar.org/CorpusID:31052666).

1. ^ [***a***](#cite_ref-vascular_port_9-0) [***b***](#cite_ref-vascular_port_9-1) ["Port Wine Stain Information"](http://www.birthmark.org/port_wine_stains.php). [Vascular Birthmark Foundation](https://en.wikipedia.org/w/index.php?title=Vascular_Birthmark_Foundation&action=edit&redlink=1). Retrieved 2008-08-02.

1. **[^](#cite_ref-10)** ["Birthmarks: Diagnosis and treatment"](https://www.aad.org/public/diseases/a-z/birthmarks-treatment).

1. **[^](#cite_ref-11)** Randolph, Vance (2013-06-18). [*Ozark Superstitions*](https://books.google.com/books?id=khx-CgAAQBAJ&dq=ozarks+Children+are+also+said+to+be+marked+by+some+sudden+fright+or+unpleasant+experience+of+the+mother%2C+and+I+have+myself+seen+a+pop-eyed%2C+big-mouthed+idiot+whose+condition+is+ascribed+to+the+fact+that+his+mother+stepped+on+a+toad+several+months+before+his+birth.+In+another+case%2C+a+large+red+mark+on+a+baby%E2%80%99s+cheek+was+caused+by+the+mother+seeing+a+man+shot+down+at+her+side%2C+when+the+discharge+of+the+gun+threw+some+of+the+blood+and+brains+into+her+face.&pg=PT170). Read Books Ltd. [ISBN](/source/ISBN_(identifier)) [978-1-4733-8824-6](https://en.wikipedia.org/wiki/Special:BookSources/978-1-4733-8824-6).

1. **[^](#cite_ref-12)** Egger, Andjela N.; Chowdhury, Aneesa R.; Espinal, Maria C.; Maddy, Austin J. (2020). ["Birthmarks: Tradition, Culture, Myths, and Folklore"](https://www.karger.com/Article/FullText/501273). *Dermatology*. **236** (3): 216–218. [doi](/source/Doi_(identifier)):[10.1159/000501273](https://doi.org/10.1159%2F000501273). [ISSN](/source/ISSN_(identifier)) [1018-8665](https://search.worldcat.org/issn/1018-8665). [PMID](/source/PMID_(identifier)) [31362285](https://pubmed.ncbi.nlm.nih.gov/31362285). [S2CID](/source/S2CID_(identifier)) [198999685](https://api.semanticscholar.org/CorpusID:198999685).

## External links

Classification D ICD-11: 2F20.2 ICD-10: Q82.5 ICD-9-CM: 757.32 SNOMED CT: 51089004

- [Birthmarks](http://my.clevelandclinic.org/disorders/birthmark/hic_birthmarks.aspx) via the [Cleveland Clinic](/source/Cleveland_Clinic)

- [Vascular Birthmarks Foundation](http://www.birthmark.org/)

- [Birthmarks](https://medlineplus.gov/birthmarks.html) via [MedlinePlus](/source/MedlinePlus)

Authority control databases: National Japan

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Adapted from the Wikipedia article [Birthmark](https://en.wikipedia.org/wiki/Birthmark) by Wikipedia contributors ([contributor history](https://en.wikipedia.org/wiki/Birthmark?action=history)). Available under [Creative Commons Attribution-ShareAlike 4.0 International](https://creativecommons.org/licenses/by-sa/4.0/). Changes may have been made.