Naevi (birthmarks)

About birthmarks

Birthmarks are very common in newborn babies. They appear where skin cells or blood vessels don’t develop as they should. There are many different types of birthmark and they all vary in size and colour and where they appear on your child’s body.

Some birthmarks fade as your child gets older but others will be permanent. Many birthmarks are harmless and don't need any treatment. However, if your child’s birthmark is affecting his or her appearance or causing health problems, it may need to be treated.

Types of birthmark

There are many different types of birthmark. They can develop on the surface of your child’s skin or in the deeper layers of the skin. Birthmarks are caused by a problem with the development of structures in the skin and soft tissues such as tiny blood vessels (capillaries) or cells that produce the dark pigment (melanin) that gives your skin its colour.

Some of the most common types of birthmark are described below.

Salmon patch or stork mark

These are one of the most common types of birthmark and are caused by dilated capillaries (blood vessels) in the top part of the skin – about half of all babies are born with a salmon patch or stork mark. They are flat red marks usually found on your baby's eyelids, top of the nose, top lip, back or neck. Frequently, the red colour is pale and difficult to see, but when your baby is crying they can become more noticeable. Most patches on the face fade as your baby gets older. However, around half of all babies with a patch on their neck (usually under the scalp hair) will still have them when they become adults.

Strawberry mark

Strawberry marks usually develop in the first month after your baby is born. They frequently develop into bright red lesions, the colour of strawberries, which is where they get their name.

Strawberry marks are more common in babies born early (premature babies). They can appear anywhere on your baby’s skin, but around six out of 10 appear on the face or neck.

A strawberry mark starts off as small, red patch, which then grows quickly and becomes a bright, red lump. Most marks stop growing by the time your baby is nine months old. It then slowly shrinks and fades. In most children the strawberry mark will have faded by the age of seven.

Sometimes strawberry marks can grow to be quite large and this can affect your baby’s appearance, particularly if the mark is on his or her face. Occasionally they can become ulcerated and if this happens they are at risk of bleeding and infection. If they grow near the eye then it can affect your baby’s visual development.

Port wine stain

Port wine stains are present when your baby is born. They are caused by dilated blood vessels in the top part of the skin. About three in every 1000 babies will have one. Medically they are called capillary vascular malformations. Port wine stains are flat dark red or purple marks that vary in size and shape. As your child gets older they may get bigger and sometimes become lumpy or a darker red in colour. Your baby is most likely to have a port wine stain on his or her face, though they can occur anywhere on the body. Port wine stains usually only affect one side of the body.

Port wine stains don’t shrink or fade naturally. They tend to grow as your baby gets older.

Mongolian blue spot

Mongolian blue spots are blue or grey areas of skin that appear most often on your child's buttocks and lower back. They can look like bruises. They are more common in babies with darker skin and babies of East Asian origin. If your child has this type of birthmark, it will probably have disappeared by the time he or she is about four.

Moles

Some babies are born with moles. The medical term for moles is melanocytic naevi. They are areas of skin where large numbers of cells called melanocytes have grouped together. Melanocytes produce a pigment called melanin, which gives your skin its colour. Where melanocytes group together your skin is darker.

Moles vary in colour from mid-brown to black and can be raised or flat and of all different sizes. Some have hairs growing out of them. Most moles don’t need treatment.

Complications of birthmarks

Most birthmarks are harmless and some will fade as your child grows older. However, your child may have problems in the future as a result of a birthmark, particularly if it affects his or her appearance or if it’s on the face or neck.

If a strawberry mark grows quickly and it’s on your baby’s face, then depending on where it is, it can affect his or her sight, breathing or feeding. If this happens, the birthmark may need treatment to shrink it or slow down its growth. Strawberry marks on your baby’s nappy area can also affect how well he or she passes urine or faeces (stool) and therefore may also need to be treated.

Sometimes a strawberry mark can become infected or develop into an open sore, which can be painful for your child. If a birthmark looks infected, for example if it’s painful and swollen and there is discharge (pus), see your GP.

Some birthmarks can be very distressing because of the way they look, for example if they are large or on your child’s face or neck. This can affect your child’s social development, their relationships with others and how they feel about themselves. If you’re worried about the effect of a birthmark on your child, talk to your GP. 

Causes of birthmarks

The reasons why some babies are born with birthmarks, or develop them in the first few months of life, aren't fully understood. However, birthmarks can’t be prevented.

Having moles may be something that is inherited, which means that if you have moles your child may also have them. Other birthmarks, such as port wine stains and strawberry marks, aren’t thought to be inherited.

Diagnosis of birthmarks

If your child has a birthmark that you're worried about, talk to your GP. He or she will examine your child and ask you questions about how the birthmark developed and whether it’s grown. Usually no further tests are needed. However, your GP may refer your child to see a specialist for any treatment.

If you or your child has a mole that has changed in appearance, your GP may refer you to a specialist clinic to have it removed and checked in a laboratory. This is to check for signs of cancer. 

Treatment of birthmarks

Salmon patches, Mongolian blue spot and many moles never need treatment. They are either harmless or shrink and fade over time. However, port wine stains, strawberry marks and some moles may need treatment. This is usually if the birthmark causes problems or if it affects your child’s appearance. The main treatments are listed below.

  • Strawberry marks. Most strawberry marks don’t need treatment. Treatment to shrink the birthmark is used for large, quick growing marks that might affect your child’s breathing, feeding or vision, or his or her ability to pass urine or faeces. Laser treatment and some medicines can be used to treat strawberry marks. These include steroids that work to reduce inflammation and a medicine called propanolol.
  • Port wine stains. Treatment for port wine stains can help the mark to fade, but may not be able to remove it completely. The main treatment is using a laser. This is done over a number of sessions for a period of up to eight weeks (see our frequently asked questions for more information). The younger your child is when he or she starts treatment the better the results. If your child’s port wine stain is small then he or she can also use cosmetic camouflage cream. This covers the birthmark rather than treating it.
  • Moles. If you have a very large mole or a number of moles, you may need to monitor them because there is a small risk of melanoma. Signs to look for include moles that get bigger, change shape or become uneven in colour and moles that itch, develop a crust or bleed. Treatment involves removing the mole.

Living with birthmarks

Many people use cosmetic camouflage cream to cover birthmarks. This can help to improve your child’s confidence and independence. These are special creams that can make a significant difference to how a birthmark looks and keep it covered for long periods of time.

There are a number of different types of cosmetic camouflage and different shades of colour available. As it’s important to match your child’s skin tone exactly, it’s a good idea to seek help from someone trained to apply it or an organisation, such as the British Association of Skin Camouflage or The Red Cross. See our frequently asked questions for more information.

If your child has a very visible birthmark, you may sometimes find other people's reactions difficult to deal with. Your child may also have questions or find that other children make comments about their birthmark. This can affect your child’s social development, his or her confidence and how they feel about themselves. It's important to be prepared for this and to help your child to be confident in coping with situations they may find difficult. There are support groups that can offer you information and advice and put you in touch with other parents or children with birthmarks.



Published by Rebecca Canvin, Bupa's Health Information Team, May 2012.

Are birthmarks painful?

Answer

No, not usually. However, strawberry birthmarks can become infected, which can be painful.

Explanation

Most birthmarks aren’t painful. However, sometimes strawberry marks can bleed or become infected. If this happens they can become painful.

If you think your child’s birthmark may be infected, see your GP. If your child needs pain relief, he or she can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.

Can laser treatment help to reduce my child's port wine stain?

Answer

Yes, although laser treatment doesn’t work for everyone.

Explanation

The main treatment for a port wine stain is laser treatment. It’s usually used when the port wine stain is large or very obvious, for example on your child’s face or neck. Laser treatment doesn’t work for everyone. However, around half of all people treated using a laser find their port wine stain has mostly faded when the treatment finishes. Treatment for port wine stains on the face is usually more successful than treatment on other areas of the body.

Laser treatment for port wine stains can be carried out at any age. However, treatment is usually most effective when your child is young, as the skin on the port wine stain is thinner than in an older child.

Your child will usually have to go to a specialist centre in hospital to have laser treatment. Older children can have treatment using local anaesthesia. This completely blocks pain from the area and your child will stay awake during the procedure. Younger children and those having treatment over large areas of skin, or near the eyes, may have a general anaesthetic. This means your child will be asleep during the procedure.

Laser treatment can cause bruising and a change in skin colour for one to two weeks after it’s done. This usually gets better without treatment.

How do camouflage cosmetics work?

Answer

Camouflage cosmetics are specially designed creams that can cover birthmarks very effectively and blend in with your natural skin tone. There are organisations and specially trained people that can help you to get the right cream for you and to apply it properly.

Explanation

Camouflage cosmetics aren’t the same as ordinary make-up. They are creams that are specially designed to blend in with your natural skin colour and they can cover birthmarks very effectively. However, they don’t work as a treatment.

There is a wide range of different creams and brands that come in pre-mixed colours to match different skin tones. You may need to wear a complementary coloured cream as well, which you can use as an undercoat to cover up very red or dark skin before you put on a natural skin matching colour. Once you have put camouflage cream on you cover it with loose powder. You can take the creams off using soap and water or cleanser.

Camouflage cosmetics are different from other beauty products because they:

  • are water resistant, which means you can go swimming with them on
  • last a long time – they should last for between eight and 16 hours before they need touching up or reapplying
  • have sun protection cream in them
  • can be used with other creams such as medicines

As it’s important to match your child’s skin tone with the cosmetic camouflage, it’s a good idea to seek help from someone trained to apply it, or a specialist organisation.