Birthmarks are common skin markings present at birth or developing shortly thereafter. While many birthmarks are red, pink, or brown, some can appear white. These white birthmarks are distinct areas of skin lacking typical pigmentation.
Understanding White Birthmarks
White birthmarks are areas of skin with reduced or absent pigment, known as hypopigmentation or depigmentation. They appear paler than surrounding skin, ranging from faintly lighter to noticeable white. These markings vary in size, shape, and location, appearing as small spots or larger patches. They are typically flat, though some may be slightly raised, with regular or irregular borders.
Unlike vitiligo, which develops later and can expand, white birthmarks are congenital or appear very early in life. Their shape and distribution tend to remain stable, growing proportionally with the body.
Causes and Specific Types
White birthmarks result from localized issues with melanocytes, the cells producing melanin. This involves a reduced number of melanocytes or their diminished ability to produce or transfer pigment effectively. Several specific conditions manifest as white birthmarks, each with distinct features and potential implications.
Nevus Depigmentosus
Nevus depigmentosus (ICD-10: Q82.5), also known as nevus achromicus, is a common type. This hypopigmented patch is usually present at birth or becomes apparent in early childhood, remaining stable in shape and distribution. It is generally benign and not associated with systemic health problems.
Hypomelanosis of Ito
Hypomelanosis of Ito (ICD-10: L81.9) presents as streaky, whorl-like, or linear hypopigmented patches. These lesions develop in early infancy. As a neurocutaneous syndrome, it can be associated with abnormalities affecting other organ systems, including neurological issues, ocular problems, and skeletal anomalies.
Ash-Leaf Spots
Ash-leaf spots (ICD-10: Q85.3) are hypopigmented macules resembling an ash leaf. The presence of three or more ash-leaf spots can indicate Tuberous Sclerosis Complex (TSC). TSC is a genetic condition causing non-cancerous growths in various organs, such as the brain, kidneys, and heart. These spots are sometimes more visible under a Wood lamp.
When Medical Consultation is Recommended
While many white birthmarks are harmless, certain characteristics or accompanying symptoms warrant a medical evaluation. It is advisable to consult a healthcare provider if a white birthmark changes in size, shape, or texture over time. Any symptoms such as itching, pain, or bleeding from the birthmark should also prompt a medical visit.
The presence of multiple white birthmarks, particularly if they are ash-leaf shaped, suggests the need for further investigation to rule out underlying conditions like Tuberous Sclerosis Complex. A dermatologist can accurately diagnose the specific type of white birthmark and provide appropriate guidance or reassurance.