Birthmarks are common skin markings present at birth or appearing shortly after. They vary in size, shape, color, and texture. Many are harmless, but lead to questions about removal.
Understanding Birthmark Types
Birthmarks generally fall into two primary categories: vascular and pigmented. Each type has distinct characteristics based on cellular origin, and its cause determines appearance and influences treatment.
Vascular birthmarks result from abnormal skin blood vessels, appearing as red, pink, or purple marks. Examples include hemangiomas (“strawberry marks” or deeper bluish swellings) and port-wine stains (flat, reddish-purple patches).
Pigmented birthmarks occur due to excess melanocytes, ranging from light tan to dark brown or bluish-gray. Examples include café-au-lait spots (flat, light brown patches) and moles (congenital nevi), which can be raised or flat.
Natural Fading of Birthmarks
Some birthmarks fade naturally, common for vascular types. Many hemangiomas (“strawberry marks”) grow rapidly in infancy but shrink and fade by age 5 to 10. Macular stains (“salmon patches” or “stork bites”) on the forehead, eyelids, or neck commonly fade by 12 to 18 months.
Other birthmarks do not fade naturally, remaining permanent unless treated. Port-wine stains, for example, usually persist and may darken or thicken. Most pigmented birthmarks, like café-au-lait spots and moles, do not fade, though their appearance can change with age or sun exposure.
Treatment Options for Birthmarks
Medical treatments can reduce the appearance of birthmarks that do not fade naturally or cause concerns, or address health issues. Treatment choice depends on the birthmark’s type, size, location, and depth. They aim to remove excess cells or vessels, or lighten pigmentation.
Laser therapy is an effective treatment, particularly for vascular birthmarks like port-wine stains. Pulsed dye lasers target blood vessels, shrinking them and lightening discoloration. It is most effective when initiated during infancy. Pigmented birthmarks, like café-au-lait spots, can also be treated with lasers that break down excess pigment.
Surgical excision may be considered for raised moles (congenital nevi) or other cosmetically bothersome or potentially malignant lesions. The procedure involves cutting out the birthmark and closing the skin with stitches. The outcome leaves a scar, whose appearance varies based on the birthmark’s size and location.
Medications can manage birthmarks, particularly proliferating hemangiomas. Oral beta-blockers, like propranolol, reduce hemangioma growth and accelerate involution. They work by constricting blood vessels within the birthmark. For superficial lesions, topical beta-blockers may also be an option.
Cryotherapy uses extreme cold to destroy abnormal cells, applicable to superficial birthmarks. It is less common for large or deep birthmarks but an option for smaller, raised lesions. Other treatments, like sclerotherapy (injecting a solution to shrink abnormal blood vessels), might be used for specific, deeper, or complex vascular malformations.
Deciding on Birthmark Removal
Treating or removing a birthmark involves various factors. Individuals and professionals weigh cosmetic concerns, health implications, and the birthmark’s characteristics. Location plays a role; those on the face or near orifices might impact self-esteem or interfere with vision, breathing, or eating.
Certain birthmarks, though benign, may pose risks like ulceration, bleeding, or, rarely, be associated with underlying medical conditions. For example, large facial port-wine stains can link to Sturge-Weber syndrome, which may affect the eyes or brain. Age is also a consideration, as some treatments are more effective or less invasive during infancy or early childhood.
Consulting a dermatologist or birthmark specialist is important. These professionals diagnose the birthmark type, assess risks, and discuss treatment options. They guide on expected outcomes, potential side effects, and manage result expectations, which vary based on the birthmark and chosen treatment.