- ● Birthmarks, also called beauty marks affect both men and women.
- ● The incidence and prevalence vary with the type of birthmark.
- ● They may occur due to either malformation or proliferation of pigment cells (i.e. melanocytes) or capillaries during fetal development.
- ● Birthmarks can occur due to positive family history or acquired.
- ● Dermatologists can help you manage your birthmarks. Treatment duration and modality depend on type, size, and location of the mark.
- ● Untreated birthmarks can have a variable course. They can grow in size, and/ cause pain, bleeding, itching, inflammation, ulceration or can resolve spontaneously on their own with age.
What Are Birthmarks?
Birthmarks are the areas of discoloured skin with or without alteration in skin texture formed due to an error in the organisation of skin cells or blood vessels during the time of fetal development.
Birthmarks can appear on any area of the body. Some of them appear above the skin surface, while some form under the skin. Birthmarks occur and are usually apparent at birth or in early childhood (first five years of life). In a few cases, small-sized marks may not be noticeable at birth until they grow more prominent at a later age.
Types & Classification Of Birthmarks:
You can classify birthmarks into vascular (derived from blood vessels) or pigmented (derived from pigment cells, i.e. melanocytes that control skin colour by the production of a pigment called melanin).
- Naevus flammeus (Port Wine Stains): The medical term for port wine stains (PWS) is naevus flammeus. Most PWS or firemarks affect the face but may involve any area of the skin. They begin as flat, faint red or purple-pink mark at birth. It often turns dark red or purple in adults, and the overlying skin becomes thicker than the surrounding one. Lumps can form, which may bleed readily. Lips or nose if involved may appear swollen. It does not go away on its own. Approximately three in every 1,000 babies (0.3%) have a port wine stain at birth.
- Macular stains – Stork bites or angel’s kiss: Medically referred to as Nevus Simplex, is a flat, pink, irregular shaped area of skin. The macular stain or salmon patch is termed as “angel’s kiss” when they appear on the front (forehead, bridge of the nose, eyelids, upper lip), and “stork bites” when they occur on the back (nape of the neck). The prevalence varies from 20-60 %. Majority of the macular stains resolve spontaneously on their own within the first year of age.
- Hemangiomas: Hemangiomas are lumpy, reddish-pink bulges on the skin. Some are superficial and appear on the surface of the skin (“strawberry marks”), while others form deeper under the skin surface. More than 50 % affect the head and neck. Usually, they involute with age (90% by nine years). The anatomical location determines the risk of complications, and they may be associated with specific syndromes.
- Dermal melanocytoses: Dermal melanocytoses are flat, bluish-grey areas of skin that look like bruises. Depending on the area of the body on which they appear, dermatologists may classify them as Mongolian spots, Nevus of Ota or Nevus of Ito. They occur due to abnormal persistence of pigment cells or melanocytes in the deeper layers of skin.
- Congenital melanocytic nevi: Congenital melanocytic nevi (CMN) are flat or raised birthmarks that range from light brown to black and can be of variable shapes and sizes (less than 1.5cm to more than 20 cm). Some nevi even have hair growing out of them. 1 in 100 people (1%) has one or more CMN at birth. Usually, they become paler in the first or second year of age, but in a few cases, they may indicate specific syndromes.
- Café-au-lait spots: Cafe-au-lait macules (CALM) are tan or light brown flat spots that are usually oval. Their incidence varies with race (0.3%-18%). Six or more such spots may be a sign of neurofibromatosis.
What Are The Causes Of Birthmarks?
Medical science has not explained the reasons for birthmark formation entirely yet. Most occur by chance alone and are not associated with other underlying medical problems. Some birthmark types can occur as part of a larger group of medical conditions called a syndrome.
- Vascular birthmarks: Vascular birthmarks occur due to improper formation of blood vessels/capillaries—there may be many clustered in an area, or they may be wider than usual.
- Pigmented birthmarks: Skin cells called melanocytes produce the pigment called melanin. Pigmented birthmarks occur due to proliferation or abnormal persistence of pigment cells in an area of the skin.
Diagnosis, Exams & Tests
A dermatologist will perform a diagnosis in the form of a physical examination of the lesion/mark. She may also use a dermascope wherever required. In case of deeper marks, your doctor may recommend imaging tests (Ultrasound, CT scan, MRI) or a skin biopsy to confirm the diagnosis.
Are You At Risk?
Most birthmarks are harmless. Some even fade or shrink over time. However, in rare instances, birthmarks may impede healthy development or body functioning or may be linked to other medical problems.
Strawberry marks at times turn into open sores due to ulceration or become infected. A reasonably common birthmark type, the melanocytic nevi, can rarely transform into cancer.
Prevention and Management
Persons with birthmarks should monitor and take note of any changes in colour, size, or texture of their skin lesions. You should consult a dermatologist immediately in case of any pain, bleeding, itching, or inflammation of the mark/lesion.
A dermatologist can remove birthmarks. Usually, the treatment method for removing a particular birthmark depends on the type, size, severity, location and more. The most common types of laser used for reducing birthmarks are:
- Q-switched Nd:YAG Lasers for pigmented birthmarks
- Pulsed dye laser for vascular birthmarks
Birthmarks are rarely life-threatening. Only marks that are functionally deforming or exhibiting unwanted symptoms need medical treatment. A dermatologist must examine large vascular or dermal lesions to determine the risk they pose and treat them accordingly.
If you have birthmarks on your body, it is critical to consult a dermatologist today to rule out any health complications in the future.
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