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Birthmarks & Hemangiomas

Dark-Pigmented Birthmarks (Nevi or Moles)

Nevi, or moles, are either congenital (present at birth) or acquired. Composed of so-called nevus cells, these spots are often dark brown or black.

Congenital Nevi

Small nevi (less than three inches in diameter) appear at birth and are relatively common, occurring in about 1 out of every 100 newborns. They tend to grow with the child and usually don’t cause any problems. Rarely, however, these moles may develop into a type of serious skin cancer (melanoma) at some later time. Therefore, while you don’t have to worry about them right away, it’s a good idea to watch them carefully and have them checked by your pediatrician at regular intervals or if there is any change in appearance (color, size, or shape). She may refer you to a pediatric dermatologist who will advise you on removal and any follow-up care.

A much more serious type of nevus is a large congenital one that varies in size from 3 inches to as the size of a book. It might be flat or raised, may have hair growing from it (although small, insignificant nevi sometimes also have hair), and can be so large that it covers an arm or a leg. Fortunately, these nevi are very rare (occurring in 1 out of every 20,000 births). However, they are much more likely than the smaller ones to develop into a melanoma, so early consultation with a pediatric dermatologist is advisable.

Acquired Nevi, or Moles

Most Caucasian people develop ten to thirty pigmented nevi, or moles, throughout the course of their lives. They usually occur after the age of five, but sometimes develop earlier. These acquired moles are seldom a cause for worry. However, if your child develops one that’s irregularly shaped (asymmetrical), has multiple colors within its structure, and is larger than a pencil eraser, ask your pediatrician to examine it.

One final note: Probably the most common acquired dark spots on the skin are freckles. They can appear as early as ages two to four years, are found more often on parts of the body exposed to the sun, and tend to run in families. They often become darker or larger during the summer and are less prominent in the winter. They represent no danger and should not cause concern when they occur in children.

Blood Vessel Birthmarks On The Skin (Hemangiomas of Infancy)

Your young infant has a red raised bump growing rapidly on his forehead and a flat dark-red patch on one arm. They’re unsightly, but are they harmful?

These birthmarks occur when a certain area of the skin develops an abnormal blood supply before birth. This, in turn, causes the tissue to enlarge over the course of several weeks or months and become reddish blue. When the condition involves only the capillaries (the smallest blood vessels), the birthmark is called a “hemangioma of infancy” (or, more simply, “hemangioma”). When the blood vessels are larger, they may be of a different type and have a different appearance.

Flat Angiomata (Stork Bites)

These most common blemishes on the skin appear most often on the eyelids or back of the neck. They usually disappear over the first months to years of life and are not serious.

Hemangiomas of Infancy

Hemangiomas of infancy (which used to be called strawberry patches) are found in at least 2 of every 100 babies born. Although frequently they are not noticeable at birth, they appear within the first or second month of life as a red patch or raised dot. They can occur on any area of the body, but are seen most commonly on the head, neck, and trunk. Usually a child has just a single hemangioma, but occasionally these marks will be scattered over several parts of the body.

If your infant develops a hemangioma, have your pediatrician examine it so he can follow its course from the start. During the first six months of life, hemangiomas usually grow very rapidly, which can be quite alarming. But they soon stop enlarging and often flatten or even disappear by the time the child is nine years old.

Quite often, the large reddish-purplish appearance of these birthmarks so upsets parents that they want to have them removed immediately. However, since the vast majority will gradually reduce in size over the second to third year of life, it’s generally best to leave them alone. Studies have shown that when this type of hemangioma is left untreated, few complications or cosmetic problems result.

At times, hemangiomas may need to be treated or removed—namely, when they occur close to vital structures, such as the eye, throat, or mouth; when they seem to be growing much faster than usual; or when they are likely to bleed profusely or become infected. Such conditions are uncommon, but require careful evaluation and management by your pediatrician and pediatric dermatologist. In some cases, hemangiomas on the face are removed in infancy because of the social stigma from having this facial birthmark and because of only minor scarring that occurs in this age group; this is a decision that can be made with your pediatrician and pediatric dermatologist, as well as with the plastic surgeon who would perform the procedure.

Very rarely, hemangiomas are found in large numbers on the face and upper trunk. On such occasions, hemangiomas also may be located on organs inside the body. If this is suspected, your pediatrician may need to conduct further tests.

Port Wine Stains

Port wine stains are flat malformations of small blood vessels, usually present at birth. They are dark red and often found on the face or limbs (usually only on one side of the body), although they may occur anywhere. Unlike hemangiomas, port wine stains don’t go away, although they sometimes fade. Even so, they rarely cause any problems. On occasion, however, if they are found on the upper eyelid and/or forehead, there is a chance of a related problem in the underlying brain structures (a disorder called Sturge-Weber syndrome). If the birthmark is located immediately around the eye, there is a possibility that glaucoma may develop in that eye.

Port wine stains should be examined from time to time to evaluate their size, location, and appearance. If your child is very unhappy with this birthmark, a special covering makeup can be used. Laser treatment has been successful in many cases, but other types of surgery are rarely recommended.

Last Updated
Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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