Types of Birthmarks and How to Identify Them

Birthmarks get their name because many show up a “mark” or different skin color at birth. Birthmarks come in many shapes and sizes. Some are present at birth, while others develop later. Most are harmless and some even disappear. Rarely, birthmarks are associated with health problems, but talk to your doctor, especially if one bleeds, hurts, itches or is infected.

The cause of most birthmarks is unknown, but the two main types are vascular and pigmented.

Vascular Birthmarks
Vascular birthmarks are blood vessels that are too wide or too many. Macular stains, also known as salmon patches, angel kisses or stork bites, are pink spots on the eyelids, neck, head, nose or lip that may become more notable with crying. Most fade in the first few years.

Hemangiomas are superficial (red) or deep (blue). They grow during the first six months but disappear by 5-9 years. Most are on the head or neck, and they can be serious if they interfere with sight, breathing or feeding. They can be treated with injected or oral steroids. Some leave a scar that can be fixed by plastic surgery.

Port-wine stains look like spilled wine, and are usually on the face, neck, arms and legs. They grow and darken as the child grows. Treatment is laser removal or coverage makeup.

Pigmented Birthmarks
Pigmented birthmarks are the most common birthmarks, and include the light brown, café-au-lait (coffee with milk) spots. If there are several larger than a quarter, this can be a sign of neurofibromatosis (disorder of abnormal nerves). They can be removed with lasers but often return.

Mongolian spots are flat, blue-gray patches on the back or buttocks and common with darker complexions. They usually disappear but can be confused for bruises.

Moles are dark spots that can be tan, brown or black, feel flat or raised, and may have hair. Moles should be checked for change in color, texture or size, which may be a sign of skin cancer (melanoma). They can be surgically removed.

Talk to your kids about any birthmarks they have. It is important to speak openly about the birthmark to help them feel comfortable explaining their unique feature. 

Dr. Meaghan Keller is a pediatric resident at Carolinas Medical Center, and Dr. Daniel Neuspiel is a board-certified pediatrician and director of ambulatory pediatrics at Levine Children’s Hospital.