BIRTHMARKS IN CHILDREN
Birthmarks are any unusual marks or blemishes present on an infant’s skin at birth. Almost 50 percent of all infants are born with red or salmon-colored marks on the mid-forehead, upper eyelids, upper lip, or back of the scalp and neck. These marks, which are sometimes quite extensive, fade and disappear during the first years of life.
Many black, Oriental, and Caucasian babies who are destined to become brunettes have smooth, blue-black marks on their backs and buttocks. These birthmarks are called “Mongolian spots.” They are often mistaken for large bruises. They gradually disappear and are almost always gone by adolescence.
One in ten babies develops one or more strawberry marks during the first month of life. These are usually not visible at birth, or they may look like slightly pale spots on the skin. As the child grows, the marks become brilliant red. They are often raised, and vary in size from 6 to 50 millimeters across. They may appear on any part of the body and increase in size for weeks or months. The strawberry marks then gradually fade and shrink. In almost all instances, they are gone by age five or six years.
Two uncommon but permanent birthmarks are port wine marks and pigmented moles. Both may be tiny or large and may appear anywhere on the skin. They grow in proportion to the growth of the child’s body. Port wine marks are smooth, flat, and purplish. Pigmented moles are brown to black, are often slightly raised, and may have dark hairs.
Signs and symptoms
Each type of birthmark is recognized by its typical appearance and behavior. Mongolian spots are often mistaken for bruises, until it becomes obvious that the spots are not fading, as bruises would fade.
In most cases, no treatment is necessary. Strawberry marks are made up of countless, closely packed capillaries (tiny blood vessels). They should be protected from scratching or rubbing, which can cause bleeding. If bleeding occurs, it can be controlled by pressing lightly with gauze directly on the bleeding point. If desired, port wine marks can be hidden by covering cosmetics when the child is older.
Precautions
• Strawberry marks occasionally become infected if the overlying skin is broken. If there is any discharge, odor, or redness of the skin surrounding a strawberry mark, call your doctor.
• Strawberry marks rarely require treatment; in almost all instances, it is best to allow them to disappear by themselves. In rare situations, they may cause anaemia or bleeding that requires correction.
Medical treatment
The doctor may decide to surgically remove some pigmented moles. Strawberry marks rarely require surgical removal, irradiation, or oral steroids. Port wine marks cannot be treated satisfactorily at present, but laser treatment is in the experimental stage and appears promising.
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