What you Need to Know about Birthmarks

Allow me to share with you my own personal experience about birthmarks. I was born with a birthmark on my left arm about the size of a 5-peso coin. It was dark brown and had hair, much like Gretchen Baretto's, only uglier and more visible. In grade school, I used to be very shy about it, always wearing shirts with sleeves that would cover it up. It gradually grew in size, in proportion to my growth as a child, until its present size of 8cm (about the size of a dalanghita). I don't exactly remember when, but it seems that I outgrew being embarrassed by this huge black thing on my arm. It became a normal part of my body. I would only remember that I have it when people point it out to me, "EEEK!! Ano yan?!" I just smile and tell them it’s my lucky charm.

No one really knows the cause of birthmarks. Our elders would say that the mother’s diet during pregnancy will have an effect on the baby’s skin color; however, this is not proven to be true. Some also say that an injury or an illness could cause the discoloration on baby’s skin, but, just like the other myths, this is also unproven.  

It is normal for moms to be worried about their baby’s birthmark, especially if it is the first time they see it. Others might be uneasy at the sight of an unusual-looking birthmark. While most of birthmarks are harmless, some are associated with other health problems, so it is best to consult your pediatrician so that she can determine if the birthmark is benign or otherwise.

There are two types of birthmarks: vascular and pigmented. Vascular means there are blood vessels involved.  Examples of these are hemangiomas, port wine stains and macular stains. Pigmented birthmarks are those that involve a skin colorant, or a pigment, examples of which are Mongolian spots, café-au-lait spots and moles.

 

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Vascular Birthmarks

Hemangiomas – These are red or bluish marks on the skin usually on the face or neck area, usually appearing a few days or weeks after birth. They can be either flat or raised and are caused by a collection of blood vessels, which give it its characteristic color. Some may grow in size during the first 6 months to one year. These should disappear eventually as the child grows older; however, there are some cases where the hemangioma continues to grow. These might cause impingement of body functions such as swallowing or breathing, so surgery might be needed to correct them.

Macular Stains – These are faint red marks usually on the forehead or the eyelids, at the nape or the back, on the nose or the upper lip. They appear immediately at birth and fade by the first or second year. Legends in the US and UK tells that storks are the bearer of babies, and deliver them at the doorstep, hence the name stork bites.  Other names for this birthmark are salmon patches and angel kisses.

Port-wine-stains - Port wine is a dark red wine, and the birthmark of that name is very similar in color. They usually start out flat at birth, but tend to be nodular by late adulthood. They can appear on any part of the body, usually on the extremities.


Pigmented Birthmarks

Mongolian Spots – These large, flat, bluish-to-gray patches which normally appear on the buttocks, lower back and sometimes the thighs are usually harmless and disappear by age 2-3 years. It has been said that a “balat sa pwet” brings bad luck, but no studies have been made to neither prove nor negate this Filipino belief.

Café-au-lait spots – These spots are the color of coffee and milk, and are very common. If it appears as a single birthmark, it is usually harmless. However, if there are several birthmarks, about the size of a 1-peso coin, please have your child checked, as these could be signs of a genetic disorder of the nerves called neurofibromatosis.  

Moles (congenital nevus, hairy nevus) – A mole is a common term for the medical word nevus (plural: nevi). Most are tiny brown dots while others are large, and all the sizes in between. They can also be flat or raised, dark brown or black, or may have hair growing out of them. Large or giant congenital nevi have the potential to develop into a skin cancer called a melanoma later in life.  

 

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With this information, I had my giant hairy nevus checked. I even had a punch biopsy done to check the actual cell structure of the birthmark. Thank God it was just a benign (harmless) nevus. My doctor advised me to have it checked every 3-5 years to monitor for melanoma.  

More often than not, birthmarks, especially those on the face and neck area, are an aesthetic concern. Even if the birthmark is benign, there is much emotional distress attached to having a disfiguring birthmark as kids could be picked on in school. If your child is old enough to understand, explain to him that birthmarks are part of his being a unique individual. If you are concerned about his health, bring him to a doctor, and don’t be afraid to ask. Often, your child will need to feel accepted despite his “flaw,” so give him that love and concern he deserves. If it causes too much distress, you might want to ask your doctor about options to remove or lighten the birthmark, but otherwise, allow your child to cope with his uniqueness in a healthy way.



Photo by bencrowe via flickr creative commons


Sources:
•    Nelson’s Textbook of Pediatrics, 18th ed.
•    “Birthmarks” kidshealth.org
•    Glenda Ethington. “Types of Birthmarks” birthmarks.com