The Armchair Dermatologist (a.k.a. our Blog...)

Tuesday, January 3, 2017

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Birthmarks: To Remove or Not to Remove?

Birthmarks are part of, well, birth! Nearly 80 percent of all people have some kind of birthmark. Some of these disappear with age, some appear well after we are born, and many remain with us for as long as we choose to take them along for the ride. The first step in a decision of whether or not to remove a birthmark is accurate identification.

Birthmarks come in two main categories: vascular birthmarks and pigmented birthmarks.

Vascular Birthmarks

Your vascular system involves your heart and the blood vessels that take your blood on the journey of your life as they move through every part of the body. When a collection of extra blood vessels divides and grows, they form a clump that becomes noticeable on the skin. That’s your vascular birthmark staring the world down. These can include:

Salmon Patches – typically flat with a pink or salmon color to them. They do sometimes fade over time. The two types are:

  • Stork Bite: salmon patch on the back of the neck
  • Angel’s Kiss: salmon patch on the face

Hemangiomas – Best guess at pronouncing that? He-man-jee-O-muh -- quite the mouthful. Often raised and usually bright red, these birthmarks occur all over the body, especially the face, back, chest and scalp. These can grow during the first year of life and then will typically shrink, even becoming flat, sometimes leaving behind a very light mark.

  • Strawberry Hemangioma: Exist on top of the skin and look bright red like fruit.
  • Deep Hemangioma: These live below the skin and cause it to bulge with a darker purplish color


Public birthmark images from the American Academy of Dermatology


Port-Wine Stains – Officially called “nevus flammeus” and commonly referred to as a “firemark,” this type of birthmark usually will not shrink with age. As the name implies, these look like someone spilled a port red wine all over the face or body. A famous example of the port-wine stain exists on the head of former Soviet leader, Mikhail Gorbachev. These birthmarks tend to grow darker as children age.

Pigmented Birthmarks

When excessive pigment or color collects in one area of skin, it creates a visible, sometimes raised, spot. That’s the pigmented birthmark. These can include:

  • Moles – Who first comes to mind when you see the words, “beauty mark?” You’re among strong company if you answered Cindy Crawford, who wanted to have the birthmark removed as a child, according an interview with Vogue, but was prompted by her mother to keep it. Seems to have worked out just fine for her, eh? Moles are typically small, round brown spots and not all moles are birthmarks. You should pay particular attention to any mole that changes shape, size or color over time and have it examined.
  • Mongolian Spots – Appearing more commonly on the backs and rear-ends of babies with darker skin, these birthmarks usually have a blue and gray tone to them. They can resemble bruises in appearance and vary in size.
  • Cafe-au-lait Spots –This type of birthmark is often oval-shaped. The French means “coffee with milk” and these can be coffee-colored on darker skin and light brown on lighter skin. They are known to fade slightly, though not entirely, with age.

Birthmark Removal Options

We’ve addressed a few options for removing birthmarks in a previous post. Newer technology like the Pulse Dye Laser can be used over multiple sessions to effectively reduce or remove red birthmarks like port-wine stains. Other procedures for lighter birthmarks might require surgical excision. The Q-switched Nd-Yag laser used for certain birthmark removals can also be used for tattoo removal. Insurance does often cover many of these procedures and you can investigate pricing here.

The decision to remove a birthmark hits people at different times in their lives. Part of the empowerment of modern technology gives us the option to proceed with keeping or removing the un-chosen marks given to us at or just after birth. The choice is yours and our team can help you make an educated decision about the procedures involved, the cost of treatment and how to choose age-appropriate timing for birthmark removal.

What did we miss? Reach out to us. Bobby Buka, MD and team would love to hear your comments on Twitter, Facebook and Instagram.