All about Birthmarks


Hemangioma before and after surgery.

By George Hoerr, MD

Parents often find imperfections on their baby’s skin. While most are tiny and nothing to worry about, some can alter a child’s appearance or interfere with normal functions. Your pediatrician should evaluate any birthmarks your child has to determine whether a more extensive evaluation or treatment is needed.

Birthmarks can be made up of either pigment cells or blood vessels. Birthmarks made up of blood vessels are called vascular birthmarks.

Common vascular birthmarks include:

  • Macular stains – small, flat, red marks often located on the forehead or the back of the neck. Also known as “stork bites” or “salmon patches,” these usually go away on their own and do not require treatment.
  • Hemangiomas – also known as strawberry hemangiomas. These are only rarely present at birth as a faint red mark, but they may grow rapidly in the first months of life. Then they gradually lose this red color and shrink. Hemangiomas may require treatment depending on their size and/or location on the body.
  • Port-wine stains – flat, pink, red or purple marks that appear at birth, often on the face, arms, and legs, and continue to grow as the child grows. Port-wine stains do not go away and often require treatment.
Common pigmented birthmarks include:
  • Café-au-lait spots – flat spots the color of coffee with milk. One or two anywhere on the body is normal, but several of them – especially if they are larger than a quarter – might be a sign of a genetic disorder called neurofibromatosis.
  • Mongolian spots – blue or purple-colored splotches on the baby’s lower back and buttocks. Over 80 percent of African-American, Asian and Indian babies have Mongolian spots, but they can occur in babies of all races. The spots are caused by a concentration of pigmented cells. They usually disappear in the first four years of life.
  • Moles – small skin marks caused by pigment-producing cells in the skin. Moles can be flat or raised, smooth or rough, and some contain hair. Most moles are dark brown or black, but some are skin-colored or yellowish. Moles can change over time and often respond to hormonal changes.

By Dr. Hoerr practices with CHKD Health System’s Children’s Plastic Surgery.

At CHKD, pediatric plastic surgeon George Hoerr, pediatric otolaryngologist David Darrow and pediatric dermatologist Judith Williams collaborate to diagnose and treat vascular birthmarks. Patients can be referred by their pediatrician for both evaluation and treatment to the Hemangioma and Vascular Birthmark Program at CHKD in Norfolk and at the CHKD Health and Surgery Center at Oyster Point in Newport News.