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Types of Birthmarks

By Glenda Ethington

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There are many types of birthmarks. Some are present at birth, and others appear soon afterward. The following list should assist in recognizing some of the more common birthmarks, and the treatments most often used, where applicable. This serves as an informational guide, and is not intended as a diagnostic tool. For a proper diagnosis and treatment plan, please consult a qualified vascular birthmark specialist.

Arteriovenous Malformation (AVM)
AVM’s are usually present at birth.
Sometimes they don’t appear until adulthood.
Can be acquired after direct trauma.
Complex mass of veins and arteries – vessels enlarge and thicken and increased blood flow to the area results.
Firm mass - when pressed feels soft and gel-like, can feel pulse or heartbeat, can cause pain.
Lips, head and neck are common areas affected.
Can also occur in the brain, brain stem or spinal cord.
Angiography used to detect AVM.
Treatment by skilled physician only – combination of embolization and surgical excision usually recommended.

Café au lait Spot
Flat patches.
Occur anywhere on body.
Tan to light brown.
If child has several spots, consult doctor.

Cavernous Hemangioma
Bluish or bluish-red in color.
Lumpy mass.
Borders not visible as with other hemangiomas.
Grows fast during first 6 months – then slows95% disappear by 10-12 years of age.
Treatments are the same as for strawberry hemangioma.

Congenital Pigmented Nevi
Appear as hairy moles.
Can vary in color – light brown to dark/almost black.
Giant pigmented nevi are not as common as small ones.
Large nevi should be examined for malignancy.

Reddish in color.
83% occur on the head and neck area.
Occur 5 times more often in females.
Some visible at birth or within 1 to 4 weeks after birth.
Can grow for up to 18 months, then start to involute.
Involution can last 3 – 10 years.
Some can be life threatening – interfere with eating, breathing, seeing, hearing, speaking, cause strain on heart.
Internal hemangiomas can be very dangerous and hard to detect – some internal lesions require no treatment and shrink in time.
If more than 3 hemangiomas are present, entire body scan should be done.

Lymphatic Malformation
Excess fluid accumulates causing lymphatic vessels to enlarge.
Sponge-like masses of abnormal channels and spaces containing clear fluid.
Leakage from skin can occur – can lead to cellulitis.
If lymph vessels in face affected, face will swell.
Can occur anywhere on body but most common in head and neck area.
In mouth area, looks like frog eggs.
Can increase and grow with the individual.
Only skilled surgeon should treat.
MRI and CAT scan are used to diagnose.
Laser treatment, sclerotherapy, and surgery used to treat or remove.

Mongolian Spot
Blue or slate grey in color.
Resemble bruises.
Common in babies of races with dark skin (African/African-American, Mediterranean, Asian or Indian descent).
Can be found on buttocks, back and sometimes legs and shoulders.
No treatment needed – usually fade over time.

Port Wine Stain or Nevus Flammeus
Red or purple in color.
Can appear anywhere on body.
Most are readily visible at birth – congenital.
Can be flat or slightly raised.
Usually permanent.
Laser treatment used to help reduce color, and to improve the texture of the skin (helps to prevent nodules and pws growth which can affect lips, gums and other tissues).

Salmon Patch or Nevus Simplex
Sometimes called “angel kiss” or “stork bite”.
Most often found on the nape of the neck.
Also appear on the forehead, upper eyelids, and around the mouth and nose.
More than 95% lighten and fade completely.

Strawberry Hemangioma
Vascular malformation.
Red, soft, raised appearance.
Size varies.
May be present at birth or first few weeks thereafter.
Will grow, but start to fade (involute), turn grey in color.
Usually disappear between ages 5-10.
Surgery might be necessary to remove – depending on size and location of lesion.
Other treatments - compression and massage, steroids, X-ray therapy, laser therapy, cryotherapy, or injection of hardening agents.

Venous Malformation
Abnormality of the large deep veins, sometimes mistaken for hemangioma.
Can be deep or superficial – deep can have no color but show a protruding mass.
Jaw, cheek lips and tongue are most common areas affected.
Soft to the touch, color disappears and empties when the lesion is compressed.
When a child cries or is lying down the lesion expands and the vessels fill and the color becomes more intense.
Slow, steady enlargement – it will grow – some things cause more rapid growth such as serious sickness, trauma, infection, hormone changes (puberty, pregnancy, menopause).
Partial removal is not recommended, as these lesions will grow back.

Venous Stain
Type of flat birthmark that is bluish in color and comprised of enlarged venular vessels – sometimes blebs appear and can pop and bleed.

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