Medicines for Birthmarks

What it is

Birthmarks are coloured marks on the skin that are present at birth or develop soon afterwards. They are common and, in the great majority of cases, harmless. There are two main types: vascular birthmarks, which are caused by abnormal or extra blood vessels in the skin and are usually red, pink, or purple (examples include "salmon patches" or "stork marks", strawberry marks or infantile haemangiomas, and port wine stains); and pigmented birthmarks, which are caused by clusters of pigment cells and are usually brown, grey, or bluish (examples include café-au-lait spots, Mongolian blue spots / congenital dermal melanocytosis, and congenital moles). Birthmarks vary widely in appearance, size, and location, and behave differently depending on the type — some are present from birth, while others (such as strawberry marks) appear in the first weeks of life; some fade or disappear over time (for example many salmon patches and strawberry marks fade during childhood), while others (such as port wine stains and café-au-lait spots) are usually permanent. Most birthmarks cause no problems and need no treatment, and they are usually just a normal, harmless variation. However, some birthmarks may occasionally be associated with other conditions, or may cause problems depending on their type, size, or location (for example if they affect vision, breathing, or feeding, or if a haemangioma bleeds or ulcerates), and some people wish to have a birthmark treated for cosmetic reasons. Treatments are available for birthmarks that need or would benefit from them (such as certain laser treatments for port wine stains, or medicines or other treatments for some haemangiomas). The key messages are that most birthmarks are harmless, that many fade over time, and that assessment and treatment are available for those that need them, so a birthmark that is changing, causing problems, or of concern should be checked.

How it is treated

Most birthmarks are harmless and need no treatment, so the approach is usually reassurance and, where relevant, assessment and treatment for birthmarks that need or would benefit from it. Many birthmarks are simply monitored, as some fade or disappear over time (for example salmon patches and many strawberry marks fade during childhood), and most cause no problems. A doctor can assess a birthmark to identify its type, reassure about its nature, and advise on what to expect and whether any treatment or monitoring is needed. Treatment is available for birthmarks that require it or where it would help, depending on the type: for example, laser treatment is used for some vascular birthmarks such as port wine stains (and can help lighten them); certain haemangiomas (strawberry marks) that are large, in problematic locations, or causing complications may be treated with medicines or other treatments; and other treatments (including surgery in some cases) may be considered for particular birthmarks. Some birthmarks are treated for medical reasons (for example if they affect vision, feeding, or breathing, or if a haemangioma bleeds or ulcerates), and some people choose treatment for cosmetic reasons, particularly for birthmarks in visible areas that affect confidence. A minority of birthmarks may be associated with, or a marker of, other conditions, so assessment is helpful where there is any concern (for example large or numerous café-au-lait spots, or birthmarks in certain locations). The reassuring messages are that most birthmarks are harmless and need no treatment, that many fade over time, and that assessment and effective treatments are available for those that need them. It is worth having a birthmark checked if it changes in an unusual way, causes problems (such as bleeding, ulcerating, or affecting vision, feeding, or breathing), is of concern, or if treatment is wanted — and, as a general point, any new, changing, or unusual skin lesion (as opposed to a long-standing birthmark) should be checked to make sure it is nothing to worry about.