By: Nick Nguyen, MD, FAAP & Sheilagh M. Maguiness, MD, FAAD, FAAP
Café-au-lait
Café-au-lait means “coffee with milk,” which describes the light brown color of these common birthmarks. As many as 20-30% of people have one. The marks are flat and usually round or oval shaped. Most are smaller than a child’s palm and have smooth borders. They are visible at birth or develop very early in life.
Most café-au-lait spots are harmless. They are unlikely to turn into skin cancer, but may become darker with more sun exposure. A large café au lait spot with jagged borders may be linked with a rare genetic condition called McCune-Albright syndrome. Multiple café-au-lait spots can be a sign of other conditions, including one called neurofibromatosis. If your child has a large café-au-lait spot, more than 5 spots, or spots in the armpits/groin, talk with your pediatrician about them.
Dermal Melanocytosis
These are the most common birthmarks in babies with highly pigmented skin. They are seen in 85% of Asians, 96% of blacks & 46% of Hispanic babies at birth. They are usually located on the lower back and bottom, but some babies may have spots on different areas of the body. These birthmarks may be a mix of colors including brown, gray, blue and black. Their unique color comes from having pigment in different layers of the skin.
Most dermal melanocytosis birthmarks, which used to be called Mongolian spots, gradually fade. Many disappear by the toddler years. The majority of them are harmless and do not need treatment. In rare cases, these birthmarks may be associated with genetic conditions. If your baby has other health problems and several spots, please talk with your pediatrician.
Pigmentary Mosaicism
Mosaicism is a word that means two sets of DNA, or genes, are present in the same person. In pigmentary mosaicism, different genes might affect the color of the skin. These changes can be subtle or very large. Pigmentary mosaicism birthmarks have unique patterns including lines and swirls. With sun exposure, areas can become lighter or darker.
Even though the genetic change involved with pigmentary mosaicism is present at birth, the affected skin may not turn color until later in life. Sometimes sun exposure can cause this to happen. These changes can give the illusion that the birthmark is “spreading.” In most children, pigmentary mosaicism is harmless. A small number of may have problems with the bones, eyes or brain especially if their birthmark covers a large area of their body, so your pediatrician may recommend some tests.
Remember:
Most birthmarks are harmless and are part of what makes your child unique. But some types of birthmarks can come with potential health problems or may cause some children to feel self-conscious. That’s why it is important to talk with your pediatrician about any unusual marks or changes on your child’s skin. There are safe and effective treatment options available today that are especially effective when started early.
Last Updated 3/11/2019
Source American Academy of Pediatrics Section on Dermatology and Society for Pediatric Dermatology (Copyright © 2018)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
