Birthmarks Birthmark is a broad term used to describe skin irregularities that are present at birth or appear later in life. Most birthmarks do not indicate a medical problem and some will resolve spontaneously over time. Some birthmarks may present a cosmetic problem, a medical problem, or be associated with future medical issues. Causes: Though the name may imply otherwise, not all birthmarks appear at birth, but can develop hours, days, weeks, or even years later. Birthmarks are caused by an overgrowth of structures or cells normally found in the skin. For example, extra pigment could cause a large mole at birth. Additionally, blood vessels could cause “angel kisses” or “stork bites” on the forehead, eye lids, back of the neck, scalp, or lower back. Large irregular blood vessels can cause “strawberry” hemangiomas, port wine stains, or larger more significant hemangiomas. Symptoms: The two most common birthmarks are vascular and pigmented birthmarks. When blood vessels grow abnormally, they form vascular birthmarks and are usually pink or red in color. The color of larger or deeper vascular birthmarks may range from red, purple, to blue. Pigmented birthmarks are caused by extra pigment in the skin and may vary in color from brown, blue, to slate gray. Birthmarks can be different shapes and sizes, flat or raised. A birthmark should not cause any pain, but if it hurts, itches, bleeds, becomes infected, or interferes with vision or eating, the birthmark should get immediate attention from your dermatologist. Treatment: Most birthmarks are harmless and will require no medical intervention. Your dermatologist should examine large moles that were present at birth annually. In addition, large gray patches present at birth on the trunk or face should be documented in the patient’s medical record. Discuss the prognosis and treatment of raised or large hemangiomas with your dermatologist. Birthmarks that appear in childhood as rough patches or warty lines on the neck, scalp, or extremities should also be brought to the attention of your dermatologist. *Results may vary per patient.