Birthmarks in Children

A birthmark is an area of skin that looks different from the surrounding skin. Birthmarks are usually present at birth or appear shortly afterwards and can vary in colour, size, and shape. Many birthmarks change over time as a child grows.

A dermatologist can help identify the type of birthmark, explain what to expect over time, and advise whether monitoring or treatment is appropriate.

Yes. Birthmarks are common in childhood, and most are benign. Many do not cause medical problems and can be safely monitored. The significance of a birthmark depends on its type, location, and how it behaves over time.

Birthmarks are broadly divided into two main groups:

• Vascular birthmarks, which relate to blood vessels

• Pigmented birthmarks, which relate to skin pigment

Common birthmarks seen in children include:

• Infantile haemangiomas

• Port wine stains

• Salmon patches (“stork marks”)

• Congenital melanocytic naevi (congenital moles)

• Café-au-lait macules

Each type behaves differently and may change over time.

No. Many birthmarks do not require treatment and can be managed with observation alone. Treatment may be considered if a birthmark is growing, affecting function, located in a sensitive area, or likely to cause long-term concerns. Management decisions are individualised.

Different birthmarks change in different ways as a child grows. Understanding how a birthmark typically behaves over time helps guide management decisions and determine when monitoring is sufficient and when treatment may be beneficial.

Some birthmarks:

·       Are present at birth and remain relatively stable

·       Appear shortly after birth and change during infancy

·       Grow in proportion with the child as they grow

·       Gradually fade or improve over time

Knowing what is expected helps clinicians and families understand what to watch for, recognise when a birthmark is behaving differently, and identify when review is important.

An infantile haemangioma is a common type of vascular birthmark made up of extra blood vessels in the skin.

Infantile haemangiomas:

• Are often not visible at birth

• Typically appear in the first few weeks of life

• Go through a period of rapid growth during the first few months

• Then stabilise and gradually shrink over several years

Many infantile haemangiomas improve on their own and can be safely managed with observation alone.

However, haemangiomas located in functionally or cosmetically sensitive areas — such as around the eyes, nose, lips, airway, or nappy area — may require prompt assessment. Early treatment in these cases can help reduce the risk of complications such as ulceration, interference with function, or long-term skin changes.

In selected situations, medical treatment, including oral medications, may be recommended, with close specialist monitoring.

A port wine stain is a vascular birthmark that is usually present at birth and tends to persist over time. While many are isolated and benign, some port wine stains may be associated with underlying complications depending on their location.

Port wine stains involving certain areas of the face may be associated with neurological or ocular complications, while those affecting a limb may be associated with overgrowth of the underlying soft tissue or bone. Recognising these patterns early allows appropriate assessment, monitoring, and referral where needed.

Some port wine stains benefit from early treatment, including laser therapy, particularly to reduce progression, complications, or long-term cosmetic impact. Management decisions are guided by location, behaviour, and associated risks.

Assessment involves identifying the type of birthmark and considering factors such as size, location, growth pattern, and the child’s age and overall health.

Management may include:

• Clinical monitoring and photography

• Medical or laser treatment where appropriate

• Referral for further investigations in selected cases

Treatment decisions are tailored to the individual child and guided by the expected behaviour of the birthmark over time.

Birthmarks can have psychosocial effects, particularly when they are visible or change in appearance over time. These concerns may affect both the child and their family.

Assessment often includes discussion about:

• Parental concerns and expectations

• A child’s awareness and confidence as they grow

• Potential future cosmetic or emotional impacts

A dermatologist can help provide information, answer questions, and support families in making informed decisions about monitoring or treatment.

At Ready Dermatology, North Shore Health Hub, St Leonards, our dermatologist provides assessment and management of birthmarks in accordance with Australian clinical guidelines. Care is individualised and considers the type of birthmark, its natural history, location, and the child’s overall wellbeing.