Birthmarks are coloured marks on the skin that develop before birth or soon after. They may be raised or flat, and can present in various colours such as brown, black, pink, red or purple. Birthmarks are broadly divided into vascular (i.e. they occur from blood vessels that did not form properly) or pigmented ones.
Symptoms
This presents as a large purplish or reddish patch that most commonly occur on the face. While they are usually flat at birth, they may deepen in colour and become raised with time. Port wine stains do not shrink or disappear without treatment. Occasionally, port wine stains may be associated with a condition known as Sturge Weber Syndrome. This syndrome is characterised by a large port wine stain that typically affects the eyelid and forehead, and is associated with ocular as well as neurological abnormalities.
Treatment
Port wine stains can lightened with pulsed dye laser. Repeated sessions, usually spaced 1-2 months apart, are often needed.
Symptoms
This is a very common condition, and is otherwise known as “naevus flammeus”. Clinically, patients present with small flat pinkish or reddish patches with poorly circumscribed borders. They may be more noticeable when the child is overheated or crying. Common sites include the back of the neck (“Stork bite”) and on the lower forehead (“Angel’s kiss”).
Treatment
Naevus simplex are harmless and most often resolve spontaneously within the first year of life. Stork bites can persist into adulthood. Lesions that do not fade may be treated with pulsed dye laser if cosmesis is a concern.
Symptoms
Infantile haemangioma (IH), also known as “strawberry naevus”, presents as a bright red, raised lesion on the skin that can rapidly increase in size during the first few months of life. While often solitary, some children present with multiple lesions. There may be associated health problems for children with more than five IHs, or if they have large IHs that occur on the face/ scalp / neck or on the lower back/ genital region. Do seek medical advice early if so.
Treatment
Most infantile haemangiomas do not require any treatment as they usually spontaneously resolve with age. However, they should be treated if they:
Treatment options include application of:
Topical Creams
Oral Medications
Laser Therapy
Symptoms
These are usually present at birth, but may also develop within the 1st year of life. They most commonly present as a brown, tan or black pigmented patch, but may have multiple shades. There is usually increased hair growth within the CMNs, and this is especially prominent around puberty. Congenital melanocytic naevi are usually asymptomatic. They grow proportionately with the child and can be classified into small (<1.5cm), medium (1.5-19.9cm), and large (≥20cm) according to their estimated size in adulthood.
Treatment
Benign CMNs do not need to be treated, unless their cosmetic appearance is a concern. If so, lasers or surgery can be performed to remove them. As with all moles, there is potential for malignant transformation in CMNs, and the risk is highest with large CMNs. Hence, do visit your dermatologist if you notice any change in clinical appearance of your CMN.
Symptoms
This is a non-cancerous skin lesion that is due to overgrowth of the uppermost layer of the skin, also known as the epidermis. Half of the lesions are present at birth, but the other half develop during childhood. Epidermal naevi are usually linear and brown or tan in colour. While they are often flat at birth, they can thicken and become rough/ warty as the child grows.
Treatment
Epidermal Naevi can be left alone. If cosmesis is a concern, surgery or laser can be performed to remove them. Topical creams may help to reduce the thickness of the lesion.
Laser Therapy
Topical Creams
Symptoms
Café-au-lait macules present as flat, round or oval brown patches that occur most commonly on the trunk and limbs. They may be present at birth or develop during early childhood. They have variable sizes ranging from a few millimetres to ≥20cm.
Treatment
Café-au-lait macules are harmless and can be left alone. However, if desired, they may be removed with laser therapy. Children with more than 6 CALM should be evaluated by a doctor, as they may have an underlying genetic condition known as Neurofibromatosis Type 1.
Following the diagnosis of vascular or pigmented birthmarks, our dermatologists will discuss a personalised treatment plan with you.
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