Does your baby have a birthmark? Let's talk about it!

As a mother, it's normal to get a little worried when you see a small spot or discoloration on your little one's skin, right? Most of the time, these are what we call 'birthmarks'. While some of them just fade away, there are times when you need to be a little concerned about them. So, let's talk about these birthmarks today in a simple way that you can understand, okay?

What are birthmarks?

Simply put, a birthmark is a spot or blemish that forms on the skin, either while the baby is still in the womb or after birth. They come in all shapes, colors, and sizes. Some are at the same level as the skin, while others are raised. Some have smooth edges, while others have irregular edges. The same goes for color; they can range from brown, light brown, black, and light blue to pink, red, and purple. The important thing is that most birthmarks are harmless. Most will go away or shrink over time. However, very rarely, some birthmarks can be associated with other health problems. That's why it's important to be aware of these birthmarks.

Why do these birthmarks occur?

Now you may be thinking, "Why did this happen to my baby? Did I do something wrong during pregnancy?" Don't let that fool you. The truth is, doctors still don't know the exact cause of most birthmarks. They can't be prevented. They're not caused by anything you did or didn't do during pregnancy. They're not caused by a minor injury or trauma to the skin when you have a baby. Some types of birthmarks tend to run in families, but no specific genetic cause has been found yet. So, don't worry about it, it's not your fault.

What are the main types of birthmarks?

Birthmarks can be divided into two main types. They differ in how they form, and therefore in what causes them.

• Vascular Birthmarks : These are caused by the small blood vessels in our body not forming properly. Either too many blood vessels are clustered together in one place, or they are wider and larger than normal.
• Pigmented Birthmarks: These are caused by the cells that give color to our skin (pigment cells) growing too much in one place, that is, clumping together.

Now let's talk about each of these types in a little more detail.

Let's first talk about vascular birthmarks.

The most common types of birthmarks are macular stains, hemangiomas, and port-wine stains. Let's take a look at what each of these are.

Macular stains or 'salmon patches'

Some people also call these 'salmon patches', 'angel kisses' or 'stork bites'. These are the most common type of birthmarks associated with blood vessels. They are light red, sometimes pink. They are usually found on the forehead, above the eyelids, behind the neck (also called the crow's feet), above the nose, on the upper lip or on the back of the head. Keep in mind that these spots may darken when the baby cries or makes a little effort. Don't be alarmed by this. Most of the time, these spots will fade by the time the baby is one or two years old. Some spots on the back of the neck may last a little longer, perhaps until adulthood. But they are not a problem.

Hemangiomas or 'strawberry marks'

Hemangiomas are a type of birthmark that some people call 'strawberry marks' because they look like strawberries when they are on the surface of the skin. They are called ``superficial hemangioma'' when they are on the surface of the skin, ``deep hemangioma'' when they are deep under the skin, and sometimes ``compound hemangioma'' when they are in both layers. A hemangioma is a small, raised mass of skin that can be dark red. Think of it like a small strawberry. They usually don't appear until a few days or weeks after birth, and then they appear. Deep hemangiomas, which are deep under the skin, may appear blue because they are connected to blood vessels in the deeper layers of the skin. An important thing about hemangiomas is that they grow very quickly during the first 6 months of a baby's life. Mothers are scared when they see it. But, after that, they usually shrink, become smaller, and disappear completely between the ages of 5 and 10. However, some large hemangiomas, when they shrink, can leave an unusual appearance on the skin, that is, a small scar. If necessary, this can be corrected later with a minor surgery. Others leave a red pigment in the skin, which can be helped with special laser treatment. Although they can occur anywhere on the body, they are most often seen on the head or neck. However, if they are near the eyes, nose, or mouth, they can sometimes interfere with things like vision, breathing, and eating. If that happens, the doctor will treat it.

Port-wine stains

These are spots that look like a little red wine has been spilled somewhere on the body. That's how they got their name. They are most often seen on the face, neck, arms, or legs. These port-wine stains can be any size, from a small dot to a large stain. But there's something special about them,These only get bigger as the baby grows, that is, with the child's growth. Over time, they become darker, and if left untreated, by middle age, they may become rough and even feel like pebbles. These will never go away on their own, and it is important to remember that. Doctors are especially concerned about port-wine stains near the eyes, to see if they are causing any problems with the eyes. If these spots are on certain parts of the face, they may need to do other tests, such as an MRI scan, to see if there is any effect on the brain.

Now let's look at pigmented birthmarks.

The most common birthmarks of this type, caused by the cells that give color to the skin, are 'Café-au-lait' spots, 'Mongolian' spots, and what we commonly call moles, which are medically called 'congenital nevi'.

Café-au-lait spots

These are very common spots. The name means "coffee with milk," because of the color of the spots. They can appear anywhere on the body. Sometimes, as your baby gets older, these spots can increase in number. It's okay to have one or two spots. However, if your baby has six (6) or more café-au-lait spots, which are larger than a pencil eraser (for a small baby) or larger than a quarter (for a slightly older child), it's important to tell your doctor about them. Because, remember, having a lot of these spots can be a sign of a genetic condition called neurofibromatosis. This condition causes abnormal growth of nerve cells. That's why it's important to tell your doctor if you see a lot of these spots.

Mongolian spots

These are flat, blue-gray spots. Although they look like bruises, they are not bruises. They are most often seen on the buttocks or lower back. They are very common in children with dark skin of Asian, American Indian, African, Hispanic, and Southern European descent. Many children in our country also have them. They do not require any treatment, and they often disappear completely by the time they are of school age, and they are not harmful.

Moles/Congenital nevi

We usually call 'birthmarks' brown spots, medically known as 'nevi' (plural) or 'nevus' (singular). Most people develop these spots at some point in their lives. A spot that is present at birth is called a 'congenital nevus', and these remain for life. Although these are usually harmless, very large or giant congenital nevi, that is, spots that are as big as a palm, are slightly more likely to develop into 'melanoma', a skin cancer, later on.However, even that risk is small. There may be a very small risk from small, congenital moles, but that too is very small. These spots can be light brown, dark brown, or black; they can be flat or raised; sometimes they may even have hair growing out of them.

How to treat birthmarks?

Now you may be wondering if all these spots need to be treated. No, they don't. Macular stains, or salmon patches, usually fade on their own. Those on the back of the neck may last a while, but they are not very noticeable and are not a problem. Most other birthmarks related to blood vessels can be treated if necessary. Port-wine stains and some hemangiomas can affect children emotionally because they affect their appearance, especially if they are on the face. Small hemangiomas in places that are not very visible usually do not need treatment. Because, as we mentioned earlier, most of them shrink on their own by the time a child is 10 years old. However, doctors treat hemangiomas that are large and visible. Some medications (such as propranolol and steroids) are injected directly into the hemangioma, some are given intravenously (through an IV), and some are taken by mouth. Children with port-wine stains may benefit from laser treatment. This involves using a high-intensity beam of light (a laser) to lighten the color of the stain. Many stains can be lightened after several treatments with a type of laser called a pulsed-dye laser. Some stains may recur, requiring further treatment. Laser treatment is usually started when the baby is still young, usually a few months old. This is because the stain and blood vessels are still small, so the results are good. Stains on the head and neck respond well to laser treatment. Special makeup, or cosmetics, can temporarily cover up a port-wine stain. Pigmented birthmarks are usually not treated and are left to grow. However, congenital moles, especially large ones, and sometimes café-au-lait spots, which we discussed earlier, are treated. Doctors can remove these birthmarks with surgery, especially large or giant congenital nevi. However, removing larger ones can be more difficult, and may require multiple procedures. Although café-au-lait spots can be removed with laser treatment, they can come back.

When should you see a doctor?

This is very important. It's best to show a birthmark to a doctor as soon as you first notice it on your baby's body to find out what type it is, what monitoring it needs, and whether or not it needs treatment. In addition,

Blood from a birthmarkIf it is draining, painful, itchy, or red, swollen, or oozing pus , you should definitely see a doctor immediately.

As with any bleeding wound, wash the wound with soap and water, apply a clean gauze bandage, and apply pressure until the bleeding stops. If the bleeding does not stop, call a doctor. Sometimes hemangiomas can develop open sores in some areas, which can become infected. Pigmented birthmarks are very rare. However, normal moles, especially congenital nevi, should be monitored for changes in size, color, shape, and height throughout life. If you notice any significant changes, tell your doctor .

What else do you want to know?

When you see a birthmark on a newborn baby, especially if it's large or on a visible spot like the face, you may feel a little shocked and sad at first. That's normal. If the birthmark is in a visible place, some people may ask questions about it and look at it strangely. It can be a little hurtful. At such times, it will help you to have a simple answer in mind to give them. Most people don't do it out of malice, they are just curious. However, if they cross the line and ask questions, or if they are hurtful, you have the right to tell them that in a kind way. Remember, from a young age, children watch how their parents deal with such situations and how they speak. That's how they learn to deal with other people's reactions. Talking to children about a birthmark simply and openly helps them accept it as a part of themselves, just like their hair color or eye color. If someone asks about it, give them a simple answer. For example, something like, "This is just a birthmark. I was born with it." Also, having a child surrounded by family and friends who treat them as normal, love them, and support them is very important for a child's mental health and self-confidence.

So, what are the main take-home messages we should take from this story?

Okay, let's now recall the most important points from what we've talked about.

• Most birthmarks are harmless, and many will fade on their own. So don't worry unnecessarily.
• The cause of birthmarks is often unknown, and they cannot be prevented. Don't feel guilty about it.
• There are two main types of birthmarks: vascular and pigmented. Within each type, there are further subtypes.
• It is very important to first show every birthmark, even if it is small, to a doctor and seek advice.
• Some spots, such as hemangiomas and port-wine stains, may require treatment, especially if they interfere with appearance, vision (if near the eye), eating (if near the mouth), or breathing (if near the nose).
• If you have more than 6 café-au-lait spots, if they are large, or if you notice a change in the size, color, or shape of congenital moles, be sure to tell a doctor.
• The most important thing is to give a child with a birthmark your love, support, and a normal, happy environment.

I hope this answers many of your questions about birthmarks. If you have any further questions, don't hesitate to ask your family doctor or pediatrician.

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Birthmarks, Baby Skin, Skin Spots, Hemangioma, Laser Treatment