Birthmarks - pigmented

  • Definition
    • A birthmark is a skin marking that is present at birth. Birthmarks include cafe-au-lait spots, moles, and Mongolian spots. Birthmarks can also be red.

  • Alternative Names
    • Nevus sebaceous; Hairy nevus; Nevi; Mole; Cafe-au-lait spots; Congenital nevus

  • Causes
    • Different types of birthmarks have different causes.

      • Cafe-au-lait spots may occur in people with the genetic disorder neurofibromatosis.
      • Moles are very common -- nearly everyone has them. Most moles appear after birth.
      • Mongolian spots are more common in people with darker skin.
  • Symptoms
    • Any type of birthmark is called a nevus. Each type has its own appearance:

      • Cafe-au-lait spots are light tan, the color of coffee with milk.
      • Moles are small clusters of colored skin cells.
      • Mongolian spots (also called Mongolian blue spots) are usually bluish or bruised-looking. They often appear over the lower back or buttocks. They are also found on other areas, such as the trunk or arms.

      Other symptoms of birthmarks are:

  • Exams and Tests
    • Your health care provider will examine your skin to make the diagnosis. You may have a biopsy to look for skin changes that are signs of cancer. Your provider may take pictures of your birthmark to compare changes over time.

  • Treatment
    • The type of treatment you have depends on the type of birthmark and related conditions. Usually no treatment is needed for the birthmark itself.

      Large birthmarks that affect your appearance and self-esteem may be covered with special cosmetics.

      You may have surgery to remove moles if they affect your appearance or raise your risk for cancer. Talk to your health care provider about how and when any of your moles should be removed.

  • Support Groups
    • Nevus Outreach ( is an organization that offers information and online support for people with large birthmarks.

  • Outlook (Prognosis)
    • Large moles that are present at birth are more likely to become melanoma, a type of skin cancer. This is especially true if the mole covers an area larger than the size of a fist. The cancer risk is related to the size, location, shape, and color of the mole.

  • Possible Complications
    • Complications of birthmarks can include:

      • Skin cancer
      • Emotional distress if the birthmark affects appearance
  • When to Contact a Medical Professional
    • Have your health care provider examine any birthmark. Report any changes in the birthmark, such as these, to your provider:

      • Bleeding
      • Color change
      • Inflammation
      • Itching
      • Open sore (ulceration)
      • Pain
      • Size change
      • Texture change
  • Prevention
    • There is no known way to prevent birthmarks. A person with birthmarks should use a strong sunscreen when outdoors (to prevent complications).

  • References
    • Habif TP. Premalignant and malignant nonmelanoma skin tumors. In: Habif TP, ed. Clinical Dermatology. 5th ed. St. Louis, MO: Elsevier Mosby; 2009:chap 21.

      Morelli JG. Diseases of the neonate. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics.19th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 639.