Birthmarks are areas of skin that differ in color or texture from the surrounding skin. They may be present at birth or appear in early infancy.

They are broadly categorized into two main groups:

• Vascular birthmarks, caused by abnormal blood vessels
• Pigmented birthmarks, caused by clusters of pigment-producing cells

Understanding the type of birthmark is essential in determining whether treatment or monitoring is needed.

What Is a Hemangioma?

Infantile hemangiomas are benign vascular growths that typically appear within the first few weeks of life.

They often present as:

• Bright red, raised lesions (“strawberry marks”)
• Deeper bluish swellings beneath the skin
• Growths that increase in size during early infancy

Hemangiomas typically follow a predictable course of growth and gradual involution over time.

Growth and Natural Course

Hemangiomas often:

• Grow rapidly during the first several months of life
• Stabilize
• Gradually shrink and fade over several years

Many resolve without intervention, although some may leave residual skin changes.

When Does a Hemangioma Need Treatment?

Treatment may be recommended when a hemangioma:

• Interferes with vision, breathing, or feeding
• Ulcerates or becomes painful
• Grows in a cosmetically sensitive area
• Is large or rapidly growing

Treatment options may include topical or oral medications, depending on the severity and location.

What Are Congenital Nevi?

Congenital nevi are moles present at birth or shortly thereafter.

They may appear as:

• Light to dark brown patches
• Flat or slightly raised lesions
• Areas that may grow proportionally with the child

Most congenital nevi are benign, but some may require monitoring over time.

What Are Acquired Nevi?

Moles can also develop later in childhood or adulthood. These are generally benign but should be monitored for changes.

When Should Nevi Be Evaluated?

Evaluation is recommended when a nevus:

• Changes in size, shape, or color
• Appears atypical
• Differs significantly from other moles

In some cases, biopsy or removal may be recommended.

Vascular Malformations

Unlike hemangiomas, vascular malformations are present at birth and grow proportionally with the child. They may require specialized evaluation and management.

Pigmentary Variations

Other birthmarks may include lighter or darker patches of skin that remain stable over time. These are often benign and require no treatment.

Clinical Examination

Evaluation begins with a detailed history and physical examination.

Key factors include:

• Timing of appearance
• Growth pattern
• Color and texture
• Location on the body

These details help determine the type of birthmark and appropriate management.

Dermoscopy and Imaging

In some cases, dermoscopy or imaging may be used to further assess the lesion.

Biopsy When Needed

Biopsy is rarely required but may be performed if there is uncertainty about the diagnosis.

Observation and Monitoring

Many birthmarks are safely monitored over time without treatment. Regular follow-up allows for early detection of any changes.

Medical Treatment

Certain vascular birthmarks, such as problematic hemangiomas, may be treated with medications to control growth and promote regression.

Laser Treatments

Laser therapy may be used for select vascular or pigmented birthmarks to improve appearance.

Surgical Options

In some cases, surgical removal may be considered, particularly for lesions that are large, symptomatic, or cosmetically concerning.

Management of birthmarks varies depending on the type and behavior of the lesion. Some require only observation, while others benefit from early intervention. Treatment plans are adjusted over time based on growth and response.

The natural course of birthmarks varies.

Hemangiomas often improve over several years, while pigmented lesions may remain stable or change gradually over time. Treatment outcomes depend on the type of birthmark and the chosen approach.

Evaluation is appropriate for patients who:

• Have a birthmark present at birth or early infancy
• Notice a birthmark changing in size, shape, or color
• Have concerns about appearance or symptoms
• Want guidance on monitoring or treatment

Early evaluation provides clarity and helps guide appropriate management.

At Treiber Dermatology, birthmarks are managed with a balanced approach that emphasizes accurate diagnosis, appropriate monitoring, and intervention when necessary.

The focus is on ensuring safety while also addressing cosmetic concerns in a measured and thoughtful way.

Patients throughout New York and Connecticut choose Treiber Dermatology for birthmark care because of the practice’s expertise in both pediatric and adult dermatology.

Care is known for being:

• Thorough and detail-oriented
• Focused on accurate diagnosis
• Thoughtful in treatment recommendations
• Tailored to each patient’s needs

The emphasis is on providing reassurance, guidance, and appropriate care.