Are all birthmarks present at birth dangerous?

Not all birthmarks present at birth are dangerous; in fact, the vast majority of these skin marks are harmless. Some fade automatically over time, while others remain unchanged without any negative health impact [2]. However, there are exceptional cases where certain types of birthmarks are associated with underlying medical conditions or require careful monitoring by a specialist physician to ensure they do not develop into larger health problems [2].

Birthmarks are medically divided into two primary categories: vascular birthmarks, resulting from the abnormal formation of blood vessels, and pigmented birthmarks, resulting from clusters of skin pigment cells [2]. Often, a medical evaluation is necessary to distinguish between types that do not require intervention and those that may necessitate follow-up.

When does a birthmark become medically concerning?

Birthmarks require evaluation by a specialist physician in specific cases, especially if changes appear in their texture, color, or size, or if they are associated with medical syndromes. Parents should consult a doctor immediately upon noticing any of the following symptoms in the birthmark: bleeding, pain, itching, open sores, inflammation, or sudden changes in color and texture [3].

The relationship between birthmarks and medical disorders

In rare cases, a birthmark can indicate a deeper health issue. For example, 'port-wine stains' that appear on one side of the face, specifically around the eye or forehead, may be associated with Sturge-Weber syndrome [1]. This rare neurological syndrome results from a genetic mutation leading to abnormal development of blood vessels in the brain, eye, and skin, which may cause seizures or glaucoma [1]. Similarly, the presence of large numbers of 'café-au-lait' spots may require screening to detect genetic disorders such as neurofibromatosis [3].

Additional considerations regarding the risks of pigmented birthmarks

Most pigmented birthmarks do not require treatment, but exceptions include large congenital nevi present since birth; medical recommendations indicate that these moles, especially if their size exceeds the area of a fist, may increase the risk of developing skin cancer (melanoma), making their monitoring or surgical removal an option that requires discussion with a doctor [3]. It is always essential to use strong sunscreen for children who have these birthmarks to protect them from sunlight [3].

For more details on cases requiring care, you can read our article on Skin Birthmarks: When are they natural and when do they need medical evaluation? (Arabic), which explains the difference between the various types and how to manage each.

Medical references

• Sturge-Weber Syndrome
• Birthmarks
• Birthmarks - pigmented