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    Birthmarks - pigmented

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

    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.


    Cafe-au-lait spots may occur in people with the genetic disorder, neurofibromatosis.

    Nearly everyone has moles, which usually appear after birth.

    Mongolian spots are more common in people with darker skin.


    Each type of birthmark 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 usually appear over the lower back or buttocks. They are also found inother areas such asthe trunk or arms.

    Other symptoms of birthmarks:

    • Abnormally dark or light skin
    • Growth of hair from pigmented skin
    • Skin lesion
    • Skin lumps
    • Textured skin that can besmooth, flat, raised, or wrinkled

    Exams and Tests

    The doctor will examine your skin to make the diagnosis. You may have a biopsy to look for skin changes that are signs of cancer. The doctor may take pictures of the birthmarkto compare changes over time.


    The type of treatment you have depends on thetype 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 theythey affect your appearance or have an increased cancer risk. Talk to your doctor how and when to remove any moles.

    Support Groups

    Nevus Outreach is a support group for people with large birthmarks called nevi.

    Outlook (Prognosis)

    Large moles that are present at birth (congenital nevi) are more likely to become skin cancer (malignant melanoma). 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.

    Mongolian spots may persist for months or years. They do NOT become cancer or develop other symptoms.

    Possible Complications

    • Skin cancer
    • Emotional distress if the birthmark affects appearance

    When to Contact a Medical Professional

    Havea health care provider examine any birthmark. Report changes in the birthmark to your health care provider, including:

    • Bleeding
    • Color change
    • Inflammation
    • Itching
    • Open sore (ulceration)
    • Pain
    • Size change
    • Texture change


    There is no known way to prevent birthmarks. A person with birthmarks should use a strong sunscreen when outdoors (to prevent complications).


    Habif TP. Premalignant and malignant nonmelanoma skin tumors. In: Habif TP, ed. Clinical Dermatology. 5th ed. St. Louis, Mo: Mosby Elsevier; 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: Saunders Elsevier; 2011:chap 639.


    • Mongolian blue spots


    • Skin layers


      • Mongolian blue spots


      • Skin layers


      A Closer Look

        Review Date: 11/20/2012

        Reviewed By: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.

        The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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