Eleanor’s story: “I’m not bothered by my birthmark”
Meeting people with visible differences helped Changing Faces campaigner Eleanor open up about her port wine stain birthmark.
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What is a birthmark?
A birthmark is a coloured mark on the skin which is present at birth or soon after. About one in three babies is born with some kind of birthmark. Most birthmarks are harmless and they often disappear with age and without treatment.
Having a birthmark may affect your confidence or self-esteem. However, many organisations provide support to people living with a birthmark and can help you overcome the challenges you may experience.
On this page, we look at what birthmarks are, explore the different kinds of birthmarks – and discuss ways you can overcome the difficulties you may face if you live with one.
I’ve learned over the last few years that my visible difference cannot stop me from achieving my goals in life and that it doesn’t define me. This empowering feeling led me to want to help others feel the same way.
Types of birthmarks
There are many different types of birthmarks, so we have listed only the most common here. For a more detailed list, please visit the Birthmark Support Group website.
Birthmarks are divided into three main groups:
- Vascular tumours, which form from cells that make blood vessels and lymph vessels. Although the word “tumour” can sound scary, birthmarks in this group are not cancerous. Your GP will let you know if they need to be monitored.
- Vascular malformations, which form when arteries, veins or lymph vessels don’t grow as they usually would. “Malformation” is a medical term.
- Pigmented birthmarks, which are caused by an overgrowth of the cells which give the skin its colour.
Here is some more information about the different types of birthmarks and the ways they can be treated. In some cases there may be a medical reason to remove or treat a birthmark, but in general you don’t need to have treatment to change your appearance unless you decide this is the best option for you.
Haemangioma (a type of vascular tumour)
A haemangioma birthmark on white skin (Image by Gstk, CC BY-SA 4.0 via Wikimedia Commons)
Haemangiomas, also known as “strawberry marks”, are the most common type of vascular tumour. They are caused when a group of blood vessels form a lump underneath the skin. Usually, the resulting tumour is the size of a penny or two-pence coin, but they can sometimes grow much bigger. The word “tumour” can sound scary but haemangiomas are not cancerous.
They may have a firm, rubbery feel but can also be soft to the touch.
There are two types of haemangioma:
- Superficial, which are red and raised, and easy to diagnose visually. These may feel warm when touched because they have their own blood supply.
- Deep, which may appear blue because of their depth, and which may need an ultrasound to be diagnosed. As they grow, they cause a swelling which is visible on the skin.
Haemangiomas occur in one in 10 babies and are more common in girls, premature babies, babies with a low birth weight and multiple births (i.e. twins, triplets etc). They occur most commonly on the head and neck, although they can affect any part of the body.
Haemangiomas appear shortly after birth and tend to grow fastest in the first six to 12 months before gradually shrinking (“involuting”) over the next one to seven years.
A congenital haemangioma is a haemangioma which is fully grown at birth and is often diagnosed during a prenatal ultrasound. They tend to be raised and warm to the touch, and appear pink to blue in colour, with pale skin around them. There are two types:
- A rapidly involuting congenital haemangioma (RICH) will shrink much faster than a non-congenital haemangioma.
- A non-involuting congenital haemangioma (NICH) will not shrink at all.
Nevus flammeus neonatorum (a type of vascular malformation)
A stork bite birthmark on white skin (Image by Wierzman, CC BY-SA 3.0 via Wikimedia Commons)
Also known as “stork bite”, “salmon patch” or “angel kiss”, this is the most common type of birthmark. Stork bites are pinkish in colour and appear on the forehead, eyelids or the nape of the neck, and may fade under light pressure. Stork bites usually fade by age 2, although those on the nape of the neck may last longer. They tend to disappear without treatment, but laser treatment may be available in some cases. They can be difficult to detect by touch as the skin is not thickened or raised.
Capillary malformation (a type of vascular malformation)
A port wine stain birthmark on brown skin (Image by ArturroD, CC-BY-SA 3.0 via Wikimedia Commons)
More commonly known as a “port wine stain”, capillary malformation is caused by widened capillaries (the smallest blood vessels) and causes a red or purple mark on the skin, most frequently on the face or neck. They usually start out flat and smooth but can become thicker and may be bumpy. About one in every 330 babies is born with a port wine stain and they are roughly twice as common in girls. A port wine stain is diagnosed visually.
Where treatment is chosen, a laser is used to reduce the width of the capillaries and lighten the colour. This is most effective when it takes place early on. It is usually performed at around 6 months of age, before being repeated six to eight times at six to eight-week intervals. Laser treatment works best on the face, neck and chest and less well on the limbs. Treatment rarely removes the birthmark fully and repeated courses are usually needed.
In rare cases, a port wine stain may be connected to uncommon conditions including Sturge-Weber syndrome, Klippel-Trenaunay syndrome and macrocephaly-capillary malformation. Ask your GP about these conditions if you are worried.
Café-au-lait spot (a type of pigmentation birthmark)
Café-au-lait spots on white skin (Image by Klaus D. Peter, Wiehl Germany, CC BY-SA 3.0 de via Wikimedia Commons)
Café-au-lait spots are flat, smooth, tan-coloured spots which can appear anywhere on the body. They are harmless in themselves and it is quite common to have a few, but if a child has six or more, it is important that they are screened for neurofibromatosis.
Blue-grey spot (a type of pigmentation birthmark)
Blue-grey spots on dark-brown skin (Image by Gzzz, CC BY-SA 4.0 via Wikimedia Commons)
Also known as slate-grey nevus or “Mongolian blue spot”, blue-grey spots have the appearance of a bruise and may cover a large area of skin, often on the back, bottom, arms or legs. They are flat with the same texture as the surrounding skin. They are more common in babies with black or brown skin. They usually disappear by age 4.
Mole (a type of pigmentation birthmark)
A mole on white skin (Image by National Cancer Institute, public domain via Wikimedia Commons)
Moles are common spots caused by an overgrowth of pigment cells in the skin. They may be flat or raised. In roughly one in a hundred people, one or more moles are present from birth. These are known as congenital moles or, in medical language, “congenital melanocytic naevi” (CMN). Moles may appear anywhere on the body. They are usually harmless, however, there can be an increased risk of moles developing into skin cancer. Contact your GP if they change shape or size. To learn more, have a look at our dedicated page on moles.
