Andrew Bronin, MD, associate clinical professor of dermatology, Yale School of Medicine, New Haven, Connecticut. He is an editor for Journal of the American Academy of Dermatology.
I have a birthmark that I’ve wondered about. Does it put me at risk for a health problem—such as cancer?
The good news is that most birthmarks are harmless. That said, you should keep an eye out for any signs of change. And, although it’s rare, some kinds of birthmarks can indicate a serious medical problem. Birthmarks, as the name indicates, are skin abnormalities that you’re born with. There are two main categories—vascular, caused by blood vessels (these include purplish marks referred to as port-wine stains and bright-red hemangiomas)…and pigmented, caused by cells called melanocytes, which are pigmentated differently than the rest of the skin and include moles. Although not all moles are present from birth, most people are born with a few. It’s also common to acquire moles as we age. They’re usually not a health problem. But if a pigmented lesion (a mole) starts to change—such as if it grows, changes color, becomes irregular in shape, crusts or bleeds—bring it to your doctor’s attention. It could be a sign of malignant melanoma, a cancer of pigment cells that is potentially fatal. Malignant melanoma can develop within a pre-existing mole or birthmark, and it can also develop on normal skin where there wasn’t a mole previously. Vascular birthmarks come in a variety of forms. Port-wine stains are flat red blotches on the skin and usually represent only a cosmetic problem, treatable if desired by laser. But some port-wine stains can indicate underlying bone and nerve development abnormalities. Babies with port-wine stains should be evaluated by their physicians to rule out such problems. Hemangiomas are rubbery, bright red nodules of skin and often disappear spontaneously over time. But sometimes hemangiomas break down, ulcerate and bleed—in which case they require treatment. Also, depending on their location, hemangiomas can grow and interfere with vision, breathing, hearing or elimination. Any hemangioma present at birth should be evaluated by a physician to assess its potential risk and to develop a management plan even if that plan is just watchful waiting. Bottom line: All birthmarks should be evaluated by a physician just to make sure there isn’t an underlying health problem—or a risk for one. Fortunately, though, most are only cosmetic—beauty marks, in fact!