The birthmark is congenital or acquired pigmented formation on the skin that may be of different colors and shapes. Birthmarks can be brown, black, red, purple. They are also called limited pigmented spots – nodules composed of clusters of melanocytes with various degrees of differentiation. The name “birthmark” is not entirely accurate since most of them are acquired. Almost every person has a certain amount of birthmarks (moles), which usually appear in childhood and adolescence. They appear in various sizes and colors; birthmarks can be flat or raised above the skin; smooth, hairy or warty; broad-based or sitting on a stem.
At a certain time, the skin cells get filled with pigment and become melanocytes, the accumulation of which is called a mole.
According to medicine statistics, they most often appear on the face — per every hundred square centimeters of the skin surface. Most often, the newborn babies do not have moles, but those appear during the first years of life. Most likely, newborns have such small pigmentary birthmarks that it is difficult to notice them. The birthmarks in a large number appear during puberty under the influence of hormones.
Hardly noticeable spots most often increase in size and sometimes change the color, up to the black. The matter is that the formation of melanin pigment in skin is strongly influenced by a melanotropin hormone of the hypophysis. New birthmarks often appear on pregnant women, the old ones sometimes change color and increase in size.
Birthmarks can appear on any part of a body, including mucous membranes, oral cavity, tongue, vagina, and anus. Moles on the mucous membranes are met more often among women than among men.
About 40-50% of malignant birthmarks develop from melanocyte of birthmarks (the others — from melanocyte of other sites of skin); these tumors are met very seldom among children and come from the large pigmented birthmarks which are present from birth.
Types of birthmarks
Lentigo (edge) is a flat, evenly pigmented stain from brown to black color, resulting from the increase in the number of melanocytes at the border of epidermis and dermis (skin layers).
The Epidermal-dermal birthmarks are usually flat but sometimes protrude over skin level a little. Color varies from light brown to almost black, sizes do from 1 to 10 mm in diameter. It usually appears as a result of melanocyte congestion on the border between epidermis and dermis. Birthmarks on palms, soles and in the genital area are usually epidermal-dermal.
Complex Birthmarks often have a dark color, and in varying degrees, they usually rise above the level of the skin. Clusters of melanocytes are localized (located) on the border between epidermis and dermis as well as in dermis.
Intradermal Birthmarks are raised above the skin level; their color varies from nude to black, and the surface may be smooth, hairy or warty.
Sutton’s nevus is a pigmented birthmark (usually complex and intradermal birthmark) surrounded by a ring of achromic (undyed) leather. Sutton’s nevus disappears spontaneously, and only in rare instances give rise to malignant melanomas.
The dysplastic birthmark is a pigmented spot of irregular shape and indistinct borders, slightly raised above the level of the skin, their color ranges from reddish-brown to dark brown on a pink background. Dysplastic birthmarks often drive attention because of the unusual look and increased frequency in some families (inherited). As a rule, they are larger than an ordinary birthmark, reaching 5-12 mm in diameter; the location is also different. Although they can occur anywhere, dysplastic birthmarks are more common in areas which are usually covered by clothing (on the buttocks, Breasts), or on the scalp. Most people have 10 common moles on average, at the same time, there may be more than 100 dysplastic birthmarks on the body. Ordinary birthmarks usually appear during the onset of puberty; dysplastic ones continue to occur even after 35 years.
Blue birthmarks raise above the skin, sometimes they have hemispherical formation, which is dense, commonly with a smooth finish, blue, dark blue, occasionally brown color, with a clear border, such birthmarks have the size from 0.5-2.0 cm, and they do not have any hair. Most common sites are the face, limbs, and buttocks.
Cellular blue birthmarks are biologically more active and they differ from ordinary blue birthmark marked by a proliferation of melanocytes. The last symptom increases the risk of melanoma developing.
Giant pigmented birthmark is most often congenital and increases in size as the child grows. These birthmarks have flat papillary surface and may occupy significant skin area of trunk, limbs and face.
The Mongolian birthmark is a bluish color of the skin in the sacral region, less frequently in buttocks or thighs, connected with the occurrence of melanin pigment in the connective tissue layer of the skin. Such name is due to the fact that such spots were first described in infants of Mongoloids, although they are common among children of other races.
“The Mongolian spots” are clearly visible in the form of the localized scattering right after the birth. These birthmarks disappear in 12-24-month; sometimes they can remain on adults in a weak form. Mongolian birthmarks appear in the field of a sacrum, have green-blue-black shades of color. The size of “Mongolian spots” is from small coins up to 6-10 cm in diameter.
Mongolian birthmark prevalence
90% of the Mongolian one-year-old children have such birthmarks, but by 10 years only 6% have them. “The Mongolian birthmarks” are met on Europeans too, though it is very rare (for example, in Bulgaria 0,6%). These birthmarks are widespread among Americans of a Mongoloid origin, Japanese, Chinese, Indonesians, Kazakhs, Kyrgyz, Yakuts, Ainu, Koreans, drill, Kalmyks, Tuvinians, Khakas, Eskimos, and Indians of North America.
Red birthmarks represent growths of vessels and it is called hemangioma. Practically every person who is senior to ten years has pigmentary birthmarks.
The capillary hemangioma, red birthmark called “strawberry birthmark” (“stork bites”) are simply the kind of birthmarks. However if the size of the hemangioma is big, it should be a case of medical observation.
What can cause the appearance of birthmarks
The generation of a birthmark is provoked by a push or an irritant. The strongest of all catalysts is the excessive sun exposure. Ultraviolet radiation in large doses causes irreversible changes of skin cells, increasing the risk of their rebirth. Most susceptible to mutagenic and sun exposure individuals are fair-skinned and fair-haired people with blue, green and gray eyes. Moles are formed on the skin from pigment cells, which are located between the dermis (inner skin layer) and epidermis (the top layer of the skin). The causes for birthmark appearance may be several:
- Heredity. One of the reasons for the appearance of moles in a certain place of the body can be incorporated into human DNA.
- Sunlight and ultraviolet radiation. Excessive exposure to ultraviolet rays can lead to excessive production of melanin, which forms birthmarks.
- Hormonal changes. In a result of hormonal disruptions or spikes (stress, illness, childbirth, and so on) either the new birthmarks may appear or the old ones disappear.
- Radiation, x-rays, viruses and injuries. All these may cause displacement of pigmented cells to the epidermis.
Don’t sunbathe from 10 to 15 o’clock
This is the most dangerous time. The midday sun has to be avoided. Neither a bathing suit nor a tent can save you from its harmful rays. At this time, the dry sand reflects 17% of UV rays, up to 50% penetrate through clouds and fog, 20% to 40% pass through the wet clothes after swimming.
At men the melanoma affects hips in 4,9% of cases, shin — in 6,7%; women have it on a hip — in 6,7%, on a shin — in 26,3%. After all, many people, remaining dressed, being in a shadow, don’t consider dangerous to sunbathe their feet.
Signs of birthmark’s generation
- Change of color (reduction or sharp strengthening of pigmentation — up to black color, uneven coloring, on the periphery of a birthmark a ring arises from the coal-black, small knots of the unequal sizes merge and form “black beads”);
- Uneven coloring;
- Violation or total absence of skin drawing in the field of a birthmark. A peeling can also occur;
- Emergence of an inflammatory areola around a birthmark (a redness in the form of a nimbus);
- Change of a configuration on peripheries, blurry birthmark contour;
- Increase in the size of a birthmark (the pigmentary spot blurs, as if “spilled”) and its consolidation;
- Itch, burning, pricking and tension in the field of a birthmark;
- A hair loss from a birthmark surface;
- The emergence of cracks, ulceration and tension in the field of a birthmark.
The risk groups are those who have lots of freckles, pigment spots and birthmarks. Especially if their diameter exceeds 5 mm. For every person critical amount of sun exposure is individual. To determine this line is not easy, so it’s best of all just to remember that prolonged sun exposure is harmful to the body. Any skin type should be protected from ultraviolet radiation. Excessive tanning inevitably burns that “hit” the immune system of the skin. Having an unusual and peculiar “memory” skin does not forgive unbearable sunstroke. As a result, malignant birthmarks and pigmentary spots can appear, and of course, an emergence of various new growths is possible. No matter how trivially it sounds, it is necessary to still to take care of yourself from the youth. After swimming in open water it is very important to shower your child and dry the skin with a towel. Remember: in a Sunny day a drop of water, the sea salt crystals work as lenses, which greatly enhance the harmful effects of sun exposure.
How dangerous birthmarks can be
- Under the influence of external factors (ultra-violet radiation, mechanical damages — a trauma or frequent rubbing) the pigmentary birthmark can regenerate grow into a melanoma — one of the most dangerous malignant tumors of the person.
- If the birthmark settles down in that place where it can often be injured, then it is desirable to remove it, previously having consulted with the doctor.
Ways of birthmark removal
Removal of birthmarks is a problem of particular importance. Before removal, consultation of the dermatologist is necessary. After removal histologic research of remote skin is obligatory. Unprofessional “removal” of birthmarks is categorically contraindicated. The removal methods for each type of pigmented spot is particular: some are removed by electrocoagulation, others by kind of radiotherapy, and some require surgery. And not only within the birthmark but with the capture of adjacent healthy skin.
In practice there are several methods of benign tumors removal of the skin: surgical, cryotherapy (burning with liquid nitrogen), electricity (use of high-frequency current), the use of the laser.
Electrocoagulation is a preferable method; after the operation, it is possible to send a new growth to analyzes. Neither laser nor liquid nitrogen gives such chance. Besides, under the influence of current, there are small and neat hems. The laser beam demands virtuosity and the unskilled hands may leave poorly healing scars. Electrocoagulation causes volume thermal defeat of skin round the deleted zone.
Many consider this method the most effective. First, when using the laser, in addition to direct removal of moles, there is the smallest blood vessel thrombosis. This is not only preventing a possible metastasis but also virtually eliminates blood loss. Secondly, the regeneration of the skin is faster. Thirdly, it is possible to reach good cosmetic effect during removal of birthmarks on the face and on open parts of a body that are important, especially for women. Of course, the significant for any patient is that modern means of anesthesia allow practically not feeling pain from the influence of the laser. The kind of laser machine used is also important. Therefore, if you face a choice to whom to entrust the removal of the birthmark, it will be better to turn to professionals, who have the most advanced medical technologies and the equipment. Removal of the tumor takes place under visual control with minimum injury and without thermal damage to the skin. Small birthmarks removal almost does not leave a trace.