There are several skin markings that are considered normal in newborns.
Bruises or marks may occur on the newborn’s face and scalp caused by uterine contractions pressing the fetus against the pelvic structures and/or the use of forceps. Bruising of the legs and feet may occur after a breech delivery. Bruises typically resolve within a few days.
Pink marks that are caused by dilated capillaries under the skin may occur on the forehead just above the nose, in the upper eyelids, or at the back of the neck (where they are called stork bites). This type of birthmark fades as the infant grows but sometimes remains as a faint mark that becomes brighter when the infant becomes excited or upset.
Milia are tiny, pearly white cysts that are normally found over the nose and cheeks. They are caused by plugged sweat gland ducts. Milia become smaller or disappear over a period of weeks.
White or yellowish cysts are sometimes found on the gums or in the center of the roof of the mouth (called Epstein pearls). They do not require treatment. These cysts go away in 1 to 2 weeks.
Mongolian spots are bluish gray, flat areas that usually occur over the lower back or buttocks. They usually occur in black or Asian newborns, tend to appear less noticeable with age, and do not require treatment.
Hemangiomas of infancy (strawberry hemangiomas) are common birthmarks. They cause the skin to turn bright red or bluish and can occur anywhere on the skin, typically the head and neck. Hemangiomas of infancy develop soon after birth and tend to grow rapidly during the first year of life. After 12 to 18 months, hemangiomas shrink and become fainter, so that by the time the child reaches school age, most are no longer visible. Most hemangiomas do not need treatment, but depending on their size and location, they are sometimes treated with laser therapy or a drug such as propranolol.
Port-wine stains are flat pink, red, or purplish birthmarks. They are caused by malformed blood vessels. Port-wine stains may be small or may cover large areas of the body. Port-wine stains themselves are harmless, but some may occur in a serious neurologic disorder called Sturge-Weber syndrome. The skin discolorations are permanent. Laser therapy can be used to treat some port-wine stains.
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