The discovery of a birthmark on a baby’s skin is always impressive and raises a lot of questions. Should we be worried? Should we be content to monitor or intervene? Answers.

Above all, don’t listen to old popular beliefs. Your baby’s “café-au-lait” stain has nothing to do with drinking coffee when you were pregnant. No more than angiomas are due to satiated cravings for red fruits. If we do not yet know exactly how to explain all these small dermatological peculiarities, one thing is certain, they are in no way related to behavior during pregnancy.

Unlike other spots present from birth, hemangioma does not appear for a few days, or even a few weeks. Common – it affects one in ten infants – this vascular anomaly affects more girls, babies with low birth weight and very premature babies. Other contributing factors have been identified: an older age of the mother, lesions of the placenta during pregnancy (detachment or biopsy for prenatal diagnosis), Caucasian ancestry, multiple pregnancy, etc.

Most of the time, doctors are content to monitor the evolution of the hemangioma, which is done systematically in three stages. First, a phase of rapid growth, which lasts between 3 and 12 months and during which the lesion develops in surface and in volume. It then stabilizes for a few months, before regressing spontaneously, before the age of 4 years. Skin sequelae (skin thickening, dilation of blood vessels) are rare but they are always possible in the event of excessive growth. Doctors then prefer to intervene to put a stop to it. You should also try to limit the expansion of the hemangioma when it is placed near an eye or the respiratory tract. Another indication for medical treatment: the appearance not of one, as is most often the case, but of several “strawberries” all over the body. It is very rare, but one can then fear the presence of other lesions, this time internal, in particular on the liver.

To slow the progression of an invasive hemangioma, cortisone has long been the standard treatment. But doctors now have a more effective and much better tolerated alternative: propranolol.

Also called “wine spots” because of their dark red color, flat angiomas can measure a few small square centimeters, such as covering an entire part of the body or even half of the face. In the latter case, doctors prefer to check the absence of other angiomas in the meninges or eyes using a brain MRI.

But, in their great majority, these small vascular anomalies are perfectly benign. A very unsightly location may however justify wanting to remove them with a laser. Doctors therefore recommend intervening early: as the angioma grows with the child, the more quickly it is taken care of, the less the surface to be treated is important and the more the number of sessions is reduced. It usually takes 3 or 4 operations, preferably under general anesthesia, to reduce the stain or even make it disappear completely.

Useless on the other hand to hope to remove the small light red spot which is sometimes at the level of the neck, at the hairline, it is indelible. As for the one that often goes together and sits at the level of the forehead between the two eyes – it is characteristic, it darkens when baby cries – it is just as banal and rest assured, it disappears on its own before age 3-4 years old.

Many children of Asian, African or Mediterranean origin have a so-called Mongoloid (or Mongolian) spot. Bluish, it is most often located in the lower back and on the buttocks but can also be found on the shoulder or forearm. Perfectly benign, it regresses on its own and disappears completely around the age of 3-4 years.

Due to an excess of melanin, these small flat light brown spots are most often found on the trunk or the root of the limbs. Because they are most often not very visible and, in the vast majority of cases without seriousness, the doctors prefer not to touch them. Be careful, however, if new “café-au-lait” spots appear during the first year. It will be necessary to consult because their presence can be the sign of a genetic disease.