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9 Baby Skin Discolorations & Birthmarks: With Pictures

Medically Reviewed by Dr. Pierrette Mimi Poinsett, MD
Updated
Here’s what you need to know about your baby's birthmarks or skin discoloration.

Have you noticed changes in your baby’s skin? Maybe they were born with a discolored patch, or you’re beginning to see a weird-looking spot.

Birthmarks are normal. They’re part of what makes each of us unique.

Some skin discoloration could be completely harmless and vanish as quickly as it appeared. It may be the after-effect of an infection, or in rare circumstances, it could be caused by a serious condition.

You or your partner might have a special birthmark, but does that mean your little one will also have one? Let’s look at baby skin discoloration and birthmarks in more detail.

Key Takeaways

  • Birthmarks are common and can appear as brown spots, white patches, or various other colors and shapes.
  • Cafe au lait macules (CALMs) and neurofibromatosis type 1 (NF1) are related to brown spots, while vitiligo and tinea versicolor cause white patches.
  • Jaundice is a common condition in newborns causing yellow discoloration and usually resolves on its own within a few weeks.
  • Common types of birthmarks include salmon patches, infantile hemangiomas (strawberry marks), Mongolian spots, and capillary malformations (port-wine stains).


Baby’s Skin Color

In our heads, we usually picture our newborn to be a chubby-cheeked wonder with perfect skin. But that’s not always how it is.

The reality is a newborn baby, fresh from the womb, will likely be purple and slimy. They may also be covered in white goo, called vernix caseosa.

A baby’s skin is paper thin. Therefore, environmental changes play a huge role in the skin’s color. You’ll likely notice straight away if your baby is cold — their feet will probably be a bluish color. Conversely, their cheeks will be red and flushed if they are hot.

Newborns will sometimes have a lighter skin complexion than you expected. Their skin tone can change over time. Some babies take up to six months or longer to develop their permanent skin color.

Pro Tip

Birthmarks or skin discoloration may be noticeable on babies when they are first born. But some may appear after birth or as your baby grows older.

Brown Spots and Discoloration

Brown spots could be more than just freckles. It’s not uncommon to find a few when bathing your baby (and you try to rub it off but realize it’s on the skin). Don’t worry; most baby spots are harmless.

Here’s what might be causing them:

Cafe Au Lait Macules

Cafe au lait macules (CALMs) are brown spots or patches. They can appear anywhere on a baby’s body and are usually present from birth. These spots are found in about 3% of infants.

They’re typically randomly and unevenly shaped and can range from one-fifth of an inch to one inch in size. They can be dark or light brown and may darken with sun exposure.

The spots can be slightly raised, although they are usually smooth. CALMs are relatively common, and there’s no reason for concern if you find a couple of these spots on your infant. But if you find six or more, you should consult your doctor so they can check for NF1.

Neurofibromatosis Type 1

Warning

Having more than six CALMs, particularly if you also find freckles around the armpit or groin, could be a sign of a genetic disorder called neurofibromatosis type 1(NF1).

There are three variations of neurofibromatosis, with Von Recklinghausen’s disease (VRD) being the most common.

NF1 affects about 1 in 3,000 babies. It causes tumors to form on the tissues and nerves in the body and on the skin, and the growths can trigger many different health issues. Symptoms vary widely, even within members of the same family.

The tumors are usually not cancerous. However, it is necessary to monitor them in case they do become malignant, especially if they multiply (1).

White Patches

Many things can cause white patches on a child’s skin. The most common is likely to be a sore or scratch, where the surface has been broken. This produces new skin not yet exposed to the sun, which makes it lighter.

Many of us moms have worried when white spots suddenly appeared on our baby’s skin to later realize it was just a scratched mosquito bite or a healing wound.

However, white patches or discoloration of the skin can also be a sign of vitiligo.

Vitiligo

VitiligoVitiligo is a condition that causes white spots and patches to develop on the skin. It can be a long-term condition that often doesn’t go away completely.

The condition results from a loss of pigment, or melanin, in the skin. It can affect people of all ages and ethnicities.

The patches can be any shade, from light to white with a pale pink center. It usually starts around the face, neck, or hands but can occur anywhere on the body.

If your child has vitiligo, it is crucial to use a strong sunscreen on the patches. The loss of pigment makes the skin much more vulnerable to sunburn.

Different types of vitiligo include segmental, focal, and generalized.

Segmental vitiligo only affects one side of the body, and focal affects just a couple of spots in one area. Generalized vitiligo shows up as symmetrical patches on both sides of the body. Some experts consider vitiligo to be an autoimmune disorder, while others refer to it as a genetic disorder (2).

Tinea Versicolor

Tinea versicolor is a fungal infection of the skin. It shows up as patches ranging from white to dark, depending on your child’s skin color. If you look closely, you may see tiny scales on the skin’s surface.

This condition is very common in children and young adults. The fungus prevents the affected skin from tanning, which means the patch will be even more obvious when exposed to the sun.

Pityrosporum ovale is a type of fungus that lives in the pores. As the condition progresses, the fungus overgrows, causing discoloration.

The patches are harmless and shouldn’t bother your little one aside from minor itching.

This condition should resolve itself, but if you’re concerned, contact your child’s pediatrician for further advice (3).

Yellow Discoloration (Jaundice)

Infant jaundiceWhile white or brown spots or patches may seem more normal, seeing your baby turn yellow can be alarming. But don’t panic; your little bundle of joy probably just has a touch of jaundice.

Jaundice is a prevalent condition in infants, generally appearing two to three days after birth. It typically turns the baby’s skin yellow and can also affect the whites of the eyes.

Neonatal jaundice occurs due to a buildup of bilirubin in the blood. When red blood cells break down, bilirubin is produced, and it has a yellow color.

Take Note

Jaundice is common in newborns because they have more red blood cells. Their liver is also not fully developed, which makes it harder to remove the bilirubin. The condition is more likely in premature babies or those with low birth weight.

Jaundice is mostly harmless and usually disappears within one or two weeks.

However, if the condition is apparent within 24 hours of delivery, it could signify a more severe problem. In this case, you should consult your doctor.

Treatment for jaundice is usually not necessary. A simple treatment you can do at home is exposing your baby to controlled sunlight for a few minutes each day.

Never place your newborn in direct sunlight, though. Instead, use a thin fabric or curtain to cover a sunlit window. Sit there with your baby for 10 to 15 minutes every day.

The sun will provide your baby with much-needed vitamin D, which helps to break down the bilirubin. As a mother of babies who both had slight jaundice, I can assure you this method is very effective.

Severe cases may require medical intervention in the form of one of the following:

  • Phototherapy: Your baby will be exposed to a particular light that changes the form of bilirubin, making it easy for the liver to break it down.
  • Exchange transfusion: If phototherapy does not work, a complete blood transfusion might be necessary to reduce the amount of bilirubin in your baby’s blood.

It is vital to diagnose and treat severe cases of jaundice correctly. If jaundice is left untreated and bilirubin levels become too high, it can lead to seizures or permanent brain damage (4).

Birthmarks

A birthmark is skin discoloration either present at birth or appearing within the first month of a baby’s life. They come in various colors, shapes, and sizes and can occur anywhere on the body. Let’s look at the most common.

1. Salmon Patch

A salmon patch is a red or pink flat patch that often occurs on the baby’s eyelids, forehead, or neck.

They usually fade entirely within the first few months, although patches on the forehead can take up to a year or more. My baby looked like a mini Harry Potter for a couple of months with a little lightning-shaped pink mark on his forehead.

These patches can become more visible when the baby cries as they fill with blood. Salmon patches are benign and are no cause for concern.

2. Infantile Hemangioma

Infantile HemangiomaThese are also known as strawberry birthmarks. Unsurprisingly, they look like strawberries. Infantile hemangiomas can appear anywhere on the body and may also develop deeper in the skin, making it look blue or purple.

Strawberry marks are strangely more common among girls than boys. They usually grow rapidly in the first few months. They then decrease in size, and most disappear eventually, although this could take several years.

These birthmarks are not harmful. However, if they interfere with feeding, vision, or other vital functions, consult a specialist for advice (5).

3. Mongolian Spots

A Mongolian spot is a blue-gray, bruise-looking birthmark that is present at birth. It is also known as a slate grey nevi. The formal term for slate grey nevi is congenital dermal melanocytosis.

These strange-looking spots are quite common in darker-skinned people. They are mostly found on the lower back or buttocks but can occur anywhere.

Mongolian spots can last for months or even years, but they usually disappear as the child ages (6). The marks are often mistaken for bruises, so it’s a good idea to ensure your baby’s doctor has a record of any spots on their skin.

4. Capillary Malformation

Capillary malformation, also known as a port-wine stain, is a flat red or purple mark. These marks vary in size. Some are only a fraction of an inch, while others cover large areas.

A port-wine stain may darken over time, and your child will likely be affected by it for life. However, there are ways to lighten it with laser technology.

These marks also tend to flare up and become more visible with changes in hormone levels. Flare-ups could happen around puberty, pregnancy, or menopause (7).

What Causes Birthmarks?

It’s not completely clear why birthmarks appear. There are two kinds of birthmarks (8).

1. Vascular Birthmarks

These marks are caused by abnormal blood vessels in or under the skin. They include port-wine stains and strawberry marks.

Vascular birthmarks get their size and color because of the nerves that control the size of the vessels.

Because these nerves don’t function properly, they constantly allow blood to be supplied to the area. This results in the bright red or purple color you see.

2. Pigmented Birthmarks

These are caused by a cluster of pigmented cells in the skin. Pigmented birthmarks are usually flat, but some can be a little raised. They include Mongolian spots and CALMs.

Baby Skin Discoloration FAQs

What Causes Uneven Skin Tone In Babies?

Uneven skin tone in babies can be caused by a variety of factors, including genetic skin variations, birthmarks, and temporary changes due to exposure to cold or heat.

It’s usually normal as a baby’s skin is still developing and adapting to the outside world. If you notice significant changes or discoloration that concerns you, it’s always a good idea to consult with a pediatrician for reassurance.

When Do Babies Get Their Final Skin Color?

Babies typically develop their final skin color within the first six months to a year.

Melanin production, which determines skin tone, continues to develop after birth, so you may notice gradual changes in their complexion during this time.

Genetics usually play the main role, so looking at both parents’ skin tones can give you a hint of what to expect.

Does Breast Milk Affect Baby Complexion?

Breast milk doesn’t directly affect a baby’s complexion in terms of lightening or darkening the skin.

However, it’s packed with nutrients essential for overall health, which can contribute to healthy skin development. Keep in mind that a baby’s skin color is determined genetically and naturally evolves over time.

Can Babies Have Hyperpigmentation?

Yes, babies can have hyperpigmentation. This can include birthmarks or darker patches of skin, which are generally harmless. If you notice any unusual or rapidly changing skin conditions, it’s wise to consult with your pediatrician.

When Should I Be Concerned About My Baby’s Skin Discoloration?

Be concerned about your baby’s skin discoloration if it’s accompanied by other symptoms like fever, rash, itching, or swelling or if the discoloration is rapidly spreading. These might be the signs of an underlying medical condition that needs medical attention.


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Headshot of Dr. Pierrette Mimi Poinsett, MD

Medically Reviewed by

Dr. Pierrette Mimi Poinsett, MD

Dr. Pierrette Mimi Poinsett is a veteran licensed pediatrician with three decades of experience, including 19 years of direct patient clinical care. She currently serves as a medical consultant, where she works with multiple projects and clients in the area of pediatrics, with an emphasis on children and adolescents with special needs.