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Baby Skin Discoloration & Birthmarks

Medically Reviewed by Dr. Pierrette Mimi Poinsett, MD
Here’s what you need to know about birthmarks and 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.

Baby’s Skin Color

In our heads, we all have the same image when we think of a newborn. 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 color. You’ll likely notice straight away if your baby is cold — their feet will probably be a bluish color. Conversely, if they are hot, their cheeks will be red and flushed.

Newborns sometimes have a lighter skin complexion than you expected. Their skin tone can change over time — some 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. Some, however, will appear shortly after birth, or as 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 will do no harm.

Here’s what might be causing them:

Cafe Au Lait Macules

Cafe au lait macules, or CALMs, are brown spots or patches. They can appear anywhere on the baby’s body and are usually present from birth. These spots are found in about three percent 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.

It is possible for the spots to be slightly raised, although they are usually smooth. Finding one, or even three, on your infant is normal and no reason for concern. But if you find six or more, you should consult your doctor, to check for NF1.

Neurofibromatosis Type 1


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).

Also known as Von Recklinghausen’s disease (VRD), this is the most common of three variations of Neurofibromatosis.

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 proliferate (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.

All of us moms have worried when we found white spots suddenly appearing on our baby’s skin. Only after did we 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.


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

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

The patches could 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 this condition, it is crucial to use a strong sunscreen on the patches. The loss of pigment makes the skin much more vulnerable to sunburn.

There are different types of vitiligo, including segmental, focal, and generalized.

Segmental vitiligo will only affect one side of the body, and focal is just a couple of spots in one area. Whereas generalized vitiligo sees symmetrical patches on both sides of the body. This is also considered to be an autoimmune condition (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 living in the pores. As the condition progresses, the fungus overgrows, causing the discoloration.

There shouldn’t be any reason for concern since besides being a little itchy, the patches are harmless.

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, 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 are broken down, bilirubin is produced. And it just happens to have a yellow color.

Take Note

Jaundice is common in newborns because they have a higher number of 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 be a sign of 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 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:

  • Phototherapy: Baby is exposed to a particular light which 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 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).


We all know 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 which often occurs on the baby’s eyelids, forehead, or neck.

They usually fade entirely within the first few months although the 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 head.

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

2. Infantile Hemangioma

Infantile HemangiomaThese are also known as strawberry birthmarks. Unsurprisingly, they actually 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 start outgrowing very 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 any other vital function, consult a specialist for advice (5).

3. Mongolian Spots

A Mongolian spot is a blue-gray, bruise-looking birthmark, which is present from 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 gets older (6). The marks are often mistaken for bruises, which is what I did when I saw my friend’s daughter had one!

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.

Port wine stains may darken over time, and your child will most likely be affected by it for life. There are ways to lighten it, though, with specialist laser technology.

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

What Causes Birthmarks?

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

1. Vascular Birthmarks

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

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

Because these nerves don’t function properly, they allow blood to be supplied to the area constantly. 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, and some can be a little raised. They include Mongolian spots and CALMs.

Headshot of Dr. Pierrette Mimi Poinsett, MD

Medically Reviewed by

Dr. Pierrette Mimi Poinsett, MD

Dr. Pierrette Mimi Poinsett is a veteran board-certified 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.