:: Birthmarks: what are they?

Birthmarks are usually considered as those skin abnormalities that are present at birth. Some lesions referred to as birthmarks can, however, appear or become very much more obvious after birth. Birthmarks can be different in size, shape and colour. Most people think of birthmarks as either flat or raised red areas that can affect any part of the body; these are made up of abnormally widened blood vessels. The other types are pigmented lesions, again, either flat or raised from the skin surface and found anywhere; these ‘moles' can be brown-black to skin coloured, and can occasionally develop hair. They can be small or very large, single or multiple. The main concerns that patients and parents have about birthmarks relate to the cosmetic appearance on the one hand, and the potential for cancerous change on the other. Most birthmarks are of no sinister consequence, although, rarely, can undergo such change. Perhaps the most likely lesions to undergo such sinister change are the large (greater than the size of the individuals palm) ‘moles', although this is still a rare occurrence, one should not be complacent: one should look out for growing or changing moles and show them to your doctor and their advice taken. The Canterbury Skin and Laser Clinic offers a self-referral service to the Consultant Dermatologist for a birthmark check up, although we prefer for your GP to be involved at the outset.

:: Pigmented lesions: what are they?

Pigmented lesions (PLs) are lesions that have some colour that distinguishes them from the normal surrounding skin. As stated above, they can be single or multiple, small or large. Shapes can vary from round to rather bizarre. They can be flat or raised from the skin surface. Most of us have at least one PL, with the commonest being a simple mole. You can read more about moles in the ‘mole section’. Other sorts of PLs include the so-called age spots or liver spots, usually caused by over exposure of skin to the sun. These are like large freckles and are commonly found on the face, backs of hands and forearms. The more warty PLs typically seen on older peoples skin are most likely to be Seborrhoeic keratoses, which can look worrying but are innocent. Having said that, however, if there is change in size, shape or colour of any PL, get it checked by your doctor just in case what you are not worried about, should be dealt with.

:: How are birthmarks and PLs treated?

The first thing to do is confirm the diagnosis: get the birthmark checked as there are a number of different entities it might be and making the correct diagnosis is paramount if you are to be informed about the lesion, as well as the treatment options to consider. This holds true for PLs too. Once you know what it is, you can be informed, and further management options discussed. Treatment options may be simple reassurance, photographs and later review to assess for potential changes, surgical excision or laser therapy, to name but a few. Where PLs are concerned, if your doctor thinks you may have an early melanoma developing, or isn't sure, then s/he will refer to the Dermatologist for a further opinion. The dermatologist will tell you if treatment or monitoring is required.
Most birthmarks and pigmented lesions are, however, benign and harmless, but can still be a worry or a cosmetic nuisance. In such circumstances, the NHS may be unable to offer treatment other than reassurance. The Canterbury Skin and Laser Clinic offers a diagnostic as well as treatment service, when appropriate, from the Consultant Dermatologist. If you are unsure about your skin, discuss with your GP or ring us for further advice or an appointment.