A Café Catch-Up with Emily and Oliver
Last Sunday, I decided to spend some time at my favorite café—a cozy corner spot downtown where I often go to unwind. I had just settled down with my cappuccino when I saw Emily, an old friend from college, walk in with her little boy, Oliver. They saw me, and I waved them over to join me.
Emily looked slightly worried as she placed her cup on the table and helped Oliver, who was busy playing with a small toy car, settle into his chair.
“Hi, Emily! It’s been ages,” I said, smiling.
Emily returned the smile, but I could tell there was something on her mind. “Priya, I’m glad we ran into each other. Actually, I’ve been meaning to ask you something. You’re still in Family medicine, right?”
I nodded. “Of course! What’s up?”
She glanced at Oliver and then leaned in closer. “It’s about Oliver’s birthmark. The one on his neck—sometimes other parents comment on it, and I can’t help but worry. Should I be doing something about it?”
I looked at Oliver. He had a bright red patch near the nape of his neck, one that I instantly recognized as common and harmless. I smiled and said, “Let’s talk about it, Emily. Birthmarks are more common than you might think.”
What Exactly Are Birthmarks?
“First off, Emily,” I began, “birthmarks are areas of discoloured skin that are present from birth or soon after birth. There are different kinds of birthmarks, and they can look a little different from one child to the next. They’re either made up of extra pigment or extra blood vessels.”
Emily nodded, listening intently.
“There are three common types we see, and Oliver’s seems like what we call a ‘stork mark’. It’s one of the most common kinds,” I said.
Different Types of Birthmarks
Emily looked interested, and I could tell she wanted more information. So, I continued.
1. The Stork Mark (Nevus Flammeus)
“The ‘stork mark,’” I explained, “is also known as a Nevus flammeus or a ‘bite mark.’ It’s a flat, pink or red patch that’s usually found on the back of the neck, eyelids, or the bridge of the nose. These marks are super common, showing up in around half of all babies, and they often fade by the time the baby reaches 18 months. Oliver’s birthmark is nothing to worry about. It’s common and it usually fades as they grow.”
Emily breathed a sigh of relief. “I always worried it might be something serious.”
I shook my head. “Not at all. Just think of it as Oliver’s own unique mark—no medical intervention is needed.”
2. The Strawberry Naevus
“Another type you might see in other children is called a strawberry naevus. It’s a bright red raised area that appears like a little lump. It starts very small, but can grow over time during the first year of life.”
Emily looked concerned, “Does it need treatment if it grows?”
“Most of the time, it doesn’t,” I reassured her. “By the time a child is 4 to 8 years old, these marks usually start to disappear. They can sometimes bleed if they get bumped, but pressing firmly on it will help stop the bleeding. Only in rare cases, if the birthmark is very large or is causing problems, a doctor might recommend some treatment.”
3. The Port Wine Stain
“Then, there’s the port wine stain, which is a bit more noticeable,” I added. “It’s a purplish-red discolouration that shows up mainly on the face or arms. These stains can be present at birth and tend to grow as the child grows. They don’t fade on their own, but they can be treated with laser therapy, especially during the early years.”
Emily’s eyes widened. “I’ve seen one of those before, but I never knew what it was called.”
“Yes,” I nodded. “In the past, people used to cover them up with makeup, but today, laser treatment is a common option for managing them if needed.”
Pigmented Birthmarks and Mongolian Blue Spots
I took a sip of my cappuccino and continued, “There are also pigmented birthmarks, which are darkened areas of skin. You might hear them called congenital melanocytic naevi—or simply moles. These are very common, and most kids have at least one or two.”
Emily looked down at Oliver’s hands, nodding. “I think Oliver has a tiny mole on his arm.”
“That’s completely normal,” I reassured her. “These moles are harmless. Sometimes, they get raised or might grow a few hairs, but they’re usually nothing to worry about. If, however, they change in appearance, become itchy, or start swelling, it’s a good idea to get them checked out by a dermatologist.”
“And then there are Mongolian blue spots, which are flat, bluish patches found mainly on the lower back or bottom. They’re often mistaken for bruises but are totally harmless and usually fade with age.”
Does Oliver Need Treatment?
Emily gave me a worried look. “So, should I do anything for Oliver’s birthmark?”
“Emily,” I said, placing my hand gently on hers, “most birthmarks, including Oliver’s, don’t need any treatment at all. They are simply part of who he is. The only time we think about treatment is when a birthmark affects a child’s health or well-being—for example, if it affects their vision or breathing, or if it makes them feel self-conscious.”
She sighed in relief. “That’s great to know, Priya. I was worried I should be doing something.”
I smiled. “Honestly, the best thing you can do is celebrate Oliver just the way he is. Birthmarks can be part of his story, and they’re nothing to be afraid of.”
When Should You Seek Medical Help?
I could see Emily relax as we talked, but I knew there were still lingering worries. “There are times when a birthmark should be checked by a doctor,” I added. “If it changes rapidly—like getting much bigger, changing color, becoming painful, or starting to bleed—you should get it looked at. But in Oliver’s case, it’s all very normal.”
Emily nodded. “That’s reassuring, Priya. I just don’t want him to feel different, you know?”
Helping Kids Understand Their Birthmarks
“I get that,” I said warmly. “The key is to make sure Oliver knows that his birthmark is just another part of him—like his curly hair or his big smile. Birthmarks don’t make us different in a bad way. They make us unique.”
Oliver, who had finished playing with his toy car, suddenly looked up at me, curious about what we were discussing. I smiled at him and said, “Hey, Oliver, did you know that the special mark on your neck is called a ‘stork mark’? It’s like a cool nickname just for you!”
He giggled, not quite understanding, but happy to be part of the conversation.
FAQs About Birthmarks
To help Emily further, I answered a few common questions about birthmarks:
Q1. Are Birthmarks Genetic?
Birthmarks can sometimes run in families, but not always. The exact cause of most birthmarks is still not fully understood.
Q2. Can Birthmarks Be Removed?
Some birthmarks can be removed for cosmetic reasons, especially if they cause distress. Laser treatment or minor surgeries are options, but not all birthmarks need removal.
Q3. Do All Birthmarks Disappear Over Time?
Not all birthmarks disappear. Some, like stork marks, often fade on their own, while others, like port wine stains, might stay but can be treated if needed.
Final Thoughts: Embrace What Makes Us Unique
As we finished our coffee and got ready to leave, I could see that Emily felt lighter. I reached over and gave her a hug. “You’re doing an amazing job, Emily. Birthmarks are just a small part of what makes Oliver, Oliver. He’s happy, healthy, and loved—that’s what matters the most.”
Emily smiled, looking at Oliver, who had started driving his toy car across the table again. “Thank you, Priya. You always know how to make things feel manageable.”
“Always here for you,” I said, waving as they headed out.
Remember Birthmarks are part of what makes each of us special. They’re nothing to be afraid of, and in most cases, they don’t need any treatment. Let’s embrace the little things that make us who we are.
