What Are Salmon Patches? Are These Birthmarks Permanent?

Birthmarks on babies happen more often than many might think. These little markings found on a baby’s body can spark terror in parents. It can make them very nervous to think that there is some kind of permanent blemish on their perfect child. If they knew the truth, though, they might be pleasantly surprised to learn how these birthmarks can gradually fade away. That is the case for most birthmarks, and that is also the case for “salmon patches.”

What Are Salmon Patches?

Also known as nevus flammeus simplex, salmon patches are the most common vascular lesions in infancy. These reddish or pink patches are often found above the hairline at the back of the neck. They can also sometimes be found on the eyelids or between a baby’s eyes.

Salmon patches are also called “stork bites” or “angel kisses.” They are caused by collections of capillary blood vessels close to an infant’s skin. Salmon patches are present in nearly 44% of all neonate Caucasian infants. They are less common in dark-skinned babies.

Research from 1989 studying Caucasian babies noted that the patches were present in 43.6% of males and 43.8% of females in the immediate neonatal period. Research did not detect patches in boys after age 6 and in girls past the age of 5.

The lesions are scarlet to pink, flat, and can be totally blanched. They usually deepen in color with vigorous activity, crying, straining with defecation, breath-holding, or changes in ambient temperature.

Differences with Port Wine Stains

Salmon patches always appear symmetrically. That is in contrast with port wine stains that have unilateral distribution. Another difference with port wine stains is that the former tends to fade away while the latter persists. 

A port wine stain is a rare congenital disorder that involves abnormal development of blood vessels. These are usually found on an infant’s body more than their face. Extra tiny blood vessels, or capillaries, in the top layer of the skin cause this type of birthmark.

Unlike most birthmarks, port wine stains do not fade away gradually. They persist throughout life, grow darker over time, and require some kind of treatment in order to remove it. Salmon patches may fade as the child grows, though patches at the nape of the neck may be permanent.  

Treatment of Salmon Patches

Salmon patches are common in the neonatal period right after a baby is born. These patches tend to disappear or significantly regress by the time a child reaches 3 years old. Those in the occiput and nape tend to persist longer. Facial lesions are rare after puberty and have not been reported in adulthood. 

Parents should be reassured that these lesions will indeed disappear. Though rare, there is some possible association with occult spinal dysraphism. In such cases, doctors recommended routine ultrasonography imaging of the lumbosacral spine for those with salmon patches in the sacral area.

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