Birthmark itch- these are the causes and backgrounds
If a birthmark is itchy, it doesn't have to mean something bad, but a closer look should be done. If the birthmark also changes, for example in size and / or color, a doctor must be consulted.
Birthmark - what is it actually?
A birthmark is a pigmentation stain that results from the fact that a particularly large number of pigment-forming cells (melanocytes) accumulate at one point and form the skin pigment there. Such a stain can also develop from nevus cells. These cells are closely related to the melanocytes.
The birthmark can already be present at birth. When we talk about a mole, we usually mean times that develop over the course of life. However, there is no precise definition for the term mole. The technical term for a birthmark is nevus (plural: nevi).
The Naevi are typified according to their color, surface structure and the layer of skin from which they originate. In medical literature, the term nevus is understood to mean the following: a congenital or even later, circumscribed malformation of the skin in connection with a herd-like accumulation of altered melanocytes or melanocyte-like cells.
Birthmarks can appear anywhere on the body. The congenital nevi can grow up to the size of the palm of the hand, the acquired ones are usually not larger than 5 millimeters. The surface is smooth, the color is different - this ranges from skin-colored to dark brown.
The causes of the increased formation of melanocytes have not yet been sufficiently clarified. It is being discussed that genetically modified progenitor cells of the melanocytes penetrate the skin, multiply there and then accumulate in a small place, which ultimately creates the birthmark.
Light-skinned people are more likely to get a larger amount of birthmarks. There is also a genetic disposition for the development of pigment spots. What also stimulates the formation of such pigment disorders is frequent and unprotected sunbathing. Anyone who has spent many hours unprotected in the sun as a child and / or adolescent increases the risk of getting birthmarks. In addition, birthmarks often develop during hormonal changes, such as during pregnancy or in the menopause. Last but not least, a weakened immune defense is one of the causes of the excessive formation of pigment spots.
The ABCDE rule exists for the determination of critical birthmarks, which states the following:
A stands for asymmetry (irregularity: not evenly round or evenly oval), B for limitation (a birthmark should be sharply delimited), C for color (color), D for diameter and E for development (changes in the four points above).
There are also warning signals such as itching, oozing, pain, burning and bleeding. If, for example, a previously flat, light-brown birthmark suddenly grows and this also irregularly, it is essential to consult a doctor. If the birthmark suddenly itches again and again, this can also be a warning.
Birthmarks are usually harmless, but can also degenerate. Therefore, they should always be observed and regularly (every two years) subjected to a skin cancer screening at the family doctor or dermatologist. This is especially true for people who have a large number of birthmarks and / or are fair-skinned. From the age of 35, the screening is paid every two years by the statutory health insurance.
Skin screening procedure
The patient is subjected to a full body inspection when undressed. The entire body, including the hairy head, armpits, genital area, face, toe spaces, oral mucosa, etc. is closely examined. This is done with an illuminated magnifying glass and, in case of suspicion, also with a dermatoscope, a special magnifying glass with which the upper layers of the skin can be examined. The application of oil or a special liquid is used for better transparency. Many dermatological practices use digital reflected light microscopy. Every spot can be transferred to a computer screen. The birthmarks are compared and their course is saved.
The skin screening takes about 10 to 15 minutes. In addition, there is an exact medical history, a questioning of the patient about lifestyle, circumstances, diseases, genetic disposition, etc. A pigment change, which the doctor classifies as questionable, is surgically removed and pathologically examined.
Removal of the birthmark
The birthmark is surgically removed with a scalpel. This is not painful because the area is previously anesthetized. Depending on the size, the spot may have to be sewn. Sports activities are usually contraindicated for a week or two. The wound should also not come into contact with water for a predetermined time. Laser removal is not possible because the tissue is burned and cannot be examined afterwards.
If the birthmark is itchy, it can also have a completely harmless cause. For example, it can of course also affect birthmarks if someone generally suffers from dry skin. Birthmarks in particular, which are located in areas that are irritated all day long (such as under the breast, where the bra is located, or at the height of the jeans button), often start to itch here. Therefore, something should be done about dry skin.
Regular moisturizing care, daily supply of the skin with a good, high-quality oil (sesame oil, almond oil, coconut oil) and adequate hydration (2 to 2½ liters of still water a day) are urgently required for dry skin.
Hormonal changeover times can also be "to blame" for dry skin. If the itching gets worse and there is no herb against the dry skin, a doctor should be consulted.
Pigment spots that are subject to constant friction
Whether a birthmark is itchy or not - pigment spots that are subject to constant friction - for example because they are under the bra wear, at the level of the waistband or directly on the sole of the foot - should be removed. A permanent stimulus is always bad for the skin and especially if a skin change in the form of a birthmark has already formed there.
Malignant melanoma (black skin cancer)
Changes in a birthmark do not necessarily have to be malignant, but unfortunately these skin changes can degenerate in rare cases. The best known representative of malignant neoplasms is malignant melanoma. With early diagnosis, the chances of recovery are very good. So - in the event of any changes, even if the birthmark only itches again and again - it would be better to go to the doctor too often than too late.
Malignant melanoma originates from the melanocytes and is highly malignant. Therefore, quick and early diagnosis and action is necessary. Unfortunately, this tumor also forms metastases quite quickly. Frequent, excessive sunbathing, frequent sunburns and also regular visits to the tanning bed - all of these are risk factors for developing malignant melanoma. People who have a large number of birthmarks are also at risk.
In the case of a disease, the focus is on the surgical removal of the degenerated tissue. First the birthmark is removed during screening, then examined pathologically. If the result is positive, the operation is repeated and that over a large area. To rule out that lymph nodes are also affected, further examinations are carried out. An MRI may also be necessary to determine whether the malignant melanoma has already spread to other organs.
The entire therapy for this disease depends on the patient's individual findings.
White skin cancer
If a birthmark is itchy, it can also indicate white skin cancer. This malignant skin disease is usually easy to treat, but is often discovered late. White / light-colored skin cancer includes various skin tumors: early forms (actinic keratoses), basalioma, and squamous cell carcinoma.
The early forms appear as reddish, rarely skin-colored, firmly adhering skin spots. This creates knots with firmly adhering small horn beads that are very difficult to remove and sometimes bleed. The tumors can grow deeper, destroying the surrounding tissue.
The light skin cancer is mainly found in sun-exposed areas such as the ears, face, neck or upper arms. The main cause of this cancer is massive sun exposure. Every sunburn increases the risk. Other risk factors include fair skin, older age, light skin cancer that has already occurred in the family, congenital genetic defects, working outdoors, light or radiation therapy, contact with arsenic or tar and a permanently weakened defense.
As with malignant melanoma, the tumor is removed first. Radiation is given to elderly patients for whom surgery is no longer advisable. Chemotherapy in the form of certain ointments is also possible. If the cancer has spread, which is quite rare in light skin cancer, conventional chemotherapy is the method of choice.
In summary, birthmarks are usually something quite normal and harmless. Nevertheless, everyone should regularly check their own pigment spots to notice changes. For all changes, but also if the birthmark is itchy, wet or bleeding and pain may still occur, a doctor should definitely be consulted. (sw)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Susanne Waschke, Barbara Schindewolf-Lensch
- German Cancer Society: Malignant Melanoma ("Black Skin Cancer"), ONKO Internet Portal, (accessed on September 5, 2019), ONKO
- Guideline program oncology (German Cancer Society, German Cancer Aid, AWMF): diagnostics, therapy and aftercare of melanoma, long version 3.1, 2018, AWMF register number: 032 / 024OL, (accessed on 05.09.2019), AWMF
- German Cancer Aid: What is white skin cancer ?, (accessed 05.09.2019), Cancer Aid
- Martin Röcken, Martin Schaller, Elke Sattler, Walter Burgdorf: Taschenatlas Dermatologie, Thieme Verlag, 1st edition, 2010