Blue Mongolian Spots In Newborn: Causes, Signs And Treatment

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Mongolian blue spots, also referred to as congenital dermal melanocytosis, slate gray nevus, dermal melanocytosis, or lumbosacral dermal melanocytosis, are a type of birthmarks having a flat, blue or blue-gray appearance. These spots appear at the base of the spine or in the areas of the upper back, buttocks, or shoulders. Some babies may have these spots from birth, while others may develop them a few weeks later.

This post explains the various causes, signs and symptoms, diagnosis, treatment methods, and prognosis of Mongolian blue spots in babies.

In This Article

What Causes Mongolian Blue Spots In Babies?

Causes of mongolian blue spots

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Mongolian blue spots or Mongolian spots appear due to the collection of melanocytes (pigment cells) in the skin’s deep layer. Entrapment of melanocytes in the dermis (deep layer of skin) usually occurs during embryonic development, and they fail to reach the epidermis (superficial layer of the skin). Melanocytes make skin pigment called melanin. Thus, the accumulation of these cells could result in the development of bluish or bluish-gray skin pigmentations or marks, known as Mongolian blue spots, on the newborn skin (1).

Extensive spots might indicate inborn errors of metabolism and vascular pathologies (2). However, in most cases, Mongolian spots are benign.

The birthmark tends to be more common in people with Asian, Native American, Hispanic, East Indian, and African ethnicities. It was originally believed to have been present only in those of Mongolian descent, hence the name.

Symptoms And Signs Of Mongolian Blue Spots

Mongolian blue spots are not painful and do not cause any serious symptoms for the babies. Parents may notice the following features of Mongolian blue spots (3).

  • Blue or blue-gray spots that commonly appear on the back, buttock, or shoulders
  • The spot may appear flat with unclear border and irregular shape
  • Each spot could usually be two to eight centimeter wide
  • Non-blanching (do not fade under pressure)
  • The texture of the surrounding skin would be normal

The birthmark may also appear on the face, limbs, or any other part of the body and are called Ectopic Mongolian Spots. In rare cases, it can be mistaken for bruises that may arise due to trauma or child abuse.

Mongolian blue spots may sometimes cover large areas of the skin. However, these spots are not cancerous and are mostly benign birthmarks. There won’t be any changes in the skin other than the color of the birthmark.

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The Mongolian spots may be two to eight centimeters wide in size (1).

Diagnosis Of Mongolian Blue Spots

Doctors evaluate the birthmarks during the routine newborn examination.

Image: IStock

Doctors can diagnose Mongolian blue spots by observing the newborn’s skin. The pediatrician usually evaluates all types of birthmarks during the routine newborn examination. There is no test required to diagnose Mongolian blue spots. In rare cases, healthcare professionals may order some tests if they suspect any underlying dermatological conditions.

Treatment For Mongolian Blue Spots

Mongolian blue spots do not require treatment if they are normal birthmarks.

However, if testing reveals other underlying conditions causing skin discoloration, the doctor may design a treatment option that is suitable to address that condition. You may discuss with a pediatrician for the individual treatment plan.

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The doctors may recommend laser treatment for children who need treatment to get rid of Mongolian blue spots (1).

Prognosis Of Mongolian Blue Spots

In many cases, the normal birthmarks may fade away by age four or during teenage. However, more extensive and persistent melanocytosis may tend to stay for several years or a lifetime.

Frequently Asked Questions

1. Do Chinese babies have Mongolian spots?

Yes, Mongolian spots could be seen in the Chinese infant population. Also, a group study highlighted that Mongolian spots are prevalent in various Chinese populations, such as Canadian Chinese infants, with its incidence slightly higher in boys. Moreover, the skin pigmentation was mainly grayish blue or grayish black (4).

2. Can Caucasian babies have Mongolian spots?

Research studies reveal that Mongolian spots are not very common in Caucasian babies. Furthermore, the prevalence of these spots is just 10%, compared to about 90% in the Asian infant population (2).

3. Are blue Mongolian spots in newborn babies linked to genetic disorders?

No. Mongolian spots in newborns are not linked to any genetic disorders or conditions. Instead, these spots are considered a normal and common skin variation observed in individuals with darker skin tones.

Mongolian blue spots are not a sign of any disease. Instead, they are blue-gray spots or pigmented birthmarks that appear due to the collection of melanocytes in the deeper layers of the skin. Although these spots are not a cause for concern, it is advised to consult with the doctor for the proper diagnosis of the cause of the spots. In addition, one should remember that these spots are not a sign of skin cancer and do not cause any pain. But, in case your baby experiences pain and other symptoms, consult the doctor promptly.

Infographic: What Other Conditions Can Cause Gray-Blue Skin Lesions In Babies?

Gray-blue skin lesions can also be seen in other health conditions in babies. Mistaking them for Mongolian blue spots and not seeking timely treatment may worsen specific underlying causes. Go through the infographic to learn about the common medical conditions in babies causing gray-blue skin lesions.

causes of gray blue skin lesions in babies (infographic)

Illustration: Momjunction Design Team

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Download Infographic in PDF version

Key Pointers

  • While most Mongolian spots are benign, extensive spots may signify inborn metabolic and vascular pathologies.
  • Blue or blue-gray color patches on the back, buttocks, or shoulders of neonates are prevalent.
  • If Mongolian blue spots appear as birthmarks, no treatment is necessary.
  • If the mark is extensive, a pediatric dermatologist evaluation is advised to rule out any underlying disorders.

Learn from this video about Congenital Dermal Melanosis, also known as Mongolian Spots. Discover what causes them and how they can be treated.


MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.

1. Mongolian Blue Spots; Icahn School Of Medicine, Mount Sinai
2. Divya Gupta and Devinder Mohan Thappa, Mongolian spots: How important are they?; World Journal of Clinical Cases; NCBI
3. Lumbosacral Dermal Melanosis; DermNet NZ
4. A.K. Leung; Mongolian spots in Chinese children; NCBI

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