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.

What Causes Mongolian Blue Spots In Babies?

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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.

Quick fact

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

Diagnosis Of Mongolian Blue Spots

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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.

Quick tip

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.

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.

Illustration: Momjunction Design Team

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

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Maria Carmela Villania-MamauagMD, DPPS

Maria Carmela Villania-Mamauag is a board certified diplomate of the Philippine Pediatric Society with a degree of Doctor of Medicine from Our Lady of Fatima University, Valenzuela City and a Bachelor in Science in Psychology from Saint Louis University, Baguio City which was augmented by a year of Bachelor in Science in Family Life and Child development at the University...more

Dr Bisny T. JosephMedical Doctor

Dr. Bisny T. Joseph is a Georgian Board-certified physician. She has completed her professional graduate degree as a medical doctor from Tbilisi State Medical University, Georgia. She has around 5 years of experience in various sectors of medical affairs as a physician, medical reviewer, medical writer, health coach, and Q&A expert. Her interest in digital medical education and patient education...more

Rohit GarooBSc, MBA

Rohit Garoo is a writer-turned-editor with over 9 years of experience in content writing, editing, and content marketing. He did his bachelors in Science at St. Xavier's College, Hyderabad, and masters in Business Administration at Osmania University. Also, he holds a certificate in Developmental Psychology from The University of Queensland and loves to expand his knowledge through certifications in various...more

Shinta Liz SunnyM.Tech

Shinta is a biotechnologist who is highly intrigued by science and technology. She holds a master's degree in Biotechnology from Karunya Institute of Technology and Sciences and a PG Diploma in cellular and molecular diagnostics from Manipal University. At MomJunction, Shinta writes on mother and child health and wellness. Previously, she worked as a scientist for three years, involved in developing...more