A cafe au lait birthmark is a flat, brown-colored skin discoloration that is present at birth or appears in the first few months of life. The term “cafe au lait” is French for “coffee with milk” and refers to the light brown colour of the birthmark. This type of birthmark is one of the most common forms of pigmented birthmarks and affects individuals of all races.
The cause of cafe au lait birthmarks is not fully understood, but it is believed to be due to an overproduction of the pigment melanin in certain areas of the skin. In some cases, cafe au lait birthmarks are associated with genetic conditions such as neurofibromatosis type 1 (NF1) and McCune-Albright syndrome.
Diagnosis and Treatment
Diagnosis of a cafe au lait birthmark is usually made through a physical examination of the skin. In some cases, a biopsy may be required to rule out other conditions, such as melanoma. If the birthmark is large or has a significant impact on an individual’s quality of life, treatment may be necessary.
Treatment options for cafe au lait birthmarks include surgical excision, laser therapy, and topical lightening agents. In some cases, observation may be the best option, especially if the birthmark is small and has no associated symptoms.
For some individuals, cafe au lait birthmarks can be a cosmetic concern, especially if they are located in visible areas of the body, such as the face or arms. While most birthmarks are not harmful, some people may feel self-conscious or embarrassed about their appearance. In these cases, cosmetic treatments, such as camouflage makeup, can be used to cover the birthmark.
In some cases, cafe au lait birthmarks can cause physical symptoms, such as itching, burning, or pain. This is more likely to occur if the birthmark is located in a sensitive area, such as near a joint. If an individual experiences physical symptoms, it is important to seek medical attention.
Association with Genetic Disorders
Cafe au lait birthmarks can be associated with genetic disorders, such as neurofibromatosis type 1 (NF1) and McCune-Albright syndrome. NF1 is a genetic condition that affects the growth and development of nerve cells, causing tumors to form on nerve tissue. McCune-Albright syndrome is a rare genetic disorder that affects bones, skin, and endocrine function.
If an individual has multiple cafe au lait birthmarks, it is important to seek medical attention, as this may be an indicator of a genetic disorder. A physician will be able to perform diagnostic tests and determine if a genetic condition is present.
Treatment Options for Cafe Au Lait Spots
Cafe au lait spots can be treated using various methods depending on the size, location, and severity of the birthmark. The following are the most common treatment options:
Observation: For small cafe au lait spots, no treatment may be necessary. The birthmark may fade over time and does not pose any significant health risk. In such cases, regular monitoring by a doctor is recommended to ensure that the birthmark does not change in appearance or size.
Topical lightening agents: Hydroquinone, a skin-lightening agent, can be applied topically to lighten the birthmark. It works by inhibiting the production of melanin, the pigment responsible for the birthmark’s colour. Topical lightening agents may take several months to produce noticeable results. However, the process is slow. At the same time, for some patients, there are potential side effects like darkening of the pigment instead of lightening it.
Laser therapy: Lasers can be used to remove or lighten the birthmark by destroying the melanin-producing cells. Lasers are typically most effective for birthmarks located on the face, neck, or other visible areas of the body.
Surgical excision: If the birthmark is large, or if it affects an individual’s quality of life, surgical excision may be recommended. This procedure involves removing the birthmark and stitching the skin back together. Surgical excision may result in scarring, so it is important to discuss the risks and benefits with a doctor.
At The Clifford Clinic, we house the Pico Laser system that deals great with Café-au-lait spot. This laser treatment is also commonly used for acne scar treatment in Singapore. It uses high-intensity light to break down the melanin in the affected area. Specifically, the 532nm wavelength of the PicoLaser is commonly used in laser treatments for café-au-lait spots. This wavelength is absorbed by melanin, causing the melanin to break down and be reabsorbed by the body. This results in a lighter appearance of the affected area.
At the same time, the down-time is fairly minimal. There can be some mild redness or mild crusting at the patch, which will clear over time. Patients can still enjoy their usual daily routines. Sun avoidance is a must. Depending on the depth of the café-au-lait spot, the number of sessions can vary.
In the past, café-au-lait spot are dealt with by direct burning of the spot using a laser. While it may be effective in the short term, it can also cause many other side effects like scarring, darkening of the spot as well as burns. As such, the Pico-laser has been gaining traction of late in treating café-au-lait spot.
For the best way to address the café-au-lait spot, do speak with one of our aesthetic doctors!