Are Mongolian Spots something to be concerned about in an internationally adopted child?

A Mongolian spot is a normal bluish-green or bluish-gray flat birthmark that is found in over 90 percent of Native American, Asian, Hispanic, and African American babies.
They are also seen in 10 percent of Caucasians, especially those of Mediterranean descent. They often have wavy borders and irregular shapes, with bluish gray to deep brown to black skin markings. Mongolian spots often appear on the base of the spine, buttocks, back and even on the ankles or wrists.

The pigmented area has large concentrations of skin cells called melanocytes, with normal skin texture. They commonly appear at birth or shortly after birth and may look like bruises. They vary greatly in size and shape. They have no relationship to any disease. There is no known prevention and they generally fade in a few years and disappear by puberty. Though occasionally they persist into adulthood, there is no need for treatment.

Because Mongolian spots can be easily mistaken for bruises, they have raised the suspicion of child abuse against some adoptive parents. It is important to be sure that your child’s pediatrician documents the presence of Mongolian spots during the post adoption examination. During this visit the pediatrician will note any suspicious lesions that may warrant close observation or further investigation by a pediatric dermatologist. It is important that you convey your concerns to the pediatrician from the beginning of the adoption process. Since the lesions may change over time, it may be helpful to take photographs of the lesions to keep in the medical chart should any issues arise at a later time.

By Nicholas Rogu M.D. of