Telangiectatic nevi, more commonly called salmon patches or nevus simplex, are flat, pink or reddish marks found on roughly a third to half of all newborns, making them the single most common vascular birthmark. They go by several nicknames: “angel kiss” when they sit on the forehead or eyelids, “stork bite” when they appear on the nape of the neck. Despite the alarming appearance they can have under bright nursery lights, the vast majority fade on their own within the first couple of years of life and require no treatment at all.
How Common They Really Are
Studies put the prevalence anywhere from about 30% to 50% of newborns, depending on the population studied and how carefully clinicians look for faint marks. A prospective survey of 1,000 neonates found salmon patches in 36% of babies, far outpacing any other vascular birthmark.1PubMed Central. Neonatal Birthmarks: A Prospective Survey in 1000 Neonates Another widely cited figure is around 44%.2Case Reports in Medicine. Persistent Salmon Patch on the Forehead and Glabellum in a Chinese Adult Some reviews report rates as high as 50%.3Actas Dermo-Sifiliográficas. Vascular Malformations in Childhood The variation depends partly on skin tone: lighter-skinned babies tend to have more visible marks, whereas on darker skin the same dilation of tiny blood vessels can be subtler and easier to overlook during a quick exam. Either way, the point is that salmon patches are not unusual. They are closer to the default than the exception.
What They Look Like and Where They Show Up
A salmon patch is a flat, irregularly bordered, pink-to-reddish area that blanches when you press on it. The color comes from dilated capillaries sitting close to the skin’s surface, not from any deposit of pigment. Press a finger against it, the blood gets pushed aside, and the spot briefly disappears. Release, and the color returns. That blanching behavior is one of the quickest ways to distinguish a salmon patch from a pigmented birthmark.
The marks cluster in predictable locations. In the 1,000-neonate survey, half of the salmon patches sat on the upper eyelids, a quarter appeared on the forehead or glabellar region (the area between the eyebrows), and a quarter were on the nape of the neck.4PubMed Central. Neonatal Birthmarks: A Prospective Survey in 1000 Neonates Less frequently, they turn up on the nose, upper lip, or lower back. A study of patients with more widespread nevus simplex found additional involvement on the scalp, lumbosacral skin, and mid-to-upper back.5Journal of the American Academy of Dermatology. Nevus simplex: a reconsideration of nomenclature, sites of involvement, and disease associations Most babies have just one patch, though having two or three in typical spots is still perfectly normal.
Why They Happen
The underlying cause is straightforward: the small blood vessels in that patch of skin remain slightly wider than they should be, letting more blood pool near the surface and tinting the skin pink. In a developing fetus, the autonomic nervous system gradually tightens its control over these tiny capillaries. Where that maturation lags behind, you get a visible patch. It is not a tumor, not a growth of abnormal cells, and not a scar. The vessels themselves are structurally normal; they are simply more relaxed and open than the vessels next door.
Because the mechanism hinges on the maturation of nerve control rather than a structural defect in the blood vessels, most salmon patches fade as the nervous system catches up after birth. This also explains why the patches tend to flare brighter when the baby cries, strains, or gets warm: anything that increases blood flow to the skin temporarily fills those slightly dilated capillaries even more, making the mark stand out.
Which Ones Fade and Which Ones Stick Around
Location is by far the best predictor of whether a salmon patch will disappear. Patches on the eyelids, forehead, nose, and upper lip almost always fade. One review noted that marks on the glabella, eyelids, nose, and upper lip are rarely detected after age six.6Case Reports in Medicine. Persistent Salmon Patch on the Forehead and Glabellum in a Chinese Adult On most body sites, fading happens within the first one to two years, though subtle residual pinkness may linger a bit longer in some children.7DermNet. Naevus simplex
The nape of the neck is the big exception. That “stork bite” has roughly a 50% chance of persisting indefinitely.8DermNet. Naevus simplex Because it usually hides under hair, most adults who still carry one never realize it is there. You can sometimes spot it when someone with short hair blushes or overheats; the back of the neck turns a brighter pink in one distinct area. Surveys of adults suggest that nape-of-the-neck salmon patches are far more common in the general population than people think; they are just invisible day to day.
Persistent patches on the forehead and glabella in adults are documented but uncommon. When they do survive past childhood, they tend to deepen slightly in color rather than fade further, and they can become more noticeable with sun exposure or after drinking alcohol, both of which increase blood flow to facial skin.
Telling a Salmon Patch from a Port-Wine Stain
This is one of the most frequent sources of parental anxiety. Port-wine stains (also called nevus flammeus) are a different kind of capillary malformation, and they do not fade on their own. In fact, they tend to darken and thicken over time. Getting the distinction right matters because port-wine stains sometimes signal deeper issues, while salmon patches almost never do.
There are a few practical differences you can observe even in the nursery:
- Color: Salmon patches are lighter, usually a soft pink or pale red. Port-wine stains start darker, often a deeper red or purple, and sit on one side of the face or body.
- Border: Salmon patches tend to have feathered, indistinct edges that blend into surrounding skin. Port-wine stains usually have a sharper, more geographic border.
- Symmetry: Salmon patches typically appear in the midline, centered on the forehead, between the brows, or at the nape. Port-wine stains are much more often unilateral, covering one cheek or one side of the forehead.
- Trajectory: Salmon patches lighten over months. A port-wine stain that has not begun to fade by four to six months is probably not going to.
A classification review identified at least seven distinct clinical patterns of capillary vascular stains, including nevus simplex, port-wine stain, reticulated capillary malformation, and cutis marmorata telangiectatica congenita, among others.9Pediatric Dermatology. Vascular Stains: Proposal for a Clinical Classification to Improve Diagnosis and Management The fact that so many related-but-different conditions exist is part of why even clinicians sometimes struggle with the differential diagnosis in newborns. When in doubt, a pediatric dermatologist can usually settle the question by examining the mark under magnification and tracking its behavior over two or three visits.
When a Vascular Birthmark Deserves a Closer Look
A run-of-the-mill salmon patch in a typical location on an otherwise healthy baby needs no workup at all. The situations that warrant more attention involve marks that look unusual in color, size, or location, or babies who show additional findings.
Large or dark capillary malformations on the forehead can occasionally be associated with Sturge-Weber syndrome, a condition involving abnormal blood vessels in the brain and eye on the same side as the facial mark. The key difference is that these forehead lesions are typically port-wine stains, not salmon patches: they are darker, unilateral, and often follow a specific distribution along the first branch of the trigeminal nerve. A faint midline “angel kiss” that lightens when you press it is not the same thing.10PubMed Central. Vascular Birthmarks as a Clue for Complex and Syndromic Vascular Anomalies
Macrocephaly-capillary malformation syndrome (M-CM, sometimes called MCAP) is another rare condition where extensive capillary malformations appear alongside an unusually large head, asymmetric body growth, extra or fused fingers or toes, and neurological differences.11PubMed Central. Megalencephaly-Capillary Malformation-Polymicrogyria Syndrome (MCAP): A Rare Dynamic Genetic Disorder The vascular marks in M-CM tend to be widespread, reticulated (web-like), and involve the midline face and body.12Journal of Child Neurology. Macrocephaly-Capillary Malformation Syndrome in a Newborn With Tetralogy of Fallot and Sagittal Sinus Thrombosis These look quite different from a simple salmon patch, but the fact that both involve capillary-level vascular changes is why pediatricians sometimes mention the condition to anxious parents. A baby with a single, small, fading midline mark and a normal head circumference is not the profile that warrants concern here.
The broader point is that vascular birthmarks exist on a spectrum. Over 30% of newborns have some type of vascular skin mark, and the overwhelming majority are benign and self-resolving.13PubMed Central. Vascular Birthmarks as a Clue for Complex and Syndromic Vascular Anomalies The rare syndromic conditions involve multiple abnormalities at once, not an isolated pink patch.
The Naming Confusion
If you search for your baby’s birthmark online, you will run into a tangle of overlapping terminology. Salmon patch, nevus simplex, naevus simplex, telangiectatic nevus, angel kiss, stork bite, nevus flammeus neonatorum: these all refer to the same thing or to closely related variants, depending on who is writing. Part of the confusion stems from the fact that the word “capillary malformation” has been used as a catch-all for many quite different conditions, from harmless salmon patches to deeper and more complex vascular anomalies.14Journal of the European Academy of Dermatology and Venereology. Capillary malformations: a classification using specific names for specific skin disorders
One classification effort identified 20 distinct types of capillary malformation and argued that each deserves its own name to prevent diagnostic mix-ups.15Journal of the European Academy of Dermatology and Venereology. Capillary malformations: a classification using specific names for specific skin disorders That same review argued that the salmon patch should not technically be classified as a nevus at all, since it lacks several features that define a true nevus. Whether that reclassification gains broad traction remains to be seen, but it helps explain why your pediatrician might use one name and a dermatologist another. If you are reading a medical report and the terminology feels contradictory, it probably is not: the field itself has not settled on one unified naming system.
Do Salmon Patches Need Treatment
In the vast majority of cases, no. Since most salmon patches fade entirely on their own, the standard medical recommendation is watchful waiting. There is no cream, ointment, or medication that speeds up the fading process, and no evidence that massaging the area or applying pressure helps.
For patches that persist past early childhood and bother the person cosmetically, pulsed dye laser therapy can lighten or eliminate the mark. This type of laser targets the hemoglobin in the dilated blood vessels, heating and collapsing them without damaging the surrounding skin. It is the same technology used for port-wine stains, though salmon patches usually respond faster because the vessels are smaller and more superficial. Treatment is rarely pursued in infants or toddlers because waiting almost always resolves the issue. If a forehead or glabellar mark persists into adolescence and the teenager wants it treated, that is typically when the conversation about laser therapy begins.
Nape-of-the-neck patches, even when persistent, rarely prompt treatment simply because they are hidden by hair. Adults who discover they still have a stork bite sometimes seek laser treatment for cosmetic reasons, but most find that once they know what it is, the mark does not bother them.
Extensive Nevus Simplex
A small number of babies present with salmon patches that are more widespread than usual, covering several typical sites simultaneously. A study that identified 27 such patients found that all had at least one mark in a classic location: roughly three-quarters had glabellar involvement, about 60% had patches on the nape and eyelids, and two-thirds had marks extending to the scalp and nose.16Journal of the American Academy of Dermatology. Nevus simplex: a reconsideration of nomenclature, sites of involvement, and disease associations In these cases, the individual patches still behave like ordinary salmon patches; they just happen to be more numerous.
Extensive nevus simplex is worth mentioning to a pediatrician because the broader distribution occasionally overlaps visually with the capillary malformations seen in rare syndromes. A careful physical exam looking at head size, limb symmetry, and overall development is usually enough to confirm that the baby is simply on the more-marked end of normal. Having widespread salmon patches alone, without any other findings, is not considered a risk factor for any systemic condition.
What Parents Commonly Get Wrong
One persistent myth is that salmon patches are caused by something that happened during labor or delivery. The pressure of passage through the birth canal, a forceps-assisted delivery, or the baby lying in a certain position in the womb: none of these cause telangiectatic nevi. The marks are present before birth and reflect the normal developmental variation in capillary regulation described above. A baby born by cesarean section is just as likely to have them.
Another misunderstanding is the belief that any red mark on a baby’s face is a hemangioma. Infantile hemangiomas are a completely different entity. They typically are not present at birth or appear as a faint precursor mark, then grow rapidly over the first several months before slowly shrinking over years. In the same 1,000-neonate survey that found salmon patches in 36% of babies, hemangiomas appeared in only about 1%.17PubMed Central. Neonatal Birthmarks: A Prospective Survey in 1000 Neonates A salmon patch is flat from day one, does not grow, and does not form a raised lump. If a mark starts flat and then begins to swell or develop a bumpy texture in the weeks after birth, that is a different conversation and should be brought to the doctor promptly.
Finally, some parents worry that sun exposure will make a salmon patch permanent. There is no evidence that sun exposure alters the natural course of fading. Sunlight can make the patch temporarily more visible because it increases blood flow to the skin, but it does not damage the underlying vessels or lock the mark in place. Standard sun protection for a baby’s skin is still a good idea for plenty of other reasons, of course, but “preventing the birthmark from becoming permanent” does not need to be one of them.