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Café-Au-Lait Spots

Café-Au-Lait Spots

Café au lait spots, also called café au lait macules, are light-to-deep brown-colored birthmarks on the skin of newborn babies. The term “café-au-lait” means “coffee with milk” in French, referring to the light coffee color birthmark. These pigmented skin spots can change in size and grow in number over time. In most cases, café au lait spots are harmless and normal. Having more than six café au lait spots at one time, however, may be a sign of neurofibromatosis type 1 (NF1), an underlying genetic condition. 

If your or your child’s café au lait spots appear swollen, bumpy, or lumpy to the touch, or if they increase in number or size, contact your Gainesville dermatologist to schedule an appointment with a dermatologist in Gainesville and to learn more about our treatments for an encompassing range of skin conditions.

What Are Café Au Lait Spots?

Café au lait spots are pigmented birthmarks characterized by flat patches on the skin. They are often light brown but may darken over time and exposure to sunlight. These marks are distinct from other birthmarks and pigmented lesions, as they often have irregular edges and variances in color and pigmentation. Additionally, café au lait spots can also vary in size. These spots can be as small as half a centimeter. Café au lait spots are usually present at birth but may appear later in life. 

While most café au lait spots are considered harmless and normal skin growths, such as those with up to three spots, in other cases, atypical café au lait spots may indicate an underlying genetic condition. Because they are not a skin rash or a skin allergy, café au lait spots don’t itch or cause pain. Developing a spot on your body, such as an atypical mole, maybe a cause for concern, but café au lait spots are benign pigmented lesions that don’t cause cancer. For additional information about café au lait spots and whether your birthmarks require treatment, contact our Gainesville dermatology office. 

What Do Café Au Lait Spots Look Like?

Café-au-lait spots are pigmented birthmarks that appear as patches on the skin with a creamy, light brown to a deep, dark brown color that differs from the color of the surrounding skin. These birthmarks can range in size from a few millimeters around to more than 20 centimeters in diameter. In many cases, café au lait spots seen in newborns are normal, but they can also develop early in childhood. They can also develop on adult skin, even if someone was not born with café-au-lait spots. The brown color of a café-au-lait macule is due to melanin, a pigment produced in the skin by cells called melanocytes. The spots may have smooth or rigid borders. They are painless and don’t cause itching or other symptoms.

Types Of Café Au Lait Spots

There are two types of café-au-lait spots identified according to their shape and pattern by our Gainesville, FL, dermatologists: coast of California café-au-lait spots and coast of Maine café-au-lait spots. If you have multiple California café-au-lait spots, consult your dermatology provider for treatment. Multiple café-au-lait spots can indicate several underlying conditions, such as neurofibromatosis, or other genetic disorders, which may affect the skin and nervous system.

Coast Of California

The coast of California café au lait spot is the most common type of café-au-lait lesion. Clear, smooth borders on all sides characterize the California café-au-lait spots. The outline of the spot can appear similar to the outline of the state of California’s coast in the United States. With this type of café-au-lait spot, there may be a single lesion or multiple spots with sharp, well-defined borders.

Coast Of Maine

The coast of Maine café-au-lait spot occurs less frequently with rough, jagged, and irregular borders. This café-au-lait spot is named for the similarity of its border to the outline of Maine. Contact us for additional information about the coast of Maine and California café-au-lait spots.

Who Do Café Au Lait Spots Affect?

Café au lait macules can affect anyone, though they are most common among children. The café au lait spot is a congenital lesion, meaning it is present at birth, although it may be difficult to see on a newborn baby. The spots usually become more visible as the baby grows older, especially after two years. Café au lait spots are typically more prevalent in those with darker skin tones, but birthmarks can appear with any skin tone. Certain café au lait lesions are an inherited trait in the person’s family history. For more information about café au lait spots, contact Gainesville Dermatology & Skin Surgery.

Who Do Café Au Lait Spots Affect?

Café au lait macules can affect anyone, though they are most common among children. The café au lait spot is a congenital lesion, meaning it is present at birth, although it may be difficult to see on a newborn baby. The spots usually become more visible as the baby grows older, especially after two years. Café au lait spots are typically more prevalent in those with darker skin tones, but birthmarks can appear with any skin tone. Certain café au lait lesions are are an inherited trait in the person’s family history. For more information about café au lait spots, contact Gainesville Dermatology & Skin Surgery.

What Causes Café Au Lait Spots?

Among the primary café au lait spots causes is an increase in melanin in the epidermis (the thin, outermost layer of skin). The exact reason for the increase in these cells is unknown. Individuals diagnosed with conditions such as neurofibromatosis type 1 (NF1)  have café au lait macules due to a certain mutation of a gene known as the NF1 gene, which prevents cells from growing too quickly. This causes melanocytes to produce an excess of melanin. 

In some cases, the NF1 gene mutation occurs in an individual randomly, without being present in the person’s family history. Others may inherit this condition from their parents if at least one of their parents has a mutated copy of this gene (autosomal dominant). According to the Cleveland Clinic, while other autosomal dominant conditions only need one mutated gene to activate the condition during a person’s childhood years, this gene does not activate until later in life, when a genetic mutation of their second copy of the gene takes place.

What Do Café-Au-Lait Spots Indicate?

In most cases, café au lait spots are harmless and do not pose a health threat, or cause any symptoms. Having multiple (more than six) café au lait spots, however, can be a sign of an underlying genetic condition, such as neurofibromatosis type 1 (NF1), neurofibromatosis type 2 (NF2), Legius syndrome, McCune-Albright syndrome, Noonan syndrome, Bloom syndrome, Silver-Russell syndrome, and Watson syndrome. 

Café au lait spots neurofibromatosis type 1 conditions are characterized by bone abnormalities, language difficulties, and other issues affecting the skin, nerves, and eyes. Other complications of this disorder can include high blood pressure, problems with vision, and epilepsy. Consult your doctor to discuss concerns regarding your café au lait spots and underlying conditions.

Can Café Au Lait Spots Appear During Adulthood?

If café au lait spots suddenly appear during adulthood, it is normal. Café au lait spots are most often present on a newborn baby's skin, but it is common for café au lait spots in adults to appear on a person’s skin later in life. No matter what age, if you have more than six café au lait spots, contact your healthcare provider to schedule an appointment for a skin examination to determine whether the spots indicate an underlying condition. Contact Gainesville Dermatology & Skin Surgery to schedule an appointment.

How Are Café Au Lait Spots Diagnosed?

If you or your child develops pigmented or colored skin patches or lesions, schedule an appointment with your dermatologist to determine whether the spots are café au lait spots or another skin lesion. No specific tests are available to diagnose ​​café au lait spots, however, your dermatologist will likely be able to diagnose café au lait spots based on a physical examination of the skin alone based on the skin patches’ appearance. If you only have one or two café au lait spots, your doctor may determine there is no need for additional testing. Contact our office for more information about this process.

How Are Café Au Lait Spots Treated?

Café au lait spots are typically harmless, benign, and don’t require treatment. Should you desire these spots to appear less noticeable, you may consider getting laser treatment. However, even if you undergo café au lait spots removal, the pigmented lesions may return later. Discuss your treatment options, including skin care, for café au lait spots with your dermatologist to determine the best treatment plan for your needs. There is no cure for the disorder for those who receive confirmation of neurofibromatosis from genetic testing results. If you develop complications resulting from or associated with this condition, your doctor may recommend multiple treatments to alleviate your symptoms. Some people with café au lait spots and neurofibromatosis may develop a benign or malignant tumor from their disorder. If this happens, then surgery may be recommended to remove the tumor. Contact our office for more information about our available treatments for café au lait spots.