Mongolian spots are flat bluish to bluish gray skin markings that commonly appear at birth (or shortly thereafter). They appear commonly at the base of the spine, on the buttocks and back and also can appear on the shoulders. Mongolian spots are benign and are not associated with any conditions or illnesses.

Mongolian spots are mostly located at the base of the spine, on the lower back and buttocks. They can also appear on the shoulders, upper back, arms, wrists, legs, ankles, lateral abdomen and elsewhere. Palms, soles, face and head are usually spared.

Mongolian spots are caused by entrapment of melanocytes in the dermis during their migration from the neural crest into the epidermis in fetal development. Microscopically dermal melanocytoses are seen in all newborn babies irrespective of race. Mongolian spots are thought to be due to entrapment of melanocytes (pigment cells) in the dermis that have failed to reach their proper location in the epidermis in the developing embryo.

Because Mongolian spots can be easily mistaken for bruises, particularly by well-meaning white people who have no experience with them, they have triggered accusations of child abuse against some adoptive parents. For this reason, it is important to be sure that both your child's pediatrician and the caseworker who completes your post-adoption work record information on the presence of Mongolian spots into their records. You can assist in the documentation of this information by taking snapshots of the spots and providing prints to be included in your child's files. Since you cannot take for granted that everyone will know what Mongolian spots are, it is good advice to have their presence recorded from the start.

They are present at birth and occur in more than 90% of children of Mongoloid race (e.g. East Asians, Polynesians, Indonesians, Micronesians). They occur less frequently in other races. Mongolian spots are benign lesions that require no treatment. Usually they spontaneously disappear by the time the child reaches 4 years old. Persistent Mongolian spots may be larger and persist for many years.