Mongolian spots

For several days now I’ve been asking close friends and relatives: “Did you or do you have the Mongolian spots?” as part of research I was doing for a paper on the development of anthropology.

Those without a background in the medical or health sciences had never even heard the term but I’m certain you’ll respond quickly in the positive as I describe what they are.

These are skin markings, described as bluish to bluish-gray, sometimes as purple, found most often in the buttocks area, base of the spine, and the back, sometimes as high up as the shoulders.

Sounds familiar now? These Mongolian spots are actually quite common throughout the world, except among Caucasians. It has several medical terms, from congenital dermal melanocytosis to slate gray nevis, and is caused by the accumulation of melanocytes (pigment cells) beneath the skin during fetal development.

The marks fade away early in childhood but in some people, they persist well into adulthood. They are not considered harmful.

Accompanying its high prevalence are the many cultural explanations that have emerged, most of which have something to do with the gods and goddesses giving a gentle slap, or kick, to the fetus, to hasten its birth.

In the Philippines, we refer to the Mongolian spots as “balat” or birthmarks, the accent different from balat, meaning skin. The birthmarks are sometimes attributed to the mother having eaten eggplants while pregnant, thus the purplish color.

Why the lay term “Mongolian spots”?

The term was coined at the turn of the 20th century by a German physician and anthropologist who served as a physician to Japanese imperial households and noticed the spots on the infants in the household. His labeling of the spots as Mongolian reflected a fixation at the time, especially among anthropologists, on explaining the different races. The race-obsessed scientists proposed that the spots originated among Mongolians and then spread to different cultures. The speculations persist to this day.

I’d prefer we stick to simpler folk wisdom that they’re special marks, even if found in the majority of populations. I’m sure humans will find new meanings for the marks. I actually “rediscovered” these Mongolian spots by reading “The Vegetarian,” a novel that won a Nobel Prize in Literature for its author Han Kang, an honor for South Korea as well as for women.

The second part of the novel is subtitled “The Mongolian Mark,” a long description of how a man discovers his sister-in-law has Mongolian spots and how it becomes erotic for him. I don’t want to give spoilers here so find a copy of the novel.

Talking about marks though, it seems that in the United States and parts of Europe, better public education about the marks is needed because they’re not as common among Caucasians. I found a long discussion thread on the social media site Reddit describing parents or guardians in the US getting into trouble with daycare centers where the staff would suspect the spots as signs of child abuse. The parents and guardians themselves sometimes didn’t know what the marks were and it took more enlightened health professionals to explain what they were.

I’d pass on advice to our Filipinos living in the US and Europe to have the spots noted on their children’s medical records, certified by a health professional, to avoid long hassles with suspicious daycare and hospital staff. Note, too, in this day and age with so many intermarriages and “interracial” sexual relationships, the incidence of the spots seems to be increasing so you never know when a child might be born with the condition.

The spots do deserve more attention in medical, nursing, and allied medical professions’ training. During COVID, several journal articles appeared noting an increase in child abuse accompanying the lockdowns, sometimes detected by bruise marks on the thighs and legs, with the reports’ authors noting that they might be confused as the spots except that the thighs and legs are not typical areas for the spots. Bruises also change their color within a few days while the Mongolian spots’ colors tend to be consistent and unchanging.

Meanwhile, we can all contribute to removing the misconceptions around the spots. Eating eggplants does not cause the spots. The spots will fade with most children but even if they don’t, think of them as special marks.

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