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Why do newborns have marbled skin color and what does it mean?
Last reviewed: 04.07.2025
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Marbled skin in a newborn is the appearance of vascular capillaries on the child's skin against the background of its pallor under the influence of certain factors. Such changes in the child's skin can occur in absolutely healthy children against the background of changes in the ambient temperature, and this can also indicate various pathologies. Therefore, it is important to understand when marbling of the skin is a serious symptom, and when it is simply a physiological reaction.
Causes of marbled skin in a newborn
The skin of a child is the means of contact between the baby and the environment. It performs many different functions, and although the skin of a child is thinner than that of an adult, the protective function is one of the main ones. The protective function is not only to create a barrier, but also that the condition of the skin indicates the functioning of the entire organism. In this case, a change in skin color, the appearance of a rash or other elements may indicate pathology.
Skin marbling is the appearance of a vascular pattern that shows through the light and thin skin of a child. Marbling can be in individual areas or cover the entire skin.
The causes of skin marbling can be divided into two groups: physiological, when it is a normal reaction of the skin to irritants, and pathological, when it indicates a problem.
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Risk factors
Risk factors for the development of skin marbling are, first of all, prematurity. Children with low body weight cannot regulate their temperature, so they are more susceptible to such skin changes. Also at risk are children with vegetative-vascular dystonia in their parents, which leads to a longer adaptation of the autonomic nervous system to the environment.
Pathogenesis
The pathogenesis of the formation of a marble pattern on the skin is that the vessels that are located most superficially to the skin begin to spasm and turn blue, which has the appearance of marbling. Such vascular spasm can develop under the influence of various factors. Under normal conditions, physiological vascular spasm in newborns can occur against the background of a sharp change in the temperature of the environment. This is explained by the fact that the skin of a newborn cannot immediately adapt to environmental conditions, and therefore, when changing the baby's clothes, his body temperature can drop sharply, which is manifested by vascular spasm. Vascular tone is restored when the child is dressed and the marbling disappears. This is considered physiological marbling of the skin in newborns. It is often possible to see that vascular spasm can only be on the legs or arms of the child, which also does not indicate pathology, but is most likely the cause of hypothermia of the child.
When marbled skin of a newborn appears very often without any apparent reason, then, most likely, the cause may be a pathological condition. Most often, such changes are observed in premature babies, when they adapt to environmental conditions very slowly. The cause of skin marbling is often hypoxic damage to the central nervous system, which can occur during pregnancy or childbirth. Hypoxia, as is known, leads to cerebral ischemia. Lack of oxygen for brain cells is very dangerous, and it leads to dysfunction of many systems. Regulation of vascular tone occurs with the participation of the autonomic nervous system. With hypoxia of the brain, the autonomic system also suffers, which can manifest itself in a violation of vascular tone, and therefore marbling of the skin occurs. Thus, marbling of the skin in newborns can occur due to hypoxia and cerebral ischemia. Such symptoms can be the entire recovery period. Birth trauma can also often cause vascular tone disorders not only of the skin, but of the organs, which will externally manifest itself in such skin color disorders.
In more severe cases, skin marbling can develop with toxic shock. This is a condition that occurs with most infectious and septic conditions and is characterized by a violation of vascular tone under the influence of bacterial toxins and blood stasis in the capillaries. This is the most serious cause of skin marbling in newborn babies, which requires urgent measures.
One of the reasons for the disruption of skin microcirculation may be a congenital pathology of the cardiovascular system. Any congenital heart defects may not immediately give pronounced clinical manifestations, and skin marbling may be the first symptom. When the pumping function of the heart is disrupted, the blood is located in the organs that primarily require oxygen. Therefore, the skin does not receive enough oxygen, and the vessels spasm to provide blood to the central organs. And thus, a disruption of the heart in a newborn can cause skin marbling as one of the manifestations of the disease.
Symptoms of marbled skin in a newborn
When the baby's skin marbling occurs because the baby's body temperature drops, it will be accompanied by cold extremities, a slight blue tint to the skin on the legs or arms. All these symptoms and skin changes should disappear after the baby is dressed.
Most often, marbling is observed in premature babies and babies born in hypoxia. If there are no other symptoms that may be alarming, then such phenomena pass by the end of the first half of life.
There are symptoms that, together with the marbling of the skin, indicate a pathology or illness of the child. These symptoms include episodic or permanent changes in the nasolabial triangle. Blue skin color in this area, which is combined with marbling of the skin, as well as cyanosis of the mucous membranes, may indicate hypoxia caused by heart pathology. The first symptoms of circulatory failure are manifested by changes in skin color in a newborn. Therefore, if the child also has episodes of rapid heartbeat, causeless subfebrile body temperature, then you need to think about congenital heart defects and carefully examine the baby.
Symptoms of skin marbling due to damage to the central nervous system due to hypoxia and ischemia may persist in a child for several months. It is considered dangerous if the manifestations of marbling are combined with a delay in the child's psychomotor development or severe muscle tone disorders. The recovery period after hypoxic damage to the central nervous system can last up to three months. In this case, all pathological symptoms should gradually fade. If hypotonia or hypertonia in a child remains for a long time without positive dynamics and there are such skin changes, then you need to think about chronic hypoxia for one reason or another. If the child does not begin to hold his head or reacts poorly to irritants, then it is possible that this is a consequence of hypoxia and you need to change the treatment or strengthen it.
Complications and consequences
Consequences of marble skin may occur if it is formed against the background of pathology of the central nervous system. In this case, the brain damage suffered may lead to a delay in the child's development, disruption of his cognitive functions. Complications of skin microcirculation disorders are rare, but such children are more prone to the development of vegetative-vascular dystonia in the future.
Diagnostics of marbled skin in a newborn
Many parents are frightened by such marble skin, because when a child is completely blue, it causes concern for his health. But it is not always worth sounding the alarm, but simply diagnosing correctly when the child needs an examination and examination.
The appearance of skin marbling along with symptoms of periodic or constant cyanosis in the facial area requires consultation with a cardiologist. The probability that such a baby may have a congenital heart defect or other heart pathology is small, but it still exists. Such a child needs to be carefully examined and find out when symptoms appear. During auscultation of the heart, it is not always possible to note any changes, but there may be noises or changes in heart tones. It is imperative to conduct instrumental diagnostics - electrocardiography and ultrasound examination of the heart. Any changes can confirm or refute the diagnosis of heart pathology, in which case it is necessary to conduct differential diagnostics with other causes.
It is very important to consult a neurologist for a child with marbled skin and impaired psychomotor development. During an examination by a neurologist, anamnesis data is clarified, whether there were problems during childbirth. During an examination of the child, muscle tone, reflexes, and their symmetry are determined, which indicates the child's nervous system. If there was hypoxia during childbirth and there are reflex disorders, then the marbled skin may be one of the symptoms of such a recovery period in a child after hypoxia. For a more thorough diagnosis, an ultrasound examination of the brain through the fontanelle is performed - neurosonography. This study allows you to determine the presence of pathological foci in brain tissue, hemorrhages.
The tests that are performed on a child with skin marbling are not specific. First, a general blood and urine test is performed. If there are any changes, then a more thorough laboratory test can be performed.
Differential diagnosis
Differential diagnostics of marbled skin should first of all be carried out with those conditions when it is not a symptom of the disease. To do this, first of all, it is necessary to exclude hypothermia in the child.
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Treatment of marbled skin in a newborn
Treatment of marbled skin in a newborn as a skin problem itself is not required. The main thing is to find the cause of such changes.
If a child has neurological problems and this is the reason for such skin changes, then a very important stage in treatment, in addition to specific medications, are vitamins and physiotherapy.
Agvantar is a drug from the group of metabolic agents, which is used in complex therapy for pathologies of the nervous system. The active substance of the drug is levocarnitine. This is a natural compound that, when entering a cell, transfers the necessary metabolites to the mitochondria, which increases the amount of synthesized energy. In neurons, this helps to restore connections faster and accelerates myelination of fibers. Therefore, the drug improves nerve conduction and normalizes the tone of the autonomic nervous system, which improves the reaction of skin vessels. Dosage - 2 drops three times a day, for a full effect, it is necessary to use the drug for at least a month. Side effects can be in the form of weakness, dyspepsia, which requires a reduction in the dose.
Massage is the main method in correcting the pathology of the nervous system after hypoxia, and the direct effect on the child's skin helps improve the condition of the blood vessels. During massage, the drainage function of the skin improves and its tone increases, which improves the tone of the skin vessels themselves. This is very effective in combating skin marbling and local heat exchange disorders in the baby.
The massage should be done in a warm room with prior ventilation. You need to start the massage between feeding and sleep. Massage the back, and then the limbs, taking into account the muscle tone of the child. To reduce muscle tone, you need to lay the child on his stomach in the "embryo" pose. To relax the muscles, you can also lay the baby on a large ball and then rock him. In this case, the arms and legs need to be placed on the ball. After this, you need to massage the muscles of the limbs in combination with the withdrawal of the arms, and pressure on the chest.
If the tone is increased, then it is necessary to perform acupressure with light finger pressure on the muscles of the back and limbs. Muscle tone is stimulated in a standing position with the child supported under the armpits. At the same time, it is necessary to swing the child in different directions, holding the arms with smooth movements.
The massage should be finished with general stroking of the skin. All the techniques are not so complicated, so after some light training the mother can do it herself.
Therapeutic exercises should be done after each bath, which improves not only the condition of the skin and muscles, but also the overall tone of the body.
Prevention
Prevention of the appearance of marbled skin in a child is a comfortable temperature regime and proper care. If marbled skin in a child is a manifestation of neurological problems, then to prevent developmental delays in the child and other complications, it is necessary to carry out complex and earlier treatment.
Forecast
The prognosis for this pathology is always favorable. If there is a suspicion of congenital heart defects, it is necessary to clarify the diagnosis in a timely manner.
Marbled skin in a newborn is not a pathology in most cases, but indicates normal adaptation of the newborn baby's skin to the environment. But if there are other dangerous symptoms or manifestations, then you need to consult a doctor to avoid complications.
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