Harlequin Color Change
T.C.’s Note: This is another repost, this time from our old family website. It’s one of those things that I wanted to save for posterity’s sake. Especially since it involves my kids. This segment features one of my twin daughters (Maria) when she was four days old.
Harlequin Color Change
This condition was new to me when Maria was born. Let me start off by saying that this is not a serious condition requiring treatment. It usually goes away on its own.What Harlequin Color Change refers to is the drastic change in the color of the baby’s skin. As you can see, Maria’s right half is a deep red while her left half is pale. There is also a definite, perfect line running down her body (from the top of her head to her pelvis) dividing the two halves. The sharp dividing line is what is so alarming for most people, but this is how the condition got its name, it looks like a harlequin costume. The condition is simply caused by an immature nervous system’s inability to regulate the dilation of blood vessels in the skin.Full-term babies will sometimes have Harlequin Color Change when they are first born and it will go away in just a few minutes. In babies who have a low birthweight, Harlequin Color Change is more prevalent and may appear frequently.
Maria, who was a premie (born at 33.5 weeks and only weighing 3 lbs. 12 oz.) was still showing signs of Harlequin Color Change at over three weeks of age. These pictures were taken when she was four days old, just before and after a sponge bath. Immediately after the sponge bath (approx. 15 minutes between the pictures) the colors had switched sides.
Harlequin Color Change is completely harmless and is not associated with any permanent disorders.
Thanks for posting the pictures of your daughter. My baby girl had this when she was first born but I did not get to see it since she was delivered by c-section and it had gone away by the time they brought her to me. It has not happened again (probably since she was full term) but I wanted to see a picture of the effect so I would recognize it. Your site was the only one I could find with photos. Thanks again for putting this info out for others. It has put me more at ease.
Shalene
You’re welcome, Shalene! The same thing happened to me when I tried to find information about Harlequin Color Change. I actually found a lot of info about it, but nothing very convincing and nothing with pictures. We were shocked by it at first, but the nurses told us not to worry about it. After the second picture was taken, Maria began to twitch on the the table. It was once per second for 5 or 6 seconds, during which time we looked at each other, at the nurse, the nurse looked back at us, then everyone looked at Maria, and she made her first sneeze. We all got a good laugh and we’ve not had any problems with Maria. Well, nothing out of the ordinary for a now 4 year old!
tc
Thanks TC for posting pictures. I am a registered nurse and I have asked many physicians and nurses what harlequin color change is and so far no one knows. I have looked it up on many of my nursing books, dictionaries, journals etc. I used to work in pediatrics, but I never observed this. Our nursing documentation on the skin system displays harlequin color change as a choice along with other choices like bruising, erythema, ecchymosis etc.
Irene
My daughter, born 16 May (35 weeks gestation) has this. She has been getting the colour change every day since she was born. I have photos, mostly of her face because she was always clothed when it occured and if she wasn’t the camera wasn’t around!, but i’m not sure how to submit them on this site. she also has a dapple patch on her chest which apparently proves a true harlequin? (which when the red is on that side it goes bright white and vice versa, I don’t have a picture of that yet!, not sure how true this is, a midwife mentioned it to me
It makes for an interesting conversation when it occurs!
regards
Jo
Thank you for including pictures, I was trying to explain this to someone.
My daughter had this when she was born, you say it usually goes away soon after birth,..
My daughter was 3 days late, and weighed over 7 pounds, I could very faintly see it up until it finally disapeared around two months.
Just letting you know sometimes it can take longer! :]
Your daughter is beautiful.
thank you for publishing this it was very frightening reading the extent of harlequin types. i have a close family member with colour harlequin and its very reassuring to read your article thanks again update much appreciated.
My daughter was born with this. We have been searching online for something to call it! Thanks for sharing your daughter’s story! My daughter was born 2 weeks early. She is now 2 weeks old and still changes. The only thing we could find online was a horrible disease and we knew she didn’t have it. Thanks again.
my son is 10 and has this line the color and all. i dont get it why has it not went away
I don’t know if you’ve run across this site:
http://dermatlas.med.jhmi.edu/derm/result.cfm?Diagnosis=76
I guess if a 57 year old woman can have HCC, then it’s not just a newborn condition.
Since I’m not a medical professional, I can’t give a straight answer about what I think is going on. But there are definitely some things that I would talk about with his pediatrician. Such as: When did he start having the color change? Do the colors switch sides? Is he allergic to any foods/medications? Are there any other co-occurring symptoms (fever, nausea, fatigue, etc)? Keep a record of these things before you see your pediatrician next and discuss it with her/him.
My little sister had this. At first me and my mom didnt notice it, but then a few minutes i siad”Look mom, doesnt emily and two different colors?(i was 7)” A nd my mom asked the nurse about it and she said she would grwo out of ,which she did. And this was the only site i could find that talked about it.
I notice this mostly happens to female babies. My son was born with this and he was not delivered early and he weighed 9 pounds.He is now 13 and still has the effects but only on his left side torso. He is perfectly normal otherwise. I wonder if it has something to do with the way he was delivered, I did not have a c-section. It seems to me there could have been some sort of pinched nerve during delivery. I am open to comments.
Thank you. Nice explanation. Searching internet for images as I prepare for an exam, I found your very well done webpage, with a reasonable and medically sound explanation for what must be frightening to many new parents. My own kid was post date, and so as a chunky little warrior at just over 7 lbs, we didn’t see this phenomenon on her, but we did see a bright red face when she hollered for milk. Baby vascular changes over just a few seconds of time, combined with changes in their autonomic tone, (relaxed to screaming) and position (hollering to pushing out a poopie) can have a dramatic effect. I’m glad you posted this important message. Thanks. Dr. G
Thank you for posting this information. I had my daugter last month. she was born completely normal then 10 mins later had one bright purple/red leg wich then spread to her arm (all on her left side). All the consultants and peadiatritians at the hospital had no clue as to what was the matter with my little girl until i saw my doctor last week. He too was very vague with info as he was not very clued up on HCC but you info mas reassured me and helped alot
Thanks very much for all your postings, i gave birth to a beautifull baby girl 18 days ago weighing 7lb 9.5 oz by emergency c section an almost straight away i noticed the color change.
This happens at diffrent times through out the day an night, my baby also go’s really red when she crys for a feed, only one baby doctor could tell me what it was nobody else had heard of it.
My baby was also turning blue when she was 2 days old an doctors have found a displaced valve on the right side of her heart, which is being monitored at the moment, but they advised that the harlequin color change is not linked and is not life threatning and it should pass, as of yet its still with her and it does change a few times a day.Hope this info helps, thanks again.