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PubMed This is a summary of 36 peer-reviewed journal articles Updated
Dermatology

Understanding Nevus of Ito

At a Glance

A Nevus of Ito is a permanent, typically benign blue or gray skin patch found on the shoulder or collarbone. It is painless and caused by pigment cells in deep skin layers. Dermatologists recommend regular monitoring to document its appearance and watch for any rare structural changes.

Finding an unusual blue or gray patch on your skin or your child’s skin can be an unsettling experience. You may have been told it looks like a bruise that never heals or a “birthmark” that appeared later in life. If you have been diagnosed with a Nevus of Ito, it is important to know that you are dealing with a specific, typically benign (non-cancerous) skin condition that is well-recognized by dermatologists [1][2].

What is a Nevus of Ito?

A Nevus of Ito is a type of dermal melanocytosis—a category of skin findings where pigment-producing cells (melanocytes) are found deeper in the skin than they usually are [1][2]. During early development in the womb, these cells typically migrate from the neural crest (a group of cells in an embryo) to the top layer of the skin. In a Nevus of Ito, some of these cells stop in the dermis (the deeper, thick layer of skin), where they remain permanently [1][3].

Importantly, a Nevus of Ito does not cause physical symptoms like itching, pain, or aching. It is a completely painless structural trait of the skin.

Why is it Blue or Gray?

While common moles are often brown or black, a Nevus of Ito appears as a “slate-blue,” gray, or grayish-brown patch [1][4]. This color difference is not due to a different type of pigment, but rather the depth of the cells. When light travels through the skin and hits melanin (pigment) deep in the dermis, the skin scatters the light in a way that makes it look blue to the human eye—a phenomenon called the Tyndall effect [1][5].

Where Does it Appear?

The defining feature of a Nevus of Ito is its specific anatomical location. It typically appears on one side of the body in the following areas [1][6]:

  • Supraclavicular region: The area around the collarbone.
  • Scapular region: The shoulder blade area.
  • Deltoid region: The upper arm and shoulder.

Key Facts for Orientation

  • Timing: It may be present at birth (congenital), but it often first appears or becomes more noticeable during childhood or puberty [7][2].
  • Permanence: Unlike “Mongolian spots” (congenital dermal melanocytosis often found on the lower back of infants), which usually fade by toddlerhood, a Nevus of Ito is persistent and does not go away on its own [8][4].
  • Stability: It is generally considered a benign condition. While extremely rare, the medical literature does note that these areas should be monitored over time for any changes in texture or the development of bumps (nodules), as rare cases of transformation have been reported [2][4].

Navigating This Guide

Understanding that this is a stable, structural part of your skin is the first step. This resource will guide you through:

01

Diagnosis and Look-Alikes: What It Is and Isn't

Learn how dermatologists diagnose a Nevus of Ito and distinguish it from look-alikes like Nevus of Ota and Mongolian spots. Understand when biopsy is needed.

02

Treatment Options: Laser Therapy for Nevus of Ito

Learn about laser therapy for Nevus of Ito. Understand the differences between picosecond and Q-switched lasers, side effects, and when to treat children.

03

Long-Term Monitoring: Risks, Complications, and Syndromes

Learn how to monitor a Nevus of Ito long-term. Understand the rare risk of melanoma, what red flags to look for, and when to see a dermatologist for a biopsy.

Every step of the way, the goal is to provide you with the information needed to feel confident in managing this unique skin trait.

Common questions in this guide

What is a Nevus of Ito?
A Nevus of Ito is a permanent, typically benign blue or gray patch on the skin. It occurs when pigment-producing cells remain in the deeper layer of the skin during fetal development instead of moving to the surface.
Why does a Nevus of Ito look blue or gray?
The blue or gray color is caused by the Tyndall effect. Because the pigment cells are deep in the skin, the way light scatters through the skin makes the patch appear blue to the human eye, rather than brown or black like a surface mole.
Will a Nevus of Ito go away on its own?
No, unlike some infant birthmarks such as Mongolian spots, a Nevus of Ito is persistent and does not fade over time. It typically requires long-term monitoring by a dermatologist as you or your child grows.
Does a Nevus of Ito cause pain or itching?
A Nevus of Ito is completely painless and does not cause physical symptoms like itching, aching, or burning. It is simply a structural trait of the skin.
Should I be worried if the texture or color changes?
Yes. While generally benign, any changes in texture, such as the development of bumps or nodules, should be evaluated by a dermatologist immediately to rule out rare complications.

Questions to Ask Your Doctor

Curated prompts to bring to your next appointment.

  1. 1.Is this specifically a Nevus of Ito, or could it be a different type of dermal melanocytosis?
  2. 2.Do you recommend a baseline skin exam (dermoscopy) to document the current appearance of the patch?
  3. 3.Since this is often permanent, what are the modern options for management or monitoring as I/my child grows?
  4. 4.Are there any specific changes in texture or color that should trigger an immediate follow-up visit?
  5. 5.How often should we schedule regular skin checks to monitor for any rare changes?

Questions For You

Tap a prompt to share your answer — we'll use it plus this page's context to start a tailored conversation.

References

References (8)
  1. 1

    [Treatment of nevus of Ota and Ito and epidermal nevus syndrome].

    Badawi A, Osman MA, Kassab AN

    Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete 2020; (71(12)):926-931 doi:10.1007/s00105-020-04710-3.

    PMID: 33145623
  2. 2

    Melanoma arising in a nevus of Ito: novel genetic mutations and a review of the literature on cutaneous malignant transformation of dermal melanocytosis.

    Tse JY, Walls BE, Pomerantz H, et al.

    Journal of cutaneous pathology 2016; (43(1)):57-63 doi:10.1111/cup.12568.

    PMID: 26260725
  3. 3

    Congenital Dermal Melanocytosis on the Foot: A Case Report and Review of the Literature.

    Cho SI, Moon J, Jo G, et al.

    Annals of dermatology 2019; (31(2)):213-216 doi:10.5021/ad.2019.31.2.213.

    PMID: 33911572
  4. 4

    Patchy Dermal Melanocytosis: Differential Diagnosis and Management.

    Zhu J, Cen Q, Chang R, et al.

    Journal of cosmetic dermatology 2025; (24(1)):e16607 doi:10.1111/jocd.16607.

    PMID: 39485055
  5. 5

    A Persistent Dark Macule on the Hand of a Hispanic Patient.

    Cordero-Martinez FC, Cuellar-Barboza A, Ocampo-Candiani J

    Acta dermatovenerologica Croatica : ADC 2023; (31(3)):151-152.

    PMID: 38439726
  6. 6

    The spectrum of benign dermal dendritic melanocytic proliferations.

    Baykal C, Yılmaz Z, Sun GP, Büyükbabani N

    Journal of the European Academy of Dermatology and Venereology : JEADV 2019; (33(6)):1029-1041 doi:10.1111/jdv.15492.

    PMID: 30767282
  7. 7

    Case report: nevus of Ota and nevus of Ito associated with meningeal melanocytosis.

    Nuñez Del Arco Serrano LA, Flores Enderica CG, Valencia Padilla CE

    Neurocirugia 2020; (31(6)):299-305 doi:10.1016/j.neucir.2019.10.001.

    PMID: 31780112
  8. 8

    Dermal melanocytosis and associated disorders.

    Franceschini D, Dinulos JG

    Current opinion in pediatrics 2015; (27(4)):480-5 doi:10.1097/MOP.0000000000000247.

    PMID: 26087431

This page provides educational information about Nevus of Ito. It is not a substitute for professional medical advice, diagnosis, or evaluation by a qualified dermatologist.

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