About birthmarks

The purpose of inclusion in cas aka the "aesthetic or cosmetics" of features caused from medical diagnosis is so that more people can connect personally to the sim when making sim selves or detailed characters with more real backgrounds. A mole/freckle is innocuous as a beauty mark until it's not but there doesn't seem to be a lot of terrible concern about the possible triggering of using moles and freckles. To that end any birth mark or possible medical skin conditions, or even medical tools/equipment or accessories utilized in cas is always treated with a certain amount of respect by maxis to anyone who may have those appearances in real life whilst not diving to unnecessarily into the deep understanding of each one. That means that what might be in reality a dangerous, scary or concerning diagnosis, doesn't constitute that it will or even should affect gameplay. I feel that is best left up the player to decide if the medical accessory which in game by definition is simply a cas cosmetic not a real diagnosis,can be used to create a story line that CAN include the fears or struggles with said possible diagnosis. For other players, there is no in-depth story, the cas items are being used as a harmless medically unaddressed aesthetic to create unique sims which is equally as acceptable for their gameplay. In RL medical conditions are not an "aesthetic" or "cosmetic" but in the game it's exactly what everything in cas is. There are mods to address randomization of cas items to prevent any "out of story" additions to pre-existing characters if you don't wish these medical themed cas items to trigger RL concerns for the digital characters.