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Cherry angiomas are common, benign bright red skin growths. Learn how they are diagnosed and the laser, electrosurgery, and cryotherapy options for removing them.
A cherry angioma is a small, bright red to purple bump formed by a cluster of dilated blood vessels close to the surface of the skin. Also called a Campbell de Morgan spot or a senile angioma, it is the most common acquired vascular growth in adults, and the number of lesions tends to increase steadily with age [1]. A cherry angioma is benign, which means it is not cancerous and does not develop into cancer.
These lesions belong to the broader family of angiomas, benign growths built from blood or lymphatic vessels. A cherry angioma itself is harmless, but its vivid colour, and the way it can bleed when caught or scratched, often raises concern and leads people to ask whether it should be checked or removed.
A typical cherry angioma is a smooth, dome-shaped papule that can range from a pinpoint red dot to a soft, raised bump several millimetres across. The colour is usually a bright cherry red, although older or deeper lesions may look purple or almost blue. The surface can blanch slightly under pressure, and minor trauma may cause the lesion to bleed. Most cherry angiomas are painless, and many people develop several of them over time rather than a single growth.
Cherry angiomas appear most often on the trunk. A general-population imaging study found that the front of the trunk was the most common location, followed by the back, with relatively few lesions on the head and neck. The same study confirmed that both the number and the size of cherry angiomas increase with advancing age [2].
Beneath the surface, a cherry angioma is a genuine proliferation of small blood vessels in the upper layer of the dermis, not simply a widening of vessels that were already present. Tissue studies of Campbell de Morgan spots have shown active endothelial cells, the cells that line blood vessels, which confirms that these growths are true benign vascular proliferations [3].
For most people, no single cause can be identified. Several contributing factors have been proposed, including increasing age, an inherited tendency, and hormonal changes such as those that occur during pregnancy. A broad review of cherry angiomas notes that, beyond age, these lesions have been associated with exposure to certain toxic substances and medications, with some benign and malignant conditions, and with immunosuppression [1].
When many cherry angiomas appear over a short period, the pattern is described as eruptive. An observational study of more than 1,300 patients found that having a large number of cherry angiomas was significantly associated with advanced age, immunosuppressive therapy, skin cancers, and internal malignancy [4]. These associations are uncommon, and most eruptive cases are not linked to serious disease, but a sudden crop of new lesions is worth mentioning to a dermatologist.
Chemical exposure has also been reported as a trigger in specific circumstances. Cherry angiomas have developed in workers after contact with brominated compounds [5], and after a single acute exposure to the solvent 2-butoxyethanol, with new lesions continuing to appear for years afterward [6]. Such reports involve unusual occupational exposures and do not reflect the everyday experience of most patients.
A dermatologist can usually recognise a cherry angioma from its appearance alone. Dermoscopy, the examination of the skin with a handheld magnifier and light, makes the diagnosis more reliable. On dermoscopy, cherry angiomas show well-defined red, red-brown, or red-blue lacunae, the small rounded spaces that correspond to blood-filled vessels [7]. Photographs are sometimes used to document a lesion and monitor it over time when there is any uncertainty.
These features help distinguish a cherry angioma from other vascular growths that can look similar under dermoscopy, including angiokeratoma and a pyogenic granuloma [7]. A venous lake, a soft blue to purple spot seen most often on the lip or ear, is another vascular lesion that is sometimes mistaken for a cherry angioma. Because a small number of skin cancers, including amelanotic melanoma that carries little pigment, can occasionally resemble a harmless red or pink bump, a skin biopsy may be recommended when a lesion looks atypical, changes quickly, or cannot be confidently identified by examination alone.
A stable cherry angioma that has not changed is rarely a cause for concern. Assessment is sensible, however, when a red or purple bump bleeds repeatedly, grows or changes colour quickly, takes on an irregular shape, or appears as part of a sudden cluster of many new lesions [4]. Family physicians frequently refer such lesions to a dermatologist for a closer look. A dermatologist can examine the lesion, compare it with the surrounding skin, and decide whether any further testing is needed.
Because cherry angiomas are harmless, treatment is not medically necessary. Removal is usually chosen for cosmetic reasons, or when a lesion is repeatedly irritated by clothing or jewellery or bleeds. A systematic review of treatment options found that both light-based and non-light-based methods can clear cherry angiomas effectively, with no single approach proven superior for every lesion [8].
Vascular laser treatments are a mainstay. Lasers such as the pulsed dye laser, the potassium titanyl phosphate (KTP) laser, and the long-pulsed Nd:YAG laser, along with intense pulsed light, deliver energy that is absorbed by the haemoglobin inside the vessels, collapsing them while sparing the surrounding skin. The same systematic review noted that the pulsed dye laser is often preferred over the KTP laser because it tends to be less painful, while the Nd:YAG laser is associated with fewer changes in pigmentation [8].
A randomized controlled trial that compared the pulsed dye laser, the KTP laser, and electrodesiccation for cherry angiomas found that all three produced comparable improvement in colour. The laser treatments, and the pulsed dye laser in particular, caused less change in skin texture and were less painful than electrodesiccation [9].
Non-laser methods remain effective and widely used. Electrosurgery, which uses a fine electrical current to destroy the abnormal vessels, and cryotherapy, which freezes the lesion with liquid nitrogen, are both common choices. In a randomized trial that compared the two for several types of benign growth, electrosurgery was the more effective option for cherry angiomas [10]. The number of sessions depends on the number and size of the lesions, and the most suitable method is chosen after the skin has been examined. Small temporary marks or colour changes can follow any of these treatments, and occasionally a lesion recurs and needs a further session.
Because the most influential factor is simply increasing age, and the underlying cause is not fully understood, there is no proven way to prevent cherry angiomas from forming. Avoiding known occupational chemical exposures is sensible for general health, but for most people these growths are a normal part of skin ageing. Removing a lesion treats only that specific growth and does not stop new cherry angiomas from appearing elsewhere over time.
A cherry angioma is a common, benign vascular growth that becomes more frequent with age and poses no health risk on its own. It can usually be diagnosed by examination and dermoscopy, and it can be removed with laser, electrosurgery, or cryotherapy when treatment is wanted. A new or changing red bump, or a sudden cluster of many lesions, should still be assessed so that other conditions can be ruled out. Anyone uncertain about a skin growth can arrange a consultation for an accurate diagnosis and a treatment plan suited to the individual.
This article is intended for educational purposes and does not replace professional medical advice. Please consult your dermatologist for personalized recommendations.
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