Cherry Angiomas: What Those Small Red Spots Are, and When Treatment Is Suitable

What are cherry angiomas?

A cherry angioma is a benign vascular proliferation, which means a small, harmless cluster of blood vessels that has grown near the surface of the skin. They are the most common acquired vascular growth, and you may also see them called Campbell de Morgan spots or senile angiomas.

They are typically small, around one to five millimetres, bright red or ruby-coloured, and dome-shaped. A cherry angioma that has clotted, or thrombosed, can look darker, bluish, or almost black, which is one reason a changing-looking spot is worth a professional eye. They are usually painless and stay put, although they can bleed if they are caught or knocked.

Who gets them, and what causes them?

Cherry angiomas are extremely common. They become more frequent from around age 40, and it has been estimated that around 75 percent of people over 75 have at least one. They are not only an older-age finding, though: roughly 5 percent of adolescents have them too. They affect both sexes and all skin types, and there may be a family tendency to develop them.

The reassuring headline is that they have no malignant potential. They do not turn into skin cancer. One pattern is worth noting honestly: a sudden eruption of many new cherry angiomas at once has, rarely, been associated with internal medical conditions, so a sudden crop of many new spots may warrant medical review. This is an association, not a cause, and a single new spot here or there is the ordinary way they appear.

When should a red spot be checked first?

This is the part to read slowly, because it is the reason the safe order matters. A few serious lesions can look like a harmless red spot, and a cherry angioma cannot be told apart from them by appearance alone.

The most important mimic to know is nodular melanoma, the highest-risk look-alike: it can appear as a firm, raised pink or red dome that may bleed or crust, which is exactly how a benign red spot can also look. Amelanotic melanoma is another, often more friable, more likely to bleed, and prone to growing or changing. Other red or raised spots, such as pyogenic granuloma, angiokeratoma and certain skin cancers, can also resemble a cherry angioma.

Cherry angiomas usually blanch, or briefly lose colour, when you press them, which is a benign sign. But a self-check cannot rule out a serious lesion, and blanching alone is not proof a spot is harmless. The Cancer Council's ABCDE guide, watching for Asymmetry, Border irregularity, Colour change, a Diameter that is growing, and any Evolving change, is a useful prompt for when to get a spot looked at.

So the lock is simple and not negotiable: any new, growing, changing, irregular, bleeding or uncertain spot should be assessed by a GP or dermatologist before any cosmetic laser. At Pink, every vascular lesion is assessed before treatment, and anything that is unclear or concerning is referred for a medical opinion first.

Can cherry angiomas be removed?

Once a spot has been confirmed benign, a cherry angioma can be cleared, and laser is an effective cosmetic approach. The vessels that make up the spot absorb the laser energy, the lesion is treated, and the body clears it over the following weeks. Most respond in a small number of sessions, with results and the exact number varying from person to person.

A word on honesty about wavelengths, because it matters here. For small, very superficial cherry angiomas, the shorter-wavelength vascular lasers, KTP at 532 nm and pulsed dye laser at 595 nm, are the better-evidenced first-line options in the published studies. Pink works with a long-pulse Nd:YAG laser at 1064 nm, which can be a suitable option for cherry angioma management, particularly where the shorter vascular wavelengths are not appropriate. It is not accurate to say Nd:YAG matches KTP or pulsed dye laser for very superficial spots, and we will not. Which approach suits your spot, if any, is something a clinician assesses individually. Because the Nd:YAG wavelength is absorbed by blood rather than pigment, it suits a broad range of skin tones, assessed clinically and with a test patch beforehand.

Pink's approach to discrete vascular spots is set out on the Laser Vein Removal page, which also carries current pricing. Vein and vascular-spot treatment is priced by the time a session takes rather than per spot, so the page is where the up-to-date number is shown.

What does assessment and management look like at Pink?

The sequence is the useful thing to hold, and it always runs in the same order: assessment first, then, if appropriate, treatment. A clinician looks at the spot, confirms it suits cosmetic clearing, and refers anything new, changing or uncertain for a medical opinion before going further. If the spot is a straightforward, confirmed cherry angioma, clearing it is usually quick.

One timing note worth mentioning: cosmetic laser is generally not recommended during pregnancy, so if you are pregnant, a cherry angioma is best reviewed after birth rather than treated in the meantime.

If you are unsure whether a spot is suitable for cosmetic laser, that is exactly what a consultation is for. And for any spot that looks concerning, the right first stop is a GP or dermatologist.

Frequently Asked Questions

Are cherry angiomas dangerous?

Cherry angiomas themselves are benign and have no malignant potential, so they do not turn into skin cancer. The important caution is that a few serious lesions, including nodular melanoma and amelanotic melanoma, can look like a harmless red spot. Because appearance alone cannot tell them apart, any new, changing, irregular or bleeding spot should be assessed by a GP or dermatologist before it is treated cosmetically.

What causes cherry angiomas?

They are benign clusters of small blood vessels that grow near the surface of the skin. They become more common from around age 40, affect both sexes and all skin types, and there may be a family tendency to develop them. It has been estimated that around 75 percent of people over 75 have at least one. A single new spot is the ordinary way they appear, although a sudden eruption of many at once may warrant a medical review.

How can I tell a cherry angioma from something more serious?

You often cannot tell by looking, which is the honest and important answer. Cherry angiomas usually blanch, or briefly lose colour, when pressed, which is a benign sign, but a self-check cannot rule out a serious lesion. A nodular melanoma can appear as a firm, raised pink or red dome that bleeds or crusts, which can look like a benign spot. Any new, growing, changing, irregular or bleeding spot should be assessed before any cosmetic treatment.

Can cherry angiomas be removed with laser?

Once a spot has been confirmed benign, yes, laser is an effective cosmetic approach and the body clears the treated lesion over the following weeks, usually in a small number of sessions. For very small, superficial spots, KTP and pulsed dye lasers are the better-evidenced first-line options in the research. Pink's long-pulse Nd:YAG laser can be a suitable option, particularly where the shorter wavelengths are not appropriate; results and session numbers vary, and a clinician assesses what suits your spot.

Should I have a cherry angioma treated during pregnancy?

Cosmetic laser is generally not recommended during pregnancy. A cherry angioma is benign, so there is usually no need to treat it in a hurry, and it is best reviewed after birth rather than during pregnancy. As always, if a spot is new, changing or uncertain, have it assessed by a GP or dermatologist rather than waiting.

If a small red spot has caught your eye, the safe first step is having it assessed. See how Pink assesses and clears vascular spots.