A cherry angioma is a small, benign cluster of blood vessels in the skin, not a mole, seen as a bright red to purple dot that becomes more common with age. It contains no pigment cells and does not turn into melanoma. Removal is optional and cosmetic, but a new, bleeding or unusual red spot is examined first.
Key facts
- What it is
- A benign capillary growth: a cluster of small blood vessels, not pigment cells
- Other names
- Campbell de Morgan spot, senile angioma, cherry haemangioma
- Typical look
- Bright red to purple, flat or dome-shaped, from a pinpoint to a few millimetres
- Who gets them
- Increasingly common with age; reviews estimate around three-quarters of people over 75 have them
- Malignant potential
- None, but a small number of red lesions are something else, so diagnosis comes first
- Removal options
- Electrocautery or radiofrequency, vascular laser or cryotherapy, matched to size and site
- First step
- Examination, with a dermatoscope where indicated, before anything is removed
What is a cherry angioma, and why is it called a red mole?
A cherry angioma is a benign growth of tiny blood vessels in the upper layers of the skin. It looks like a mole because it is a small, well-defined dot, and many people call it a red mole for that reason. Biologically it is a different thing: a mole is a cluster of pigment-producing cells, while a cherry angioma is a cluster of capillaries, and its colour comes from the blood inside them rather than from melanin.
Dermatologists know the same lesion as a Campbell de Morgan spot, a senile angioma or a cherry haemangioma. They range from a pinpoint red fleck to a smooth dome a few millimetres across, bright red when young and often darker, towards purple, as they mature. Most sit on the trunk, upper arms and shoulders, and they are unusual on the hands and feet.
Their importance is not medical. They cause no symptoms and carry no risk of turning into cancer. But they are visible, they can bleed when nicked by a razor or caught on a strap, and they are easy to confuse with other spots that do matter, which is the real reason to understand them.
Why do cherry angiomas appear as we get older?
Age is the clearest driver. Cherry angiomas become noticeably more numerous from around the age of 40, and reviews estimate that around three-quarters of people over 75 have them. A smaller proportion of people notice their first ones in their twenties, or even in adolescence. New spots appearing gradually over the years is the expected pattern, not a sign that something has gone wrong.
Molecular studies have found specific acquired mutations, in genes such as GNAQ and GNA11, in the vessel cells of many cherry angiomas. That helps explain why they behave as small, stable growths rather than as a rash or inflammation, and why no cream, diet or supplement makes them recede. A gradual accumulation reflects how skin vessels behave over time, not anything you did or failed to do with your skincare.
Other associations are described but are far less common: pregnancy, certain medicines and chemical exposures, and, rarely, a sudden eruption of many new angiomas alongside other illness. A slow accumulation of a few spots with age needs no investigation. A sudden crop of many new lesions, or angiomas appearing while you feel generally unwell, is worth mentioning to a doctor.
“Do not remove your mole until you have scoped it.”
Dr Sin YongOn examining any spot before it is removed
Cherry angioma, mole or seborrhoeic keratosis: how do you tell them apart?
Colour and texture are the first clues. A cherry angioma is red to purple and smooth. A mole is made of pigment cells, usually tan, brown or black, flat or raised, and it can change in ways that matter. A seborrhoeic keratosis, the so-called age wart, is a waxy, stuck-on growth, tan to dark brown, that looks as though it could be lifted off with a fingernail. Skin tags, soft flesh-coloured flaps, often sit on the same skin. All of these become more common with age, which is why people confuse them.
Older angiomas can darken towards purple or look almost black, and that is where self-assessment fails. A dark, dome-shaped spot could be an angioma that has clotted, a pigmented seborrhoeic keratosis or a pigmented lesion that needs attention, and from the surface they can look alike. Under a dermatoscope the distinction is usually much clearer: angiomas show well-defined red to purple vascular compartments, while moles show a pigment network.
Other red spots belong in the comparison too. Facial thread veins are fine lines of dilated vessels rather than a dot. Spider angiomas have a red centre with fine vessels radiating from it, and several appearing together are worth mentioning to a doctor because they have different associations, including pregnancy and liver disease. A red lump that appeared quickly and bleeds easily may be a pyogenic granuloma, and rarely a skin cancer can be pink or red with little visible pigment.
When should a red spot be checked by a doctor?
A red spot should be checked when it is new and growing quickly, bleeds without an obvious injury or keeps re-bleeding, crusts or breaks down, looks different from your other angiomas, or sits somewhere unusual. Simply being unsure is also a good reason. None of these mean the lesion is serious; they mean the decision should rest on an examination rather than an assumption. A dated phone photograph of the spot beside a ruler is a useful record if you are unsure whether it is genuinely changing.
Examination is quick. The spot is looked at under good light and, where indicated, with a dermatoscope, which shows the vessel pattern beneath the surface. A classic cherry angioma can then be left alone or removed for cosmetic reasons. Anything atypical is not cauterised away: it is removed in a way that preserves tissue for histology, or referred, as with any lesion that does not look straightforward. The same principle runs through mole removal at the practice.
It is worth having the rest of your skin glanced over at the same visit. People with many angiomas often have moles and seborrhoeic keratoses as well, and the appointment that settles one red spot can settle several brown ones. The questions worth asking before any lesion is removed are set out in the mole removal guide.
How are cherry angiomas removed, and what are the trade-offs?
Removal is optional and cosmetic. The common approaches are electrocautery or radiofrequency, which seal and remove the vessels with a fine tip under local anaesthetic; vascular laser, in which light absorbed by haemoglobin heats and closes the vessels; and cryotherapy, which some clinicians use for small lesions. Which suits a given angioma depends on its size, how raised it is, where it sits and your skin type, and the options are discussed at assessment rather than chosen from a menu.
Each method trades something. A small, flat angioma may suit a vascular laser, while a raised one often needs to be taken down to skin level with an energy tip. A small mark can remain where a larger angioma has been treated, and in Asian skin a treated site can darken for a while or, occasionally, leave a pale spot, so sun protection while it heals matters. A randomised trial comparing cryotherapy and electrosurgery for common benign lesions, including cherry angiomas, recorded pigment change and occasional small depressed marks in a minority of treated lesions.
Removal treats the lesions present, not the tendency to form them. New angiomas may continue to appear over the years, and some people return to have new ones dealt with as they arise. Home methods such as corrosive pens, freezing kits, tying off or picking are not advised: angiomas bleed readily, and destroying a lesion that has not been examined removes the chance to check what it was.
What happens at the visit, and what affects the cost?
The visit starts with the examination described above, followed by a discussion of which lesions to treat and how. Treated sites are numbed with local anaesthetic or a topical cream, and treatment of each small lesion is brief. A small crust may form and separate as the skin heals. Aftercare is simple: keep the area clean, do not pick, and protect it from the sun. A treated site that bleeds repeatedly, becomes increasingly painful, red and warm, or is not healing as expected should be reviewed rather than watched at home.
Cost depends on how many lesions are treated, their size and site, and the method used. Singapore's healthcare advertising rules do not allow prices for licensable healthcare services to be published, so fees are set out at consultation, after the spots have been examined and before anything is done.
Dr Sin Yong, MBBS (NUS), MRCS (Edinburgh), MSc Aesthetic Medicine with Distinction (Queen Mary, London), MSc Practical Dermatology (Cardiff), examines skin lesions personally at Orchard Road, and will say plainly when a red spot can simply be left alone. Where removal is suitable, it is carried out at the clinic after that assessment.
