What Are Red Moles (Cherry Angiomas)?

Cherry angiomas, which may appear as red bumps on the skin, are lesions of small blood vessels that have dilated, swelled, and broken. While cherry angiomas may look like moles, they are not actually moles.

Risk factors for cherry angiomas include genetics and pregnancy. Cherry angiomas commonly appear in older adults, usually popping up after age 30. About 75% of people over 75 develop cherry angiomas. Only 7% and up to 41% of adolescents and people in their 20s have cherry angiomas.  

Cherry angiomas are not a cause for worry. Still, some people may remove them for cosmetic reasons or if they bleed after an injury.

Read on to learn about cherry angiomas, including their symptoms, causes, and when to see a healthcare provider.

Cherry Angiomas Symptoms

Cherry angiomas are benign, or noncancerous, skin growths.

You may identify a cherry angioma based on characteristics like:

• Color: Cherry angiomas are red because they are made up of blood vessels. Cherry angiomas may appear blue if a person's body tissues have low oxygen levels. A pale circle of skin, or a halo, surrounds cherry angiomas.
• Shape: Cherry angiomas are usually dome-shaped. The growths are mostly smooth but are sometimes raised.
• Size: Generally, cherry angiomas start small and may grow slightly over time. The growths are one to five millimeters, or about the size of a pinhead to less than one-fourth of an inch.

Cherry angiomas can appear anywhere on the body, regardless of whether the skin has been exposed to the sun. Cherry angiomas most commonly show up on the trunk or arms. Rarely do the growths appear on the hands, feet, and face. In most cases, multiple cherry angiomas show up close to each other.

What Causes Cherry Angiomas?

Cherry angiomas occur when new blood capillaries dilate. Capillaries are the smallest blood vessels in the body. They transport oxygen and nutrients to cells in organs and tissues. 

When the capillaries dilate, they turn red and swell. You can see capillaries on the skin's surface if they break.

Risk Factors

Researchers do not know precisely why cherry angiomas appear on the body. 

Several factors may increase your risk of cherry angiomas, including:

• Age
• Genetics
• Hormone changes (I.e. during pregnancy or when taking oral contraceptives)

Factors that increase the risk of multiple cherry angiomas include:

• A weak immune system
• Cancer
• Exposure to certain chemicals (i.e., nitrogen mustard)

How Are Cherry Angiomas Diagnosed?

Healthcare providers commonly diagnose cherry angiomas based on the growth's color, shape, and size. Examining the growth can help rule out other skin conditions like petechiae. 

Petechiae are tiny red skin spots that happen when broken blood vessels bleed into the skin. Those growths closely resemble cherry angiomas. Petechiae are usually round and raised, whereas cherry angiomas are dome-shaped and typically flat.

A healthcare provider may use optical coherence tomography (OCT), or a type of imaging. OCT uses low-energy light to find out how deep the broken capillary goes under the skin. 

Cherry angiomas are benign. In some cases, the growth may resemble melanoma, a severe type of skin cancer. Some cherry angiomas might look like amelanotic melanoma because of their color. Melanotic melanomas make up most cases of melanoma, whereas amelanotic melanomas constitute about 2% to 20% of cases.

A healthcare provider will remove the lesion and send it for testing if they suspect a cherry angioma may be cancerous.

Cherry Angioma Removal

In most cases, cherry angiomas don't require treatment. Cherry angiomas typically are not harmful and do not have symptoms beyond skin color or potential discomfort. 

Healthcare providers can remove cherry angiomas for cosmetic reasons if the lesion is in a place that makes you uncomfortable. 

Procedures that remove cherry angiomas include:

• Electrocauterization: Also known as electrocautery, this procedure removes unwanted or harmful tissue. Electrocauterization can burn blood vessels to seal them.
• Intense pulsed light (IPL) therapy: Sometimes known as flashlamp therapy, IPL therapy is non-invasive and non-ablative. IPL therapy uses high-intensity light pulses to improve skin problems like acne, rosacea, and skin lesions.
• Laser therapy: One of the most common treatments for cherry angiomas is vascular lasers, such as Nd:Yag or diode lasers. Research has found that cherry angiomas typically darken, scab, and peel within a few weeks using lasers. Laser therapies do not damage the surrounding skin.
• Shave excision: Dermatologists often use this technique to remove lesions raised above or on the top layer of skin.

Rarely does removing cherry angiomas leave scars. 

How To Prevent Cherry Angiomas

There are not any absolute ways to prevent cherry angiomas. Many risk factors of cherry angiomas, like genetics and age, are not modifiable. 

Clopidogrel, a drug that lowers heart disease risk, may help prevent the growths. A study published in 2020 found that people taking clopidogrel had fewer cherry angiomas than others. The researchers noted that the drug may have stopped the growth of new capillaries. More studies are needed to verify those findings.

Related Conditions

Anyone can develop cherry angiomas. Still, people with certain health conditions may be more likely than others to have cherry angiomas.

Those health conditions include:

• Acromegaly: This disorder happens when the body makes too much growth hormone (GH) and insulin growth factor 1 (IGF-1). People with acromegaly may develop cherry angiomas due to lipid abnormalities that affect capillaries. Lipids are fatty acids, which include oils.
• Chronic graft-versus-host disease (GVHD): This is a negative reaction to an allogeneic transplant. GVHD happens when the host's cells attack the recipient's cells. Multiple cherry angiomas are common with GVHD.
• Human herpesvirus-8 (HHV8): Research has found that nearly 53% of people with multiple cherry angiomas have HHV8. HHV8 is a type of herpesvirus that causes Kaposi's sarcoma, a type of cancer.
• Multicentric Castleman disease (MCD): This rare disorder causes cells in the lymph nodes to multiply quickly. The proteins causing cell overgrowth may raise the risk of multiple cherry angiomas.
• Vitiligo: This condition happens when the skin loses its natural color in patches. Topical nitrogen mustard, a treatment for vitiligo, raises the risk of multiple cherry angiomas.

When To See a Healthcare Provider

Keeping an eye on any moles or other spots that appear to be growing or morphing over time is essential. Consult a dermatologist if a red spot changes in color, shape, or size or starts to bleed.

Cherry angiomas do not itch, so the lesions may be something else if they do. 

Skin conditions that may cause itchy red lesions include:

• Eczema: Inflamed and irritated red areas of skin 
• Hives: Red bumps that usually go away quickly
• Psoriasis: Red patches of thick skin

Melanoma may cause lesions to change appearance and itch, too. Talk to a dermatologist if you notice any changes to cherry angiomas, including itching.

Cherry angiomas have very few possible complications. The growths can bleed if injured, or they can change appearance. Bleeding after an injury is another reason people remove cherry angiomas.

A Quick Review

Cherry angiomas are benign small, red skin growths of capillaries that have broken to become visible on the skin's surface. Some people may remove them for cosmetic reasons or if the growths bleed after an injury.

Age is one of the most common factors that raise the risk of cherry angiomas. Genetics, pregnancy, and certain conditions or treatments also play roles.