Cherry angiomas are very common skin growths that appear as red spots on the skin. They can be flat or raised skin lesions and usually appear after the age of 30. They are harmless but if needed, they can be removed.
Cherry angiomas are known by several other names – red moles, ruby spots, senile angiomas, and Campbell de Morgan spots.
What is a cherry angioma?
Red moles or cherry angiomas are common non-cancerous skin lesions that can appear as red flat spots or bumps on the skin. They are composed of blood vessels which give them a bright red color hence, giving them the names “red moles” and “ruby spots”.
Cherry angiomas are often seen in adults over the age of 30 years of age and the elderly. As per one study, cherry angiomas were found in 5% of adolescents and 75% of adults over 75 years of age. They are harmless, however, if traumatized or irritated they may bleed.
Cherry angioma vs hemangioma
Cherry angiomas are also called cherry hemangiomas.
Angioma is a broader term that includes tumors composed of lymphatic or blood vessels. A hemangioma is a tumor that is composed of blood vessels, so it is a type of angioma.
Appearance
Cherry angiomas may appear as red flat lesions called macules or raised dome-shaped skin lesions called papules. The size can range from pinpoint (1-2 mm) to 5 mm.
They are usually bright red in color, although they can be purple or bluish in color. In a few cases, they may be surrounded by a pale halo, especially in older individuals with more than 4 spots or larger lesions (> 3 mm).
Red moles commonly appear on the trunk, arms, and legs and rarely on the hands, feet, and face. In one study (done in 2004), cherry angiomas were seen on the scalp in 72% of the patients.
Pictures
Do they itch?
Cherry angiomas usually do not itch or hurt, but they can bleed if scratched or due to trauma.
Causes
The exact cause of cherry angiomas is not clear. They may be related to the following factors:
- They usually appear after 30 years of age and their number increases with age. So, the aging process may play a role.
- Cherry angiomas may develop during pregnancy, so hormones may play a role.
- Genetic factors may play a role in making some individuals more prone to getting cherry angiomas.
- Mutations in genes GNAQ and GNA11 are associated with cherry angiomas.
- Exposure to certain chemicals may lead to cherry angiomas. These include nitrogen mustard, 2-butoxyethanol, or derivatives of bromine.
- Due to medications, such as cyclosporine or ramucirumab.
- Cherry angiomas are found more commonly in individuals with diabetes, transplant, immunosuppression, graft-versus-host disease, or those living in tropical climates.
Relation to pregnancy
The exact reason why they often appear during pregnancy is not known. It is thought that it may be due to hormones, especially prolactin.
Prolactin stimulates angiogenesis, that is the growth of new blood vessels. So, that may be the mechanism behind it. Prolactin is a hormone responsible for breast growth and milk production during pregnancy.
Are they connected to liver disease?
There is very scarce data on this. There is one study (2015) that included 340 participants with cherry angiomas, all over the age of 40. Of these, 238 individuals had nonalcoholic fatty liver disease.
However, even otherwise cherry angiomas are very commonly seen in individuals over 40 years of age. So, we need more data to see if there is any strong association between these two.
Another type of angioma, called spider angioma is more often associated with chronic liver disease.
Cherry angioma vs spider angiomas
Cherry angiomas may be confused with spider angiomas which are often seen in individuals with liver dysfunction or chronic liver disease like cirrhosis.
In comparison to cherry angioma, a spider angioma has a central red body with red extensions (it may look like a spider).
Can you have hundreds of cherry angiomas?
There is no cut-off that defines a normal number of cherry angiomas. Some people will see many cherry angiomas on their bodies, especially at the ages of 60-70. It is simply due to the fact that cherry angiomas may increase in number with age.
However, if you see the sudden appearance of multiple cherry angiomas, it may be best to get them evaluated by a doctor.
Are they dangerous?
Cherry angiomas are harmless and do not become cancerous. However, if you notice any change in the size, shape, or color of the red mole, you should get it evaluated by a doctor.
Treatment
Cherry angiomas usually do not go away on their own. They are harmless and do not require treatment. However, if you want to get rid of them or they bleed, cause discomfort, or are too big, there are few procedures to remove them.
Note: Cherry angiomas cannot be treated at home. There are no home remedies that are proven to remove them.
The treatment options for cherry angiomas include:
- Electrosurgery: It involves the use of electric current to burn the cherry angioma.
- Cryotherapy: It involves the use of liquid nitrogen to freeze the angioma.
- Laser therapy: It involves the use of lasers like pulsed dye laser (PDL) which targets the blood vessels. The light is converted to heat which destroys the blood vessels.
- Shave excision: This involves shaving the angioma at the level of the skin. The lesions can also be cut out with a scalpel which is followed by suturing of the wound.
Read the detailed post on cherry angioma removal.
When to see a doctor
Cherry angiomas usually do not cause any problems. However, one should see a doctor if:
- If you see any change in the appearance (size, shape, or color) of the red mole.
- If they cause any symptoms or do not stop bleeding.
- If you have any other systemic symptoms like weight loss, enlarged lymph nodes, etc.
- If the red moles are surrounded by a red or purplish halo (may indicate systemic amyloidosis, rare case reports on this).
- If there is a sudden appearance of multiple cherry angiomas without any known reason.
- The red spots affect your self-confidence or you want to get them removed.
- If you are not sure, that the red bumps are cherry angiomas or something else.
Prevention
The exact cause of cherry angiomas is not known, so these cannot be prevented.
However, since there is some data on their association with chemicals like nitrogen mustard, bromides, and butoxyethanol, one can avoid the use of them.
Key points
Cherry angiomas or red moles are harmless skin spots that are often seen in adults. They do not require treatment. At the same time, they usually do not go away on their own. So, if you want to get rid of them, you will need a procedure like a laser or cryotherapy.
Any red mole that changes in appearance should be examined by a doctor.
References
- Betz-Stablein B, Koh U, Edwards HA, McInerney-Leo A, Janda M, Soyer HP. Anatomic Distribution of Cherry Angiomas in the General Population. Dermatology. 2022;238(1):18-26. doi: 10.1159/000517172. Epub 2021 Jul 22. PMID: 34293748.
- Askari N, Vaez-Mahdavi MR, Moaiedmohseni S, Khamesipour A, Soroush MR, Moin A, Jalaie S, Ghazanfari Z, Faghihzadeh E, Ghazanfari T. Association of chemokines and prolactin with cherry angioma in a sulfur mustard exposed population–Sardasht-Iran cohort study. Int Immunopharmacol. 2013 Nov;17(3):991-5. doi: 10.1016/j.intimp.2012.12.016. Epub 2013 Jan 29. PMID: 23370299.
- Fettahlioglu Karaman B. Halo Formation Around Cherry Angiomas: A Rare But Substantial Finding. Med Sci Monit. 2018 Jul 20;24:5050-5053. doi: 10.12659/MSM.908644. PMID: 30028831; PMCID: PMC6067034.
- Schmidt CP. Purpuric halos around hemangiomas in systemic amyloidosis. Cutis. 1991 Aug;48(2):141-3. PMID: 1935240.
- MURISON AR, SUTHERLAND JW, WILLIAMSON AM. De Morgan’s spots. Br Med J. 1947 May 10;1(4505):634-6. doi: 10.1136/bmj.1.4505.634. PMID: 20248075; PMCID: PMC2053226.
Disclaimer: This blog post is for information purposes only and does not replace medical advice.