What Are Cherry Angiomas?

Many little bumps or spots of various colors can pop up on your skin. Common growths include whiteheads, blackheads, moles ranging in colors from pink to blue, and skin-colored growths called skin tags. Another type of growth is cherry angiomas, red lesions made up of small blood vessels that have dilated, swelled, and broken. 

Some risk factors for cherry angiomas include genetics and pregnancy. However, cherry angiomas commonly appear in older adults, usually popping up after age 30. In fact, about 75% of people over 75 develop cherry angiomas. In contrast, only about 7% of adolescents have cherry angiomas. Also, up to 41% of people in their 20s have cherry angiomas.

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

Cherry Angiomas Symptoms

Cherry angiomas are benign, or noncancerous, skin growths. The following characteristics define a cherry angioma:

• Color: Cherry angiomas are red because they're made up of blood vessels. In contrast, if a person's body tissues have low oxygen levels, cherry angiomas may appear blue. A pale circle of skin called a halo surrounds cherry angiomas.
• Size: Usually, 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.
• Shape: Cherry angiomas are usually dome-shaped. The growths are generally smooth but are sometimes raised.

Cherry angiomas can appear anywhere on the body, regardless of whether the skin has been exposed to the sun. However, 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. If capillaries break, you can see them on the skin's surface.

Risk Factors

Researchers don't know precisely why cherry angiomas appear on the body. However, several factors may increase your risk of cherry angiomas, including:

• Age
• Genetics
• Pregnancy

Additionally, factors that increase the risk of multiple cherry angiomas include:

• A weak immune system
• Cancer
• Exposure to certain chemicals, like nitrogen mustard

How Are Cherry Angiomas Diagnosed?

Most commonly, healthcare providers diagnose cherry angiomas based on the growth's color, size, and shape. 

Examining the growth can help rule out other skin conditions, like petechiae. Petechiae are tiny red spots on the skin that happen when broken blood vessels bleed into the skin. Those growths closely resemble cherry angiomas. However, petechiae are usually round and raised, whereas cherry angiomas are dome-shaped and usually flat.

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

Cherry angiomas are benign. However, in some cases, the growth may resemble melanoma, a severe type of skin cancer. Specifically, 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.

If a healthcare provider suspects a cherry angioma may be cancerous, they will remove the lesion and send it for testing.

Treatments for Cherry Angiomas

Typically, cherry angiomas aren't harmful and don't have symptoms beyond skin color or potential discomfort. In most cases, cherry angiomas don't require treatment. Still, healthcare providers can remove cherry angiomas for cosmetic reasons if the lesion is in a place that makes you uncomfortable. 

Healthcare providers can use any of the following procedures to remove cherry angiomas:

• Electrocauterization: Also known as electrocautery, this procedure removes unwanted or harmful tissue. Electrocauterization can also burn blood vessels to seal them.
• Cryotherapy: This procedure uses extreme cold to freeze and destroy unwanted tissue. Cryotherapy is a relatively short procedure that comes with some discomfort.
• 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.
• Shave excision: Dermatologists often use this technique to remove lesions raised above or on the top layer of skin.
• 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 using lasers, cherry angiomas typically darken, scab, and peel within a couple of weeks. Also, laser therapies do not damage the surrounding skin.

With any of those procedures, the removal of cherry angiomas rarely leaves scars. 

How To Prevent Cherry Angiomas

Many risk factors of cherry angiomas, like genetics and age, are not modifiable. There aren't any absolute ways to prevent the growths. Still, some research has found that clopidogrel may help prevent cherry angiomas. Clopidogrel is a drug that lowers cardiovascular disease risk.

One 2020 study found that people taking clopidogrel had fewer cherry angiomas than others. The researchers hypothesized that the drug stopped the growth of new capillaries. However, more studies are needed to verify those findings.

Comorbid 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). Some evidence suggests that people with acromegaly may develop cherry angiomas due to lipid abnormalities that affect capillaries. Lipids are fatty acids, which include oils.
• 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.
• Chronic graft-versus-host disease (GVHD): This is an adverse reaction to an allogeneic transplant. GVHD happens when the host's cells attack the recipient's cells. Research has found that multiple cherry angiomas are common with GVHD.
• Multicentric Castleman disease (MCD): This is a rare disorder in which cells in the lymph nodes dangerously multiply. Some evidence suggests that the proteins causing cell overgrowth may also raise the risk of multiple cherry angiomas.
• 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, and MCD.

When To See a Healthcare Provider

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

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

A Quick Review

Cherry angiomas are benign small, red skin growths made up 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 significant factors that increase the risk of cherry angiomas. Genetics, pregnancy, and certain conditions or treatments play roles, as well.