Red moles, appearing as small, bright red dots on the skin, are a common dermatological finding. These growths are typically benign vascular lesions, meaning they involve blood vessels. They are often mistaken for other types of skin spots. This article clarifies the nature of these growths, explores the biological factors behind their appearance, and provides guidance on how to distinguish them from other lesions.
What Are Red Moles
The most common form of red mole is the cherry angioma, also referred to as a senile angioma or a Campbell de Morgan spot. These are noncancerous growths characterized by a proliferation of small blood vessels near the skin’s surface. Their distinctive bright, cherry-red color comes directly from this dense cluster of dilated blood vessels.
A typical cherry angioma presents as a small, smooth, dome-shaped papule, ranging in size up to five millimeters in diameter. While they can appear anywhere, they are most frequently observed across the torso, arms, and shoulders. Applying pressure may cause the angioma to slightly lighten or blanch, though they often retain their color because the vessels are permanently dilated.
Biological Factors Behind Their Formation
The formation of a cherry angioma involves angiogenesis, the creation of new blood vessels from pre-existing ones. This process includes the overgrowth and dilation of endothelial cells, which line the inside of blood vessels, leading to the visible cluster of capillaries. Though the exact trigger is not fully understood, their development is associated with several biological factors.
The most significant factor is the aging process, which is why they are sometimes called senile angiomas. Their prevalence increases dramatically with age, with a majority of adults over 75 having at least one. Genetic predisposition also plays a role, as the tendency to develop them often runs in families.
Research has identified specific somatic mutations in genes like GNAQ and GNA11 within the lesions. These genes regulate vascular pathways and may predispose an individual to capillary proliferation. Hormonal shifts, such as those during pregnancy, have also been observed to trigger the appearance or growth of new cherry angiomas. Certain medical conditions and exposure to specific chemicals have also been linked to the eruption of multiple lesions.
Telling Benign Moles Apart from Other Spots
Distinguishing a benign cherry angioma from other red skin lesions is important for appropriate medical management. One key difference is the three-dimensional, dome-like structure of the angioma, which sets it apart from flat spots. Other red lesions can mimic the appearance of a red mole but have distinct characteristics.
Petechiae, for example, are tiny, flat, pinpoint red or purple spots resulting from minor bleeding under the skin. Unlike cherry angiomas, petechiae are always flat and will not blanch when pressure is applied because the blood has already left the vessel. Pyogenic granulomas are another vascular lesion that can be confused with a red mole, but they grow rapidly, often appear raw or raspberry-like, and bleed easily with minimal trauma.
Another similar lesion is an angiokeratoma, which is dark red or purple but has a rougher, warty surface texture. Spider angiomas are also red but feature a central red spot with fine blood vessels radiating outward, creating a spider-web appearance.
Signs That Require Medical Evaluation
While red moles are harmless, any skin lesion that exhibits concerning changes should be professionally evaluated to rule out rare but serious conditions, such as amelanotic melanoma. A consultation is warranted if a red spot begins to change rapidly in size, shape, or color, especially if it develops multiple shades or becomes dark.
Specific signs requiring medical attention include irregular or ragged borders, asymmetry (where one half does not match the other), or an increase in diameter beyond six millimeters. Spontaneous bleeding, frequent crusting, oozing, or persistent itching also signals the need for a professional examination. When a cherry angioma is confirmed, removal is typically a cosmetic procedure performed using methods like electrocautery or laser therapy.