The appearance of small, bright red spots on the skin is a common experience, especially as people move past early adulthood. These lesions are a nearly universal occurrence, appearing on a majority of individuals over the age of 30. They are classified as benign, non-cancerous growths and represent one of the most frequently observed vascular changes in aging skin. This tendency to develop these small red moles is a normal, though often confusing, physiological process that prompts many to seek understanding about their origin and nature.
Identification and Characteristics of Red Moles
These common skin growths are clinically known as Cherry Angiomas, also sometimes referred to as Campbell de Morgan spots. They are distinctive for their bright, ruby-red color due to their composition. These moles usually measure between one and five millimeters in diameter, starting as small, flat macules before growing into slightly raised, dome-shaped papules.
Cherry Angiomas most frequently appear on the torso, arms, and shoulders, but they can develop almost anywhere on the body. While they are generally harmless and asymptomatic, their vascular nature means they can sometimes bleed profusely if they are scratched or irritated by clothing. Their uniform, symmetrical, and small size helps distinguish them from other types of skin lesions.
Underlying Biological Causes
The mechanism behind the formation of a Cherry Angioma is the localized proliferation of endothelial cells that line the inside of blood vessels. This process, a type of benign angiogenesis, results in a dense cluster of tiny, dilated capillaries within the dermis layer of the skin. The pooling of blood in this tight grouping of vessels gives the spots their characteristic bright red hue.
Age is the most significant factor in their development, with prevalence increasing dramatically after the third decade of life; it is estimated that over 75% of people aged 75 and older have them. This strong age-related correlation has led to them being informally called senile angiomas. Genetic predisposition also plays a role, as a familial tendency to develop numerous angiomas is often observed.
Molecular research suggests some lesions carry somatic missense mutations in genes such as GNAQ and GNA11. These genetic changes are involved in signaling pathways that regulate cell growth, creating a localized environment that encourages the proliferation of the blood vessel cells. Other less common triggers include hormonal changes, such as those that occur during pregnancy, and exposure to specific chemicals. For instance, a sudden onset of numerous lesions has been linked to exposure to bromides or topical nitrogen mustard.
When to Seek Medical Evaluation
While Cherry Angiomas are almost always benign, any new or changing skin growth should be evaluated by a healthcare professional. The primary reason for a medical check is to distinguish the harmless angioma from certain types of skin cancer that can sometimes mimic its appearance. These concerning look-alikes include amelanotic melanoma or nodular basal cell carcinoma, which lack the typical dark pigment of most moles.
A visit to a dermatologist is warranted if a red spot exhibits rapid growth, irregular or asymmetrical borders, or a non-uniform color distribution. Unlike a typical angioma, a potentially serious lesion may show multiple colors or have a poorly defined edge. Frequent, unprovoked bleeding, crusting, or tenderness of the spot are also warning signs that require professional attention.
The sudden, rapid appearance of a large number of new Cherry Angiomas, known as eruptive angiomas, can occasionally signal a systemic issue. Although rare, this rapid proliferation has been associated with certain underlying conditions or reactions to specific medications. In such cases, a dermatologist may use a diagnostic tool called a dermatoscope for a closer look or perform a biopsy to confirm the exact nature of the growth.
Options for Removal
Since Cherry Angiomas pose no health risk, their removal is typically performed for cosmetic reasons or if they are frequently irritated and bleeding due to friction with clothing. The procedures are straightforward, quick, and usually completed in an outpatient setting with local anesthesia. The goal of removal is to destroy the cluster of capillaries that form the lesion while minimizing damage to the surrounding skin.
One common method is electrocautery, which uses a fine probe to deliver a high-frequency electric current to the lesion, destroying the tissue with heat. This process simultaneously seals the blood vessels, which helps prevent bleeding.
Another effective technique is cryosurgery, which involves applying liquid nitrogen to the spot, freezing the tissue and causing the lesion to blister and eventually fall off. Laser treatment, often utilizing a Pulsed Dye Laser, targets the red hemoglobin in the blood vessels. The light energy is absorbed by the blood, causing the vessels to collapse without damaging the outer layer of skin. For larger, more raised angiomas, a superficial shave excision may be performed to physically remove the growth.