Cherry Angioma

What is cherry angioma?

Cherry angiomas are small, red, harmless skin findings that occur commonly in older adults. They are clumps of overgrown cells derived from the inside of blood vessels, or vascular endothelium. Cherry angiomas most commonly start appearing around age 40 and some estimates suggest that the majority of adults will have at least one by age 70.

Symptoms are limited to the presence and appearance of cherry angiomas. They are commonly found on the chest, back, or shoulder, and appear as small, red, purple, blue or black skin bumps.

Though treatment is not necessary, some individuals may wish to remove cherry angiomas for cosmetic reasons, and a number of procedures are available to accomplish this.

You do not need to see a doctor for a cherry angioma. If you want to get rid of the spot, a doctor can prescribe propranolol, topical beta-blockers, and systemic corticosteroids on a case-by-case basis.

Cherry angioma symptoms

Because cherry angiomas represent a group of overgrown cells, cherry angiomas are "technically" tumors but they are entirely benign. Cherry angiomas can be diagnosed by examination. Biopsies to confirm are usually not required.

Main symptoms

Cherry angiomas can be defined by the following details.

• Appearance: Cherry angiomas classically appear as small, "cherry-red" skin bumps. They can also look purple, blue, or even black if there is not much blood flowing through them.
• Location: They are most often found as multiple lesions starting on the chest, back or shoulders of older adults.
• Size and shape: Most cherry angiomas are less than a quarter inch across (or roughly 0.5 cm) and can look more like a red dot than an obvious bump. They are often raised and rubbery but can be flat, particularly early on.
• Bleeding or irritation: This can be seen, but is usually as a result of minor trauma such as scratching or shaving.

Causes of cherry angioma

The specific cause of cherry angiomas remains unknown, but the most likely explanation is random variation in aging cells.

About blood vessel growth

Blood vessels are supposed to grow after an injury to help heal the wound. Vessel growth is part of normal tissue maintenance and repair, controlled by a balance of signals known as cytokines, hormones, and intracellular messengers.

Cell aging

As we age, older cells become more prone to signaling mistakes and sometimes overgrow. Very rarely this can take the form of cancer known as angiosarcoma, but far more often the result is simply a harmless bundle we call an angioma. In many ways, they are similar to the harmless "strawberry hemangiomas" often seen on newborns.

Risk factors

Known risk factors for cherry angioma include a family history of angiomas and hormone changes, which can be seen in pregnancy or liver failure.

Treatment options and prevention for cherry angioma

Cherry angiomas are harmless and do not require any treatment. In some cases, your physician may wish to biopsy an angioma to confirm the diagnosis.

Removal

While treatment is not necessary, some people choose to remove angiomas for cosmetic reasons. This can be done safely using a few different methods, and you and your physician can decide which one is best for you. These procedures are commonly performed in your physician's office, and it is likely you will receive a local anesthetic for mild discomfort.

• Laser treatments: A pulsed dye laser (PDL) or another medical laser can be focused on the angioma and destroy it using heat. Bruising may occur, but some studies found this to be the most effective, comfortable option overall. Multiple rounds may be needed, but scarring is usually very minimal.
• Electrocautery: A special tool is used to cauterize, or burn off, the cherry angioma using heat. You may experience some slight discomfort and scarring as the area heals.
• Shave excision: Excision involves shaving or cutting off the angioma. Some discomfort and scarring may occur afterward.
• Cryotherapy: A very cold substance, commonly liquid nitrogen, is used to target the angioma effectively destroying it. Similar treatment is used for other skin issues, such as warts and actinic keratosis. Some scarring may occur.

Prognosis

Additional angiomas will often appear regardless of management. There is no known treatment to prevent their appearance.

When to seek further consultation for cherry angioma

In general, if you are concerned about new skin lesions, you should see your physician. While cherry angiomas are themselves harmless, they can sometimes look similar to more dangerous lesions. Either a primary care physician or a dermatologist can usually identify a cherry angioma by appearance alone and without any further testing.

If you have to receive a skin biopsy

If there is uncertainty regarding the appearance, a skin biopsy can verify the diagnosis. Once cherry angiomas are diagnosed, they may change in size or brightness but shouldn't change dramatically in shape or color.

If you notice changes in previously stable skin lesions

You should consult your physician just to be safe. It is also always a good idea to take pictures of skin lesions, ideally next to a size reference (such as a coin) which will help trend any changes over time.