Cherry angiomas: the small red dots that arrive with the decades
Last updated September 3, 2026.
Cherry angiomas (Campbell de Morgan spots) are small, bright-red, dome-shaped skin spots made of tiny blood vessels: appearing from the thirties onward and multiplying gently with the decades. They are harmless (not cancer, never turning into anything), universal in the middle-aged and older, and worth treating only if they bleed, catch, or bother: with the simple removal options.
What do they look like?
The unmistakable look: the small (1-5mm), bright cherry-red to slightly-purple, smooth, round or slightly-domed spots, scattered on the trunk and the upper arms mainly (the face and the legs less), arriving one or two at a time from the thirties, multiplying slowly with the decades (the seventies collecting them), and bleeding briskly if nicked (the shaving, the scratching: the blood-vessel nature showing). They do not itch, do not hurt, and do not change quickly.
Why do they happen?
The skin's tiny blood vessels dilating into the little clusters: the aging is the main driver (universal by the later decades), with the genetic tendency (the families collect them), the pregnancy (the hormonal blooming), and the occasional bursts reported. They are not caused by the liver (the persistent myth: the liver's spider veins are a different lesion), not by anything you did, and not a marker of the internal disease: the ordinary cherry angioma is the skin's gray hair.
How are they managed?
- The vast majority: nothing. The reassurance is the treatment.
- The bleeding one: the firm pressure for the minutes (they bleed briskly, and stop).
- The catchers and the botherers: the removal: the cautery, the laser, or the shave (the quick clinic procedures: simple), with the small scar traded for the spot.
- The cosmetic kind: the laser effective for the visible ones (the private route usually: the NHS removal is for the symptomatic).
- The different lookalikes: the changing, the irregular, or the single new dark lesion gets the skin check (the melanoma-rule-out: different-looking from the cherry-red dome).
When to get one checked?
The ordinary cherry angioma (the bright-red, domed, stable, multiplying-slowly kind) needs no check; the skin-lesion red flags apply: the spot that changes quickly, the irregular or the dark pigmented new lesion, the bleeding that will not settle, and the single lesion you are unsure about: the GP skin check. The eruptive sudden appearance of very many is the prompt-review kind (rare, worth the look). Pymander's escalation routing is built and tested specifically for this class of decision; see the safety architecture working paper.
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Common questions
Are they a sign of something wrong inside?
no, and the myth deserves the proper burial: the cherry angiomas are the skin's own little blood-vessel clusters (the local, benign, age-related change), with no association with the internal disease in the ordinary case (the studies: they are the near-universal finding of the middle-aged skin), and the persistent liver rumor comes from the genuine confusion with the spider naevi (the different lesion: the central dot with the radiating legs, the kind associated with the liver and the pregnancy), which look and behave differently (the spider blanches from the center, the cherry is the solid dome). The one noted pattern (the eruptive sudden appearance of very many at once: rare) gets the prompt look for the completeness, but the slow-multiplying-with-the-decades kind you describe is the skin's ordinary aging, as meaningful as the gray hairs and less alarming.
Why am I getting more every year?
Because that is what they do: the cherry angiomas begin in the thirties-forties typically and multiply gently with the decades (the count rising with the age: the seventy-year-old collecting the dozens), driven by the aging skin (the tiny vessels' tendency to dilate and cluster), the genetics running (your mother's loads: the familial tendency genuine), and not by anything you did or could have prevented (no cream, no diet, no habit changes the trajectory), with the pregnancy blooming them (the hormonal kind, often fading after). The honest frame: they are the commonest acquired skin marking of the adult life, universal by the later decades, and their slow multiplication is the evidence of their ordinariness: the thing to watch is never the count but the individual odd-one-out.
One bled a lot when I scratched it. Is that dangerous?
Not dangerous, and expected: the cherry angiomas are literally the blood-vessel clusters (the tiny vessels in the dome), so the nicking (the scratching, the shaving, the catching on the clothing) bleeds briskly and (the small vessels under the pressure), which alarms but is the lesion's ordinary behavior, not the deterioration: the management is the firm pressure (the finger or the cloth, held firmly for five to ten minutes: they stop), and the bleeding-spontaneously-and-repeatedly one (without the trauma) or the bleeding that will not settle is the review-worthy kind (rare). The repeatedly-catching one (the bra-line, the waistband, the shaving path) is the good candidate for the simple removal, and the removal is simple. The bleed was the anatomy, not the alarm.
Can they be removed? Will they scar?
simply, with the honest trade: the removal options are the quick clinic procedures (the cautery: the heat sealing the vessels; the laser: elegant for the red color: the vessels absorbing the light; the shave or the snip for the domed kind), each the minutes-and-small-discomfort kind, effective, with the genuine trade to name: the spot is traded for the small mark (the little white or the faint scar: smaller and quieter than the bright-red dome for most people, and the reason the removal is chosen for the catching and the visible ones rather than the whole collection), and the NHS-versus-private reality (the removal is routine for the symptomatic: the bleeders and the catchers; the purely-cosmetic removal is the private route). The new ones continue appearing with the years (the removal treats the spot, not the tendency), so the removing is for the bothering few.
How do I know one of them is not a melanoma?
The important distinction, and the reassuring logic: the cherry angioma has the fixed signature (the bright cherry-red, the smooth dome, the small round shape, the stable over the years, the multiplying-slowly-as-a-group), while the melanoma is the different-looking lesion (the dark brown-to-black, the irregular shape and the irregular color, the changing over the months: the ABCDE rules), and the color alone separates almost always (the bright red of the vessel-cluster versus the dark pigment of the melanoma: the rare amelanotic melanoma being the pink exception, which is why the changing or growing single pink-red lesion, especially the solitary new one, earns the skin check). The practical rule: the group of the stable bright-red domes is the harmless collection; the individual lesion doing something different (the changing, the growing, the dark, the bleeding without the cause) gets the individual look. Your slow-multiplying bright-red kind is the ordinary collection.
Do I need to tell my GP about them?
optional for the ordinary kind: the cherry angiomas are the recognized-by-sight benign lesions (the GP identifies them in the seconds), so the mentioning at the next ordinary appointment (the genuine once-over: the confirmation spoken aloud) is the proportionate response, while the worth-an-appointment kinds: the lesion changing, the single different one, the bleeding-without-cause, or the sudden eruptive appearance of the very many (the rare, worth-the-look kind). The skin anxiety tends to collect the questions (the mole map, the new spots, the old ones), and the ordinary skin check answers them all in the one appointment: the cherry angiomas are the least worrying residents of the skin, and the naming of them (yours, familial, ordinary) is the end of the question.