An angioma is a benign growth made up of small blood vessels that cluster together under or on the surface of the skin. Most angiomas are completely harmless, require no treatment, and never become cancerous. They come in several forms, the most common being the small, bright-red dots (cherry angiomas) that appear on the chest and torso as people age. While the vast majority are nothing more than a cosmetic concern, certain types can form inside the brain or signal an underlying health issue worth paying attention to.
Common Types of Angiomas
The word “angioma” is a broad, somewhat informal term that covers several distinct growths. The three you’re most likely to encounter are cherry angiomas, spider angiomas, and cavernous malformations. Each looks different, forms differently, and carries different implications for your health.
Cherry angiomas are the most familiar type. They appear as small, dome-shaped red or purple dots, usually between 1 and 5 millimeters across, though some grow larger. They’re extremely common after age 30 and tend to multiply with age. They have no malignant potential.
Spider angiomas look like a tiny red dot with thin lines radiating outward, resembling spider legs. The center is a dilated arteriole, and the “legs” are smaller vessels branching from it. A few spider angiomas are normal, but clusters of them can be a sign of liver disease or hormonal changes (more on that below).
Cavernous malformations (sometimes called cavernous angiomas) are clusters of abnormal blood vessels that form deeper in the body, most notably in the brain and spinal cord. Unlike the surface-level types, these can cause serious neurological symptoms and sometimes require medical intervention.
What Causes Them to Form
Angiomas develop when endothelial cells, the cells lining blood vessels, multiply abnormally and form dense tangles of tiny vessels. During the growth phase, a signaling protein called vascular endothelial growth factor receptor plays a central role, triggering new blood vessel formation within the cluster. This is why angiomas can grow quickly in their early stages before stabilizing.
For cherry angiomas specifically, research has revealed a strong genetic component. A 2022 molecular study of 85 cherry angiomas found that about 82% carried mutations in a family of genes (GNA14, GNAQ, and GNA11) involved in cell signaling. These mutations were present in the growth itself, not inherited body-wide, meaning they arise spontaneously in individual cells rather than being passed down from parents. This finding confirmed that cherry angiomas are true neoplasms (new growths from mutated cells) rather than simple malformations.
Age is the single biggest risk factor for cherry angiomas. Hormonal shifts, particularly elevated estrogen during pregnancy, are strongly linked to spider angiomas. Sun exposure and certain chemical exposures have been suggested as additional triggers, though the evidence is less definitive.
Spider Angiomas and Liver Disease
Spider angiomas deserve special attention because they can be a visible marker of liver cirrhosis. In one study of 60 patients with nonalcoholic liver cirrhosis, 27% had spider angiomas. The connection involves several overlapping mechanisms.
When the liver is damaged, it can’t properly break down estrogen, leading to elevated levels in the blood. Estrogen has a direct dilating effect on small arteries, which may explain why these characteristic radiating vessels form. Cirrhotic patients with spider angiomas also showed significantly higher levels of substance P, a peptide that promotes blood vessel dilation, compared to cirrhotic patients without them. On top of this, cirrhosis creates a state of hyperdynamic circulation: higher cardiac output and lower blood pressure pushing blood through widened vessels.
A few spider angiomas on their own are usually nothing to worry about, especially during pregnancy or in children. But if you notice several appearing on your face, neck, chest, or arms without an obvious explanation, it’s worth having your liver function checked.
Angiomas Inside the Brain
Cerebral cavernous malformations (CCMs) are a rarer and more serious form of angioma. These clusters of abnormal blood vessels in the brain or spinal cord can leak blood into surrounding tissue, producing symptoms that vary depending on their location. Common signs include seizures, persistent headaches, vision or hearing changes, and back pain. In rare cases, a CCM hemorrhages severely enough to cause a stroke.
CCMs are diagnosed with MRI, which can reveal the characteristic “popcorn-like” appearance of these growths and pinpoint their location. Some people have a single CCM discovered incidentally on a brain scan done for another reason and never develop symptoms. Others, particularly those with a familial form of the condition that produces multiple malformations, face a higher lifetime risk of bleeding episodes.
How to Tell an Angioma From Something Serious
Most angiomas are easy to recognize: a small, uniformly colored, dome-shaped red spot with smooth borders. The concern arises when a red skin lesion doesn’t fit that tidy description, because certain aggressive skin cancers, including amelanotic melanoma (a form of melanoma that lacks the dark pigment people associate with the disease), can mimic the appearance of a harmless angioma.
Dermatologists use a straightforward screening approach for suspicious red lesions: look for redness, raised texture, and recent change (sometimes called the “3 Rs”). A cherry angioma that has looked the same for years is almost certainly benign. A red, raised spot that is new, growing, bleeding without trauma, or changing shape warrants a closer look, potentially including a full-thickness biopsy. This is especially true for people with a personal history of skin cancer. A biopsy is generally not needed for a typical-looking angioma unless it must be distinguished from a borderline or malignant vascular tumor.
Treatment and Removal Options
Because angiomas are benign, treatment is entirely optional for the skin-surface types. Most people who seek removal do so for cosmetic reasons or because an angioma is in a spot that gets repeatedly bumped or irritated.
Electrosurgery is one of the most effective and affordable options. For smaller cherry angiomas, a brief pulse of electrical current (electrocoagulation) destroys the tiny vessels. Larger ones can be shaved flat first, then the base is sealed with the same technique. Spider angiomas and fine thread veins respond well to electrocoagulation as well. The procedure is quick, usually performed in a dermatologist’s office, and heals within a week or two.
Laser treatment is another common approach, particularly pulsed dye lasers that target the red pigment in blood vessels. Cryotherapy (freezing) is occasionally used for small angiomas but tends to be less precise than electrosurgery or laser.
If an Angioma Bleeds
Cherry angiomas that sit on the skin’s surface can bleed if scratched, bumped, or caught on clothing. The bleeding often looks dramatic relative to the size of the spot because the growth is essentially a dense ball of blood vessels. The management is simple: press a clean piece of gauze firmly against the spot for a full five minutes without lifting it to check. If blood soaks through, add more gauze on top rather than removing the first layer. Leave the gauze in place for at least 48 hours to allow a stable clot to form. If bleeding restarts or won’t stop with pressure, seek medical attention.