When a new, small red spot appears on the skin, it is usually a benign change. These lesions are typically small, appearing as pinhead-sized dots or slightly raised bumps. They range in color from bright ruby red to a deeper purplish hue. For the vast majority of people, these common growths are completely harmless.
Identifying the Most Common Type of Red Spot
The small, bright red spots most frequently noticed are known as cherry angiomas. These growths are a common form of acquired vascular proliferation, consisting of numerous tiny blood vessels, or capillaries, clustered just beneath the skin’s surface. They are usually dome-shaped papules, well-demarcated from the surrounding skin, and typically measure between one and five millimeters in diameter. Cherry angiomas often appear first on the torso and upper extremities, such as the arms and shoulders, and tend to increase in number with age.
Cherry angiomas can be distinguished from other red spots like petechiae, which are flat, non-blanching, pinpoint spots caused by bleeding under the skin. Unlike petechiae, cherry angiomas are raised and will often blanch, or temporarily turn white, when light pressure is applied due to the blood vessels within them. They are also distinct from simple broken capillaries, which are fine, thread-like lines on the skin’s surface.
Biological Factors Influencing Their Appearance
The formation of these vascular growths is linked to the natural aging process of the skin, making them rare before age 30 but increasingly prevalent afterward. By age 75, nearly all adults have developed at least a few cherry angiomas. The tendency to develop these spots often runs in families, indicating a strong genetic component influencing their appearance.
Hormonal fluctuations can also play a role, as some individuals experience a temporary increase in the number of angiomas during pregnancy. A molecular mechanism drives the proliferation of the tiny blood vessels within these lesions. Sun exposure is not considered a primary or direct cause of cherry angiomas.
Recognizing Signs That Require Medical Attention
Any new or changing skin lesion warrants professional evaluation to rule out rarer, more serious conditions. A red spot that rapidly changes in size or shape, or develops irregular, notched, or poorly defined borders, requires immediate attention. The appearance of multiple colors, especially shades of black, blue, or dark brown mixed with the red, can be a warning sign of an atypical mole or an amelanotic melanoma. If a red spot begins to bleed frequently without trauma, develops a persistent crust, or fails to heal, a consultation is necessary. Other red lesions, such as nodular basal cell carcinoma or a pyogenic granuloma, can sometimes mimic the appearance of a cherry angioma and require a definitive diagnosis.
Procedures for Cosmetic Removal
Since these lesions are medically harmless, removal is typically sought for cosmetic reasons or if the spot is located where it is frequently irritated or bleeds from friction. Several minimally invasive procedures are available that can be performed in an outpatient setting.
Electrocauterization
Electrocauterization uses a fine probe with an electric current to heat and destroy the blood vessels feeding the angioma, sealing the area to prevent bleeding.
Cryosurgery
Cryosurgery involves applying liquid nitrogen to the lesion, which freezes and destroys the affected tissue; the spot then scabs and falls off over a short period.
Laser Therapy
Laser therapy, often using a Pulsed Dye Laser, is a highly precise method that targets the red color of the blood vessels with an intense beam of light, causing them to shrink without damaging the surrounding skin.
Because removal is usually classified as cosmetic, these procedures are generally not covered by medical insurance.