Red moles, angiomas or red spots on the skin - How to remove them?

Red moles on the skin can appear with little or no warning. If you are concerned about their appearance, you are definitely not alone, but you can take a deep breath and relax. Most of these red spots on the skin are totally benign, so there is no need to panic.

My name is Sebastian Podlipnik and I am dermatologist at the Hospital Clínic de Barcelona and at the clinic Diagnosis Dermatológica. Fortunately today we have effective techniques for the treatment of angiomas that I will tell you about below. 

What will I talk about in this article?

What are red moles?

Red moles are very common benign cutaneous vascular lesions that can develop on almost any part of the body. They manifest themselves as red spots on the skin that progressively appear. The presence of small blood vessels and capillaries within them are responsible for their characteristic reddish appearance (hence the name blood moles). 

Contrary to popular belief, these red dots on the skin actually are not moles, but rather small vascular dilatations and the correct medical name is angioma

Searching the web I have come across multiple terms for the same entity and perhaps you know them by some of the following names:

  • Senile angioma
  • Cherry angiomas
  • Blood mole
  • Ruby point
  • Red dots 
  • Capillary hemangioma
  • Cherry hemangioma
  • Campbell's stains of Morgan
  •  Nevus rufus

What do angiomas look like?

An angioma is usually bright red, circular or oval in shape, and are small in diameter, usually ranging in size from the head of a pin to half a centimeter. 

Some are flat and even with the skin, while others are slightly raised. They may bleed if irritated, for example by scratching or by bra rubbing in women. 

Sometimes they cause more concern when red spots appear on the face because they are less aesthetic, however they have no different meaning. 

Detail of red moles or red dots on the skin of an elderly patient with photodamage.
Detail of red moles or angiomas on the skin of a patient.

Why do red moles appear on the skin?

The exact cause of angiomas is not known, but there may be a genetic factor that makes certain people more prone to getting them. They have also been linked to pregnancy, and some medical conditions and chronic sun exposure (photoaging).

There also seems to be a relationship between the appearance of the first red spots on the skin and age. They often begin to appear from the age of 30 and appear to increase in size and number with age. A study assessing the prevalence of angiomas showed that more than 75% of people over 75 years of age have them.Quote

It is very common to hear the urban myth that the appearance of angiomas is related to liver problems. However, having angiomas NO have no relation with liver problems or other diseases.

Popularly people commonly associate the appearance of red spots on the skin with liver disorders or problems. They even go further by saying that they are caused by the accumulation of toxins in the liver. Evidently, all this is false and there are no problems in your body if you have angiomas. 

Do I have to worry if I have a lot of red spots on my skin?

These types of benign skin tumors are not usually a cause for concern, unless some of them bleed frequently, change in size, shape or color. In these cases it is important that you contact your dermatologist to request an assessment and rule out other malignant lesions that can be confused. 

On the contrary, if you have many red spots on your skin and they remain stable over time, you can rest assured. 

How do we remove red moles on the skin?

First of all it is not necessary to remove the angiomas or the different vascular lesions previously described. Dermatologists usually treat them by esthetic reasons. Other common reasons why angiomas need to be removed are because of annoying, since are found in areas that rub easily, which can cause bleeding or irritation. Below I will detail the most common methods for the removal of angiomas or red moles.

1- Electrocautery

This surgical method of treatment involves burning the angioma using an electric current delivered by a small probe. While it is very effective there may be small marks left after treatment, especially in darker skinned people. It is usually a good option on small angiomas but is not my favorite.

2- Cryotherapy

Cryotherapy consists of freezing the angioma with liquid nitrogen (-195.8 °C). The extreme cold will destroy it. This method is known to be a quick and relatively easy procedure to perform. Often only one treatment session is needed for cryotherapy to be effective.

Although it sounds very easy to perform, it is not my favorite method for the treatment of angiomas. This is because we can only treat a few angiomas in one session and we always freeze the healthy skin around the red spots. This can cause skin discoloration changes that can last for many months or years.

3- Lasers (Preferred method)

For me the laser treatment is the treatment of choice for angiomas. This type of procedure involves the use of a vascular laser, intense pulsed light or CO2 laser for the definitive removal of the angioma or red mole. This method is quick, painless and is performed on an outpatient basis.

Depending on the number of red spots you have on your skin, you may need between one to three treatment sessions. In addition, post-treatment care is minimal and you can resume your activities immediately.

Watch the following video to see how I remove angiomas with the CO2 laser. 

4- Surgery (NO please!)

Angioma surgery has also been described, although it is rarely used today. The surgery is invasive and has a high likelihood of scarring. For these reasons, these lesions should not be treated with surgery since we have previously described techniques with high efficacy, minimally invasive and with excellent aesthetic results.

Once the red dots are removed, will they reappear again?

Angiomas to be removed will not appear again. The problem is that being a genetic condition, new red moles will appear throughout life. Dermatologists recommend recurrent and, according to the needs of each patient, periodic sessions to remove the new red spots that appear on the skin. The time is variable but can be every several months to years.

How to prevent more red spots from appearing?

As I have explained, the appearance of these angiomas is directly related to the aging of the skin and the genetics of each person. That is why nothing can be done to prevent them. 

But if you do not like them, it is important that you consult as soon as possible, because if we remove them as soon as possible, there will be no visible marks on the body. 

What care should I take after the removal of red moles?

The care after angioma removal will be quite simple and you practically don't have to do any further care. We usually recommend:

  • Avoid exposure of the treated area to the sun, and use sun protection creams. 
  • Wash daily with soap and water to prevent crusting.
  • Use an antibiotic ointment, vaseline or regenerative cream during the first days of treatment.

Do you have red spots and want to eliminate them?

What other types of vascular lesions are common?

Like angiomas, there are also other benign cutaneous vascular lesions that can appear during life. Many of them are very similar to red moles and have a very similar treatment. Because of the similarities between these lesions I think it is interesting for you to know about them as well.

Venous lake

A venous lake or vascular lacuna is a dilatation of the venules. It is a common lesion, usually manifesting as an asymptomatic dark blue to purplish papule on the ear or lip. Venous lakes are thought to be the result of sun damage, which weakens the blood vessels and this allows dilation of the superficial venous structures.

Elderly patient presenting with a vascular lacuna in the lower lip.
Patient has a vascular lacuna in the lower lip indicated by an arrow.

Spider vascular or spider angioma

Clinically, this type of red spots on the skin are due to a small central artery from which numerous small blood vessels radiate. The ascending central artery appears like the body of a spider, and the radiating vessels resemble spider legs. They are benign and we usually see them on the face of children or pregnant women.Quote

Vascular spider on the face of a young patient resembling a red mole
Vascular spider on a woman's cheek

Here is a treatment (before and after) with intense pulsed light of a spider vein in the nasal ala of a patient. 

Treatment of spider veins on the nose
Before and after laser treatment of spider veins on the nose

Angiokeratoma

They are asymptomatic benign vascular neoplasms that are characterized by clinically appear as bluish or black papules or warty nodules. As they clinically resemble bluish black lesions (like melanoma skin cancer) it is always necessary to use dermoscopy in order to make a correct diagnosis before treating them. Quote

There is a very common variant called angiokeratoma of Fordyce appearing on the skin of the scrotum or vulva. They are most commonly found in the scrotum in large groups. This type may develop on the vulva of pregnant women. They are not harmful, but are prone to bleeding if scratched.Quote

Angiokeratoma that may manifest as a red mole
bluish-red moles compatible with angiokeratomas

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Sebastian Podlipnik - Skin cancer

Sebastian Podlipnik

Dermatology Blog

I am a dermatologist and cum laude MD and author of multiple research studies. I specialize in skin cancer, laser technologies and cosmetic dermatology. The intention of this blog is to bring you closer to topics of interest in dermatology and research.

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