Taula de Continguts
- What cherry angiomas are and why they appear
- Before the laser: medical diagnosis comes first
- How the vascular Nd:YAG laser works on an angioma
- Cherry angiomas versus other benign lesions: when laser and when not
- What the skin looks like in the days afterwards
- How many sessions are needed
- How we work at Santé Madrid
- Frequently asked questions
Cherry angiomas, also called ruby spots or senile angiomas, are small, bright red, benign vascular lesions that commonly appear from adulthood onwards. Once a doctor confirms that a spot is a cherry angioma, vascular laser is one of the most widely used options to remove it, although results vary with each skin and each lesion. In this guide we explain what they are, why any new or changing spot should be seen by a doctor first, how the vascular Nd:YAG laser works, how they differ from other benign lesions and what to expect in the days afterwards, following the approach we use at our clinic in Chamberí, Madrid.
Key points
- A cherry angioma is a benign proliferation of small blood vessels, very common and increasingly frequent with age.
- Before treating any red spot, the doctor confirms the diagnosis: a spot that is new, changing, growing quickly or bleeding needs a medical assessment first.
- The long-pulse 1064 nm Nd:YAG laser acts on the haemoglobin in the vessels and is one of the options described for these lesions.
- Not all red or pigmented lesions are treated the same way: a mole, for example, is not removed with a vascular laser.
- The number of sessions varies with the size, depth and response of each lesion, and the medical team decides it after the assessment.
What cherry angiomas are and why they appear
A cherry angioma is a small, rounded spot, cherry red or purplish red, which may be flat or slightly raised. It usually appears on the trunk, arms or shoulders, although it can show up in other areas. Inside, it is a small cluster of dilated capillaries: that is why its colour is so vivid and why the light of a vascular laser can act on it.
A case report published in Case Reports in Dermatology describes them as the most common acquired vascular proliferation of the skin: bright red, dome-shaped papules that usually measure a few millimetres and appear mainly on the upper trunk and arms. Their cause is not well understood, but they tend to increase in number with age. The manufacturer of the device we use, Alma Lasers, also notes that they are very common on the body and increasingly frequent with age. A case-control study points out that no clinical consequences have been attributed to them and notes that, when there are many, they have been linked to age, chronic immunosuppression, some diseases and exposure to certain substances and medicines.
For the vast majority of people they matter only cosmetically. Even so, the fact that a lesion is common does not mean that every red spot is a cherry angioma, and that is why diagnosis always comes first.
Before the laser: medical diagnosis comes first
A vascular laser removes a lesion, but it does not analyse it. If a spot is treated without a clear diagnosis, the chance to know what it was is lost. And not every red spot is an angioma: a study published in Diagnostics explains that Merkel cell carcinoma, an uncommon malignant skin tumour, is often mistaken for harmless lesions such as a cherry angioma or a haemangioma. That is why the doctor examines each lesion before proposing a treatment, and if there is any doubt, it is not treated with laser.
When a lesion does not fit a typical angioma, changes quickly or bleeds easily, the right step is for a doctor to assess it before any aesthetic treatment. If the doctor still has doubts after the examination, they will refer you to a dermatologist. This is not meant to alarm you: most cherry angiomas are exactly what they appear to be. But the right order protects your health and avoids treating something that needed a different approach.
How the vascular Nd:YAG laser works on an angioma
Each laser emits a wavelength that is best absorbed by a specific target in the skin. In vascular lesions, that target is the haemoglobin in the blood flowing through the small vessels. As it absorbs the energy, the vessel heats up and is selectively damaged, and the body gradually reabsorbs it over the following weeks.
At Santé Madrid we work with the vascular Nd:YAG head of the Harmony XL Pro platform. According to the official Harmony XL Pro product page, it is a long-pulse 1064 nm laser that is well absorbed by haemoglobin and penetrates deeply, and the manufacturer describes its use in vascular lesions of the face and body. On its vascular lesions page, Alma specifically lists cherry angiomas among the lesions that can be treated with its 1064 nm laser.
Laser is not the only option. The same case report notes that cherry angiomas can be treated with different techniques, such as curettage, laser or electrosurgery, and that some people wish to remove them for cosmetic reasons or because they bleed after a knock. The choice depends on the size, the location and the skin type. With a vascular laser, the energy and pulse duration are adjusted to each lesion: a small, flat spot is not treated in the same way as a thicker, raised one. That is why the parameters are always decided by the doctor after the assessment, and results vary with each skin.
Cherry angiomas versus other benign lesions: when laser and when not
Many people come to the consultation with several different lesions at once, and it is not always easy to tell which is which. The table summarises the most common ones and how each is usually approached. It is a guide only: the final decision is made by the doctor after examining your skin.
| Lesion | What it usually looks like | Vascular laser? | Worth knowing |
|---|---|---|---|
| Cherry angioma (ruby spot) | Cherry red spot, flat or slightly raised, on the trunk or arms | Yes, once the diagnosis is confirmed | Size and depth influence the number of sessions |
| Spider angioma (spider naevus) | Red central dot with fine vessels radiating like legs, often on the face or chest | Yes, after assessment | If several appear, the doctor may assess whether there is an underlying cause |
| Facial telangiectasias | Small, fine, linear vessels, mainly on the nose and cheeks | Yes, although another technology is sometimes preferred | For very superficial vessels, intense pulsed light may be chosen instead of Nd:YAG |
| Mole (melanocytic naevus) | Brown or black spot or bump, of more or less uniform colour | No | It is not a vascular lesion; any change calls for a dermatological assessment |
On spider angiomas and telangiectasias, a study with long-pulse 1064 nm Nd:YAG found it safe and effective in these common superficial vascular lesions, although it noted that it is not the first choice for very superficial facial vessels. That is why, in some skins, the medical team may suggest another head of the same platform. In the case of moles, a vascular laser is not the right tool and, as we have seen, treating them without a diagnosis can delay the detection of a lesion that is not benign.
What the skin looks like in the days afterwards
It is usual to notice redness and some swelling around each treated spot, which tend to settle over the following days. There may be a feeling of warmth or mild stinging for a few hours. The lesion may change shade, look darker or greyish, and in some cases a thin crust forms that falls off on its own. The exact course depends on the lesion, the parameters and your skin, and the doctor will tell you what to expect in your case.
- Let the crust fall off by itself: scratching or picking it increases the risk of a mark.
- Gentle cleansing and the cream or routine the doctor recommends.
- Broad-spectrum sun protection on the area, in winter too. The Madrid sun is strong for much of the year and treated skin can pigment more easily.
- Avoid saunas, intense heat and very demanding exercise for as long as we advise.
- If you notice blisters, increasing pain or signs of infection, message us so we can check it.
As with any laser, possible risks include pigment changes, with lighter or darker areas, and less often a scar. According to a review on skin of colour, in darker skin post-inflammatory hyperpigmentation appears more often and more intensely, so choosing the parameters calls for more caution. The doctor will explain these risks in your case before starting.
How many sessions are needed
There is no fixed number. A small, flat cherry angioma may respond differently from a large, raised one, and the response also varies from person to person. That is why it makes no sense to promise a number of sessions before seeing the lesion.
In practice, the doctor treats, waits for the skin to recover and reviews the result before deciding whether another session is needed. If the lesion has gone, it is not repeated; if it persists, a new pass is considered, sometimes with adjusted parameters. When there are many spots, treatment usually starts with one area or a few spots to see how your skin reacts.
It is also worth knowing that treating an angioma does not stop new ones from appearing over the years, because their appearance is associated with age. If more appear later, they are assessed just like the first ones: diagnosis first and then, if indicated, treatment. Results vary with each skin, and the goal is a realistic and safe plan for you.
How we work at Santé Madrid
Our clinic is at C. de Amador de los Ríos, 1, Chamberí, 28010 Madrid. This is the usual pathway when you come in about cherry angiomas:
- First consultation. You can start with a free aesthetic assessment with a Beauty Coach, or with a €50 medical consultation (the price of the consultation, not of the treatment).
- Examination of the lesions. The Santé Madrid medical team reviews every spot you want treated and goes over your history, your medication and your sun exposure. If a lesion does not look like a typical cherry angioma, we do not treat it and we recommend a dermatological assessment.
- Plan. If laser is indicated, the doctor chooses the parameters of the Harmony XL Pro vascular Nd:YAG head according to the size of the lesion and your skin type.
- The session. We cleanse the area, protect your eyes and apply the laser to each spot. It usually feels like a brief prick of heat.
- Follow-up. We review how it evolves and decide with you whether another session is needed.
If you would like to know about the other heads of the platform, we explain them in our guide to the Harmony XL Pro laser. For a short summary of this same topic, there is also our quick guide to laser for cherry angiomas.
Frequently asked questions
Are cherry angiomas dangerous?
Cherry angiomas are benign lesions. What matters is confirming that the spot really is a cherry angioma: if it is new, changes, bleeds or looks different, a doctor should see it before any treatment.
Does laser for cherry angiomas hurt?
It usually feels like a brief prick of heat on each spot. The sensation depends on the area and the size of the lesion, and the doctor will explain how to make it more comfortable.
How many sessions will I need?
It depends on the size, depth and response of each lesion. Some respond sooner than others. The doctor reviews how it evolves after each session and decides whether another one is needed.
Can it leave a mark?
There may be pigment changes and, less often, a scar. Choosing the parameters carefully, not picking the crust and protecting the area from the sun help reduce the risk, which the doctor assesses in your case.
Will they come back?
A treated spot may need another session if it persists, and over the years new ones may appear, because their appearance is associated with age. Each new lesion is assessed just like the first.
Can a mole be treated with the same laser?
No. A mole is not a vascular lesion and is not removed with a vascular laser. If a mole changes or worries you, the right step is a dermatological assessment.
Can I be treated if my skin is tanned?
The prudent approach is to wait until the tan fades, because it increases the risk of dark marks and burns. Also tell the doctor if you are pregnant or take medication that increases sensitivity to light.
A cherry angioma is usually a benign lesion that is straightforward to assess, but the order matters: diagnosis first and then, only if indicated, laser. If you have doubts about any lesion, the first step is an assessment with the Santé Madrid medical team.
