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What Are Red Freckles?

K. Reynolds
K. Reynolds

Red freckles, also called cherry angiomas, hemangiomas, senile angiomas and Campbell de Morgan spots, are lesions resulting from a concentrated, high number of dilated blood vessels near the surface of the skin. More specifically, they occur when the number of endothelial cells lining the inside of the blood vessels rapidly grow and divide. Normally occurring on the trunk, they usually are fairly small in size with a flat or slightly raised shape, with a range of colors from bright red to black. It's more common for those who are approaching middle age to get them, with the number often increasing over time. They usually are completely benign and don't need treatment, but removal options are available.

Physical Appearance

An individual may undergo cryotherapy to remove red freckles.
An individual may undergo cryotherapy to remove red freckles.

Early on, red freckles are usually very small and are often described as being the size of a pinhead. They can become bigger over time, however, with large ones often reaching up to 0.25 inches (0.635 centimeters) in diameter. The smaller ones typically are flat, while bigger cherry angiomas frequently become raised or dome shaped. Despite their title, the lesions can have a purple or bluish color, or in some cases, brown or even black.

Location

Cherry angiomas pose no health risk, but are often removed for cosmetic reasons.
Cherry angiomas pose no health risk, but are often removed for cosmetic reasons.

A person can develop a cherry angioma anywhere on the body, but in general, they tend to appear more often on the torso. Areas of the skin with mucus membranes rarely have them, and they aren't very common on the hands or feet. When they appear in a location that someone can't hide easily, such as the face, they often cause some psychological distress, with the person who has them feeling less attractive. Even ones that an individual can cover with clothing can get itchy and bleed when they are scratched, and they can be sensitive to particular types of clothing.

Presentation

Cherry angioma removal using cryotherapy entails destroying tissue by freezing the fluid in and between cells.
Cherry angioma removal using cryotherapy entails destroying tissue by freezing the fluid in and between cells.

These lesions can show up at any age, but they usually begin to appear after the age of 30. The number of red freckles also tends to go up as a person gets older. In the past, medical professionals referred to them as senile angiomas for these reasons, but this term somewhat has grown out of favor, as the spots generally are not associated with any loss of mental function, and because always pairing senility and aging is a kind of stereotyping.

Depending on the size and prevalence of the red freckles, a dermatologist may apply laser treatment.
Depending on the size and prevalence of the red freckles, a dermatologist may apply laser treatment.

Research has not found evidence linking any particular race or ethnicity to a higher rate of presentation, and the spots occur relatively equally between men and women. They are generally more noticeable on people with light skin, however, which has led some people to think that they are most commonly associated with those of Caucasian descent.

Cause

Laser treatments encourage the breakdown of a cherry angioma, allowing it to dissipate with minimal scarring.
Laser treatments encourage the breakdown of a cherry angioma, allowing it to dissipate with minimal scarring.

Medical professionals are not sure exactly what causes red freckles. Some experts believe that there might be genetic links, and they know that a decrease in microRNA 424, a non-coding RNA molecule that plays a role in regulating how genes are expressed, is present in the lesions. People who get them often have a lot of mast cells, which are similar to white blood cells in function. There is some evidence linking the spots to particular chemical compounds, such as mustard gas, as well. It might be that, as with many other medical conditions and traits within someone's phenotype, both genetics and the environment might determine whether they appear.

When to Be Concerned

In most cases, red freckles are completely benign and are nothing to worry about. If they suddenly change significantly in number, color, size or shape, however, or if they become painful, itchy or scaly, it's a good idea to seek medical attention. These shifts sometimes can be symptoms of other serious conditions, and in rare instances, they suggest cancer — this is more commonly associated with brown or black lesions, which usually involve a mass of blood called a hemorrhagic plug within a blood vessel.

Treatment

Many people want to remove their red freckles, either because they are uncomfortable and bleed too easily, or because they cause problems with general appearance. Depending on the size and prevalence of the red freckles, a dermatologist can often cauterize them using electrodessication, freeze them with cryotherapy or apply laser treatment, which removes the freckle and repairs blood vessels from beneath the skin. These treatments usually take just a few minutes and usually have excellent results, but scarring is possible, especially if the spots are big.

Medical professionals usually do not recommend that someone try to remove red freckles at home, simply because they can bleed so profusely, and because individuals do not always use the right equipment or sterilize it properly. The risk of scarring also is higher for home procedures. Ruling out underlying medical conditions and getting a differential diagnosis is also important.

Discussion Comments

umbra21

My father was having some kind of dental surgery at a hospital and he asked the surgeon to get rid of a couple of red freckles that were on his face while he was at it.

My dad is fairly persuasive, so I don't know if this would work for most people, but if you are going under anyway, it might be worth asking your doctor to get rid of anything that's bothering you, as long as it's just going to be a quick and simple procedure.

irontoenail

@indigomoth - I've never even considered having mine removed. I barely notice that they are there. The first time I spotted one I had it checked out by a skin specialist and after that, I basically forgot about them.

I think I might be more genetically prone to them or something, because I have quite a few, but maybe lots of people have them and just don't ever mention them, or have them removed as well. I did notice that one of my aunts had a lot when I was a kid, but I haven't seen her since then. It might have some kind of heredity component.

indigomoth

These things can be a real pain in the neck. I had one on my side, right around where my bra strap usually went, and it often got sore and kind of enlarged, to the point where I thought it was cancerous or something.

But the doctor insisted it was benign and it was just because the bra strap was rubbing against it all the time. In the end I had it removed anyway, because it was extremely irritating.

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    • An individual may undergo cryotherapy to remove red freckles.
      By: topdeq
      An individual may undergo cryotherapy to remove red freckles.
    • Cherry angiomas pose no health risk, but are often removed for cosmetic reasons.
      By: F.C.G.
      Cherry angiomas pose no health risk, but are often removed for cosmetic reasons.
    • Cherry angioma removal using cryotherapy entails destroying tissue by freezing the fluid in and between cells.
      By: Gordon Lau
      Cherry angioma removal using cryotherapy entails destroying tissue by freezing the fluid in and between cells.
    • Depending on the size and prevalence of the red freckles, a dermatologist may apply laser treatment.
      By: mkrberlin
      Depending on the size and prevalence of the red freckles, a dermatologist may apply laser treatment.
    • Laser treatments encourage the breakdown of a cherry angioma, allowing it to dissipate with minimal scarring.
      By: spotmatikphoto
      Laser treatments encourage the breakdown of a cherry angioma, allowing it to dissipate with minimal scarring.