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Dr. Alpana Mohta Ranka, MD, DNB, IFAAD, is a dual-board-certified dermatologist with over 90 research publications in peer-reviewed scientific journals.


Cherry Angioma vs Petechiae: Understanding the Differences

Updated: Dec 23, 2023

When it comes to spots on the skin, two spots that often create confusion are cherry angioma and petechiae. Both are common, but distinguishing between them is essential for accurate diagnosis and treatment. Dive into this comprehensive guide to understand the differences and what each means for your skin.


Table of Contents


What is Cherry Angioma?

Cherry angiomas, often referred to as "ruby spots" or "senile angiomas," are small, bright red growths that naturally appear on the skin. They are benign tumors made up of blood vessels.

Cherry Angioma

Key features of Cherry Angioma

  • Color: Typically bright red, but can darken over time.

  • Size: Ranges from pinpoint-sized to around a quarter inch.

  • Shape: Usually round or oval.

  • Location: Common on the torso but can appear anywhere on the body.

  • Causes: While the exact cause is unclear, factors like advancing age, genetics, pregnancy, and some medical conditions like lymphoproliferative disorders might influence their development.

How to Identify Cherry Angioma?

Cheery angiomas are often seen in groups on the body, mostly on the torso and arms, but rarely on the face, hands, or feet as well. When they bunch together, they're called polypoid angiomas. The angioma usually blanches when you put enough pressure over it.

Eruptive Cherry Angioma

Eruptive cherry angiomas happen when lots of sudden cheery angiomas appear over large area of the skin. This can happen in several situations:

  1. As a side effect of medications like cyclosporine and topical nitrogen mustard (use to treat vitiligo).

  2. In conditions like chronic graft-host disease.

  3. In certain lymphoproliferative disorders.

  4. Due to the medication ramucirumab, which can trigger changes in blood vessels.

  5. Sometimes, a virus named human herpesvirus-8 (HHV8) can be linked to eruptive cherry angiomas.

How to Treat Cherry Angioma?

Cherry angiomas are often symptomless, but they can bleed if injured. People may want to remove them for cosmetic reasons or to prevent bleeding.

Small ones can be numbed with lidocaine and removed using electrocauterization. Larger ones are typically shaved off and cauterized. Cryotherapy or CO2 laser therapy can also be used for superficial ones. Newer methods like pulsed dye laser or intense pulsed light have been successful. However, removal might lead to scarring, which patients should be aware of.

What is Petechiae?

Petechiae are tiny, flat, round spots that appear on the skin due to bleeding under the skin. They are a symptom, not a disease, and can indicate a variety of underlying conditions, some serious.


Key features of Petechiae

  • Color: Red, purple, or brown.

  • Size: Usually less than 3 mm in diameter.

  • Shape: Round.

  • Location: Can be seen anywhere on the body, often in clusters.

  • Causes: Various, including injury, medications like blood thinners, infections like dengue, low platelet count, and other health conditions.

Cherry Angioma vs. Petechiae: How to Differentiate?

  1. Duration: Cherry angiomas are permanent unless removed. Petechiae, on the other hand, fade within 3-4 days. However, until the underlying cause is treated, the lesions can keep reappearing.

  2. Texture: Cherry angiomas are slightly raised, while petechiae are flat.

  3. Cause: Cherry angiomas are benign skin growths with unknown exact causes, whereas petechiae arise due to underlying conditions or factors causing blood to leak into the skin.

  4. Impact of pressure: Pressing on petechiae won't make them blanch, but other red skin spots, like some rashes, might.

When to See a Dermatologist

Following is a non-exhaustive list of reasons to see a dermatologist when concerned about petechiae or cherry angiomas:

  1. Rapid Appearance: If numerous spots appear suddenly.

  2. Associated Symptoms: Fever, unexplained bruising, or other unusual symptoms alongside skin spots.

  3. Concern about Appearance: For aesthetic concerns or potential other skin conditions.

  4. Uncertainty: If you're unsure about any skin change, it's always wise to seek a professional opinion.


While cherry angiomas and petechiae both present as red spots on the skin, understanding their distinct characteristics is crucial. I hope you found the above guide useful.

Did you know that petechiae can also occur in the palate of your mouth? It sounds scary, but it occurs quite often. You might have even seen it happen to someone you know but might not have known the exact term for it.


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