Cherry Angioma or Melanoma? How to Tell Them Apart
Cherry angiomas are one of the most common skin growths in adults — small bright-red dots that multiply with age and are entirely harmless. Most people develop several, and they cause no problems beyond the occasional snag. The reason they trigger worry is that any new red or dark spot can prompt a skin-cancer search. The reassuring reality is that a classic cherry angioma is easy to recognise, and it looks and behaves quite differently from melanoma. This guide explains what cherry angiomas are, how they differ from skin cancer, and the few features that mean a 'red dot' deserves a closer look.
What a cherry angioma is
A cherry angioma (also called a Campbell de Morgan spot) is a benign cluster of small dilated blood vessels. It appears as a bright cherry-red, sometimes purple, dome-shaped dot. Most are 1-5mm, smooth, and slightly raised. They are made of blood vessels, which is why their colour is a true vivid red rather than the brown or black of pigmented lesions.
They become more common from the 30s onward, increase in number with age, and tend to appear on the trunk, chest, and shoulders. They are harmless and require no treatment, though they can be removed for cosmetic reasons or if one repeatedly catches and bleeds.
What melanoma looks like by contrast
Melanoma is usually a pigmented lesion — brown, black, or blue, often with more than one shade — judged by the ABCDE rule: Asymmetry, Border irregularity, Colour variation, Diameter over 6mm, and Evolution. A typical melanoma does not have the uniform bright-red, dome-shaped look of a cherry angioma.
The one melanoma that can cause genuine confusion is amelanotic melanoma — a melanoma with little or no brown pigment that can appear pink or red. That is the reason a 'red dot' should not be dismissed purely on colour if it is also growing, changing, or behaving unlike your other cherry angiomas.
Difference 1: Colour
Cherry angioma: uniform bright cherry-red or purple throughout. The colour is the red of blood vessels and is the same across the whole dot.
Melanoma: usually brown, black, or multi-coloured (the C in ABCDE). Even amelanotic melanoma, when pink or red, tends to be a less uniform, less vivid red and is often accompanied by other changes. A single shade of vivid cherry-red across a small dome is reassuringly typical of an angioma.
Difference 2: Shape and symmetry
Cherry angioma: round, symmetrical, smooth-domed, with a clean even border. One half mirrors the other.
Melanoma: often asymmetric with an irregular or ragged border (the A and B in ABCDE). If a red or dark spot is lopsided, has uneven edges, or is irregular rather than a neat round dome, that asymmetry is a reason to evaluate it rather than file it under 'cherry angioma.'
Difference 3: Stability vs evolution
Cherry angioma: stable. New ones appear over the years, but an individual angioma stays much the same size and colour over time. It does not slowly grow or change shape.
Melanoma: evolves (the E in ABCDE) — growing, darkening, or changing shape over weeks to months. Any red or pigmented spot that is actively changing, rather than sitting unchanged like your other dots, deserves a dermatologist's eye.
Difference 4: The blanch test and bleeding
Cherry angioma: because it is made of blood vessels, gentle pressure may briefly cause it to blanch (pale) slightly as blood is pushed out. If snagged or scratched it can bleed quite a lot for its size, then heals normally.
Melanoma: pigment sits in cells, not in a vessel pocket, so it does not blanch with pressure. Spontaneous, repeated bleeding from a lesion that is not simply being caught on clothing — combined with growth or colour change — is a warning sign rather than the one-off bleed of a snagged angioma.
Difference 5: Number and pattern
Cherry angiomas: typically multiple. Once you have one, you usually have several others scattered on the trunk that look just like it. That pattern of many similar dots is itself reassuring.
Melanoma: a solitary lesion that stands out from its neighbours — the ugly duckling. If you have a dozen identical red dots and one spot is different (darker, larger, growing, irregular), that single outlier is the one to evaluate, not the matching crowd.
When a 'red dot' needs checking
Cherry angiomas almost never need medical attention. See a dermatologist if a red or pigmented spot is: irregular, asymmetric, or multi-coloured; growing or changing over weeks; bleeding repeatedly without being snagged; or clearly different from your other red dots (the ugly duckling).
While a sudden large crop of new cherry angiomas is usually just part of ageing, mention it to your doctor if it is dramatic, so they can take a general look. Do not try to remove or freeze a red bump at home — if there is any doubt about what it is, a dermatologist can confirm it is benign in seconds, and removal of a genuine angioma is a quick in-office procedure.
Use our free ABCDE checker for any spot that is changing, irregular, or different from your other red dots. A classic bright-red, round, stable dome is almost always a harmless cherry angioma.
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Content based on clinical guidelines from the American Academy of Dermatology (AAD), British Association of Dermatologists (BAD), and peer-reviewed literature from JAAD, BJD, and JAMA Dermatology. Epidemiological data from NCI SEER and IARC GLOBOCAN. Full methodology