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They appear from the age of about 35 and increase in number with age. They are benign and their cause is unknown but there is a genetic tendency and often a family history of the same condition.

Individual lesions vary from being a small (approximately 0.1mm diameter) red and flat to larger raised papules of a stronger red colour up to 5mm diameter.

The angioma is a vascular lesion composed of small blood vessels and it is the blood within the lesion which gives it the red colour. Occasionally the angioma can become thrombosed and the papule then looks black.

The diagnosis is clinical and the lesions have a characteristic pattern on examination with the dermatologist’s dermatoscope. No treatment is necessary, but they can be treated on cosmetic grounds with hyfrecation (electrocautery) or the vascular laser. Occasionally if it needs to be continued that the black lesion is a thrombosed angioma, not a melanoma then it will be excised for histological examination. 

Other common red lesions are spider naevi which consist of a central papule and it is the end on view of the blood vessel (the body) with tiny radiating blood vessels (the legs of the spider). These are common in children particularly on the face and in adults increase in number with pregnancy, the contraceptive pill and alcoholic liver disease. 

If they persist and treatment is required on cosmetic grounds, they respond very well to a vascular laser or the hyfrecator, the choice depending on the location of the lesion.

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