Will the removed lesion come back? Recurrence of cherry angiomas and warts

Cherry angioma: what it actually is and where it comes from

Cherry angiomas — technically known as spider angiomas or capillary angiomas — are dilated, tiny blood vessels in the skin, visible as red dots or small spider veins, most often on the face, chest and arms. They are entirely benign and have no connection to cancer. Their colour comes from the fact that the vessel is filled with blood and sits just beneath the skin's surface — under stronger light, it becomes clearly visible.

Where do they come from? The shortest answer is: from a circulatory system that behaves as it pleases. The walls of small blood vessels lose tone with age, and react to hormonal fluctuations, sun damage, heat, alcohol, chronic stress and a range of factors we don't fully understand. The vessel dilates, stays in that dilated state and — voilà — a cherry angioma appears. This is why cherry angiomas so often accompany vascular skin, rosacea, pregnancy and oestrogen therapy.

What laser does to a cherry angioma — and what it doesn't do

Laser removes cherry angiomas using a method called selective photothermolysis: light energy is absorbed by the haemoglobin in the vessel, converts into heat and destroys the capillary wall. The vessel "closes off", blood stops flowing through it, and the body gradually absorbs it over a few weeks. The skin at the treatment site may be slightly red or swollen for a few days, but the lesion itself fades and, in many people, disappears completely.

And here's an important point: the laser removed a specific vessel, but it didn't change either the vessels' tendency to dilate or the factors that trigger that tendency. If the skin has a vascular predisposition, if rosacea, hormonal fluctuations or constant sun exposure are at play in the background — new vessels can form regardless of how many times we remove the old ones. This isn't a flaw in the treatment. It's simply the biology of vascular skin.

1. 01

   Immediately after treatment

   The vessel is closed. Skin may be slightly red or swollen. This is a normal response to treatment.

2. 02

   First 2–4 weeks

   The cherry angioma fades — the body absorbs the remnants of the closed vessel. In many people, the lesion disappears completely.

3. 03

   After a few months

   If new dots appear nearby, these are usually new vessels, not a returning old one. It's worth assessing whether contributing factors are still at play.

4. 04

   Long term

   With vascular skin or rosacea, new cherry angiomas may appear regularly. A series of sessions plus daily care (SPF!) reduces how often they occur.

Viral wart: a completely different story

A viral wart isn't "overgrown skin" or a "vascular lesion" — it's skin infected with the HPV virus (Human Papillomavirus). The virus enters epidermal cells and forces them to multiply uncontrollably, forming a characteristic, rough growth. On the hands and feet they look different from on the face or neck (flat warts, filiform warts), but the mechanism is always the same: the virus is inside.

There's one fundamental problem with viral warts: laser can destroy the lesion, but it doesn't always eliminate the virus from the surrounding tissue. It's like removing fungal growth from one spot in the soil — spores can still be everywhere around it. This is why viral warts have a high recurrence rate even after a successful treatment, and why no honest practitioner promises 100% permanence after a single session.

How laser works on a wart — and why recurrence isn't a failure

Laser works on a viral wart differently than on a cherry angioma. The goal isn't to close a vessel, but to destroy the tissue in which the virus has multiplied — while also triggering an immune response in the skin. The heat generated by the laser destroys infected cells, and the body has to clear them away and "tidy up" the area. This process takes time — results aren't immediate, and the skin may look unremarkable for several days or weeks.

Recurrence of a viral wart isn't a sign of poor laser work or a specialist's carelessness — it's a sign that the virus was deeper or more widespread than the visible lesion suggested. Or that the immune system, weakened at that particular moment, allowed the virus to reactivate. This is why treatment for viral warts is often carried out in a series: several sessions at set intervals, monitoring whether the lesion is genuinely clearing and whether new spots are appearing.

What actually reduces the risk of recurrence

The question "what can I do to stop it coming back" is entirely valid — and has specific answers. Different for cherry angiomas and warts, because the causes differ. But the common thread is: work on what caused the lesion, not just on the lesion itself.

• Cherry angiomas — protecting vessels from harmful factors. The single strongest factor you control day to day is sun exposure. SPF applied regularly to the face, décolletage and arms genuinely reduces the risk of new vessels forming. Sensible vessel-strengthening skincare (for example, products with vitamin C, rutin, centella asiatica) also helps — it won't work miracles, but it can support capillary walls.
• Cherry angiomas — controlling trigger factors. If you have vascular skin or rosacea, it's worth knowing your triggers: alcohol, hot drinks, spicy food, extreme temperatures — for many people, these are what cause vessels to suddenly dilate and, over time, become permanently damaged. You don't need to give everything up forever — but it helps to know what affects your skin.
• Warts — supporting immunity. Since HPV is a virus, immunity is the first line of defence. Sleep, diet, limiting chronic stress — this isn't a medical fairy tale: these genuinely affect whether the virus stays dormant or starts multiplying. Treating other infections and addressing deficiencies (iron, zinc, vitamin D) in consultation with a doctor can also help.
• Warts — preventing spread. Don't touch the wart unnecessarily. Don't shave directly around it without covering the lesion. If it's on the foot — don't walk barefoot in public places (swimming pools, saunas). This reduces the risk of spreading it to other parts of the body and to other people.
• Observation and time. With both cherry angiomas and warts, assessing results too early can be misleading. Skin needs time to respond fully — often several weeks. The decision about a further session should be made after a genuine assessment of the skin's condition, not after a few days.

When recurrence is worth thinking twice about

In most cases, recurrence of a cherry angioma or wart is a biologically predictable event, not a cause for concern. There are, however, situations where it's worth consulting a specialist before going for another session.

• A wart that grows quickly or looks different from before — any skin change that alters shape, colour or surface, or starts bleeding without an obvious cause, needs a dermatologist's assessment before any further laser treatment.
• Warts appearing in large numbers — if dozens of new lesions appear in a short time instead of just one, it's worth checking your overall immune status.
• Cherry angiomas in unusual places — individual vessels on the face are one thing, but if red dots appear on mucous membranes, or in large numbers on the torso, it's worth having a medical consultation to rule out a different type of lesion.
• No improvement after several series of treatments — if a lesion isn't responding despite correctly performed treatments, it's worth reviewing the diagnosis. Not every pinkish lesion is a cherry angioma, and not every rough growth is a viral wart.

In summary: laser is a precise tool that does exactly what it's designed to do — it removes a visible lesion. Whether the lesion comes back depends, above all, on what created it in the first place. By understanding the mechanism — vessel versus virus — you can genuinely influence how long the treatment's effect lasts. There's no guarantee of permanence, but there's something more valuable: knowing what to do to make it last as long as possible.