Angiokeratoma Manchester & Cheshire, UK

What is an Angiokeratoma?

Angiokeratomas are benign (non-cancerous) skin lesions that develop due to the dilation of small blood vessels in the skin, combined with a thickening of the overlying epidermis. These lesions often appear as small, dark red or purple spots on the skin, and they can sometimes have a rough, wart-like surface. While angiokeratomas are harmless in most cases, their appearance can cause concern, particularly if they are mistaken for other skin conditions or skin cancers. Angiokeratomas can occur at any age, although they are more commonly seen in adults and the elderly.

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Causes of Angiokeratomas

Angiokeratomas are typically caused by the enlargement of capillaries (small blood vessels) near the skin's surface. Several factors may contribute to their development, including:

Genetic Factors

Some forms of angiokeratomas are hereditary, and certain genetic conditions like Fabry disease are associated with their appearance. Fabry disease, a rare inherited disorder, leads to the accumulation of fatty substances in the body, including blood vessels, which can trigger the formation of angiokeratomas.

Aging

As the skin ages, the small blood vessels near the surface of the skin can become more prone to dilating, which may result in angiokeratomas. This is particularly common in elderly individuals.

Trauma or Irritation

Repeated irritation or minor trauma to a specific area of the skin can lead to the development of angiokeratomas. This can happen in areas like the legs, where friction from clothing or physical activity is more likely to occur.

Hormonal Changes

Changes in hormone levels, especially during pregnancy, can also increase the likelihood of angiokeratoma formation, as the blood vessels become more sensitive during this time.

What Do Angiokeratomas Look Like?

Angiokeratomas typically appear as small, raised spots that are dark red, blue, or purple in colour. They are often about 1-5 millimetres in size but can vary. These lesions can have a smooth, shiny appearance, though some may feel rough or scaly to the touch due to the thickened skin over them. They are usually not painful, but they can occasionally bleed if they are scratched or injured. In rare cases, they may be mistaken for skin cancer (such as melanoma) because of their colour and appearance, which is why it’s important to seek medical advice if you notice any new or unusual skin changes.

Areas That Can Develop Angiokeratomas

Angiokeratomas can occur on various parts of the body, with some areas more commonly affected than others. The different types of angiokeratomas are often classified based on their location and pattern of appearance:

Angiokeratoma of Fordyce: These are found on the genitalia, typically on the scrotum or vulva. Angiokeratoma of Fordyce is the most common type and can sometimes be mistaken for other conditions due to its location. This can often look like a blood blister on the the scrotum or testicles in males.
Angiokeratoma Circumscriptum: This type is usually found on the legs and may appear in a clustered pattern. These lesions can be more extensive and occur in larger patches.
Angiokeratoma of Mibelli: This type often appears on the hands, feet, or knees and is associated with a history of minor trauma or cold exposure in the affected areas.
Angiokeratoma Corporis Diffusum: This is a rare form associated with genetic disorders like Fabry disease. In this type, angiokeratomas can be spread across multiple areas of the body, including the trunk, buttocks, and thighs.

Treatment Options for Angiokeratomas

Angiokeratomas are usually harmless, and in many cases, no treatment is required. However, if the lesions cause discomfort, bleed easily, or for cosmetic reasons, individuals may seek treatment. Treatment options include:

Cryotherapy

This involves freezing the angiokeratomas with liquid nitrogen to destroy the tissue. Cryotherapy is a common treatment for benign skin lesions and can be effective for small, superficial angiokeratomas.

Electrocautery

This technique uses heat generated by an electrical current to burn away the lesion. It’s a precise method for removing angiokeratomas but may cause some discomfort and requires local anaesthesia.

Surgical Excision

For larger or more troublesome angiokeratomas Manchester & Cheshire surgeons may consider using surgical excision to remove them. This involves cutting out the lesion and stitching the skin back together. This option is more invasive and typically used for more extensive lesions.

Laser Therapy

Laser treatments, particularly using vascular lasers such as the pulsed dye laser or the Nd:YAG laser, are highly effective for treating angiokeratomas. Lasers work by targeting the dilated blood vessels, causing them to shrink without damaging the surrounding skin. Laser therapy is often preferred for cosmetic reasons as it leaves minimal scarring.

How Does Laser Treatment Work for Angiokeratomas?

Laser treatment is one of the most effective and minimally invasive options for treating angiokeratomas. The specific type of laser used, such as a pulsed dye laser or an Nd:YAG laser, targets the blood vessels within the angiokeratoma. The laser's energy is absorbed by the haemoglobin (the pigment in red blood cells), which causes the blood vessels to coagulate and shrink. Over time, the angiokeratoma will fade or disappear as the blood vessels are reabsorbed by the body.

Laser therapy has several advantages, including:

Precision

The laser specifically targets the blood vessels within the angiokeratoma without affecting the surrounding skin, reducing the risk of damage or scarring.

Minimal Downtime

The procedure is quick and usually requires little recovery time. Most patients can resume normal activities immediately after the treatment.

Cosmetic Results

Laser treatment typically results in a smoother and more even appearance of the skin, making it a preferred option for treating angiokeratomas in visible areas like the face or genital region.

Laser treatment is generally well tolerated, though some patients may experience mild discomfort, redness, or swelling in the treated area for a few days following the procedure.

Is Angiokeratoma Sexually Transmitted?

Angiokeratomas are not sexually transmitted. Although they can appear in the genital area, particularly in the case of angiokeratoma of Fordyce, they are completely unrelated to sexually transmitted infections (STIs). Their appearance in the genital region can sometimes cause concern, but angiokeratomas are simply the result of dilated blood vessels and are not linked to any infection or contagious condition. It's important to seek medical advice if you have lesions in the genital area to rule out other conditions, but rest assured that angiokeratomas themselves are benign and not sexually transmitted.

Are Angiokeratomas Contagious?

Angiokeratomas are not contagious. They cannot be passed from one person to another through physical contact, sexual activity, or any other means. These lesions are caused by structural changes in the blood vessels and skin, rather than by an infection or virus, so there is no risk of transmitting angiokeratomas to others. If you have an angiokeratoma and are concerned about its appearance or whether it may be related to other conditions, it’s a good idea to consult with a dermatologist or healthcare professional for an accurate diagnosis.

Conclusion

Angiokeratomas are benign skin lesions caused by dilated blood vessels and thickened skin. While they can appear in various areas of the body, including the genital region, they are not sexually transmitted or contagious. Most angiokeratomas are harmless and require no treatment, but options such as laser therapy, cryotherapy, and surgical excision are available for those who seek treatment for cosmetic reasons or discomfort. Laser treatment is particularly effective, offering a minimally invasive solution with excellent cosmetic outcomes.

If you notice any new or changing skin lesions, especially if they appear dark or irregular, it’s always best to consult your GP or out team at CLNQ to rule out more serious conditions like skin cancer.

Angiokeratoma in Manchester and Cheshire