Skin growths are extremely common findings in clinical dermatology. Many patients develop benign lesions over time that may raise concerns about cancer, cosmetic appearance, irritation from clothing, or changes in size or color. Most of these skin growths can be diagnosed by their appearance during a clinical exam by Dr. Neidig.
Cherry angiomas
Cherry angiomas are benign vascular lesions composed of clusters of dilated capillaries and post-capillary venules in the superficial dermis. They characteristically appear as small, bright red to purple raised bumps on the trunk, arms, or legs. Most individuals develop them in middle age or later, and their prevalence increases with age. The precise cause of cherry angiomas is not fully understood, but age-related changes in vascular structures, genetic predisposition, and possibly hormonal influences contribute to their formation. They are not associated with systemic disease and have no malignant potential.
Cysts
Cutaneous cysts are sac-like structures filled with keratin, sebum, or other material. The most common type is the epidermoid cyst, which arises from a hair follicle. Pilar cysts often occur on the scalp, and dermoid cysts may be present congenitally. Cysts generally present as firm, mobile nodules beneath the skin, occasionally with a central punctum. They are benign and may remain stable for years.
Causes include blockage of hair follicles, trauma, and developmental abnormalities. Some individuals are prone to multiple cysts due to inherited conditions or acne history. Cysts may become inflamed, infected, or rupture, leading to tenderness and swelling.
Lipomas
Lipomas are benign tumors of adipose tissue, typically presenting as soft, rubbery, mobile lumps. They occur most commonly on the trunk, neck, and extremities. Lipomas grow slowly and are generally painless unless they compress adjacent structures. They are among the most common soft-tissue tumors in adults.
The exact cause of lipomas is unknown, though there is a hereditary component in some cases, as well as associations with trauma and metabolic conditions. Lipomas have no malignant potential, though some very rare types must be excluded when a mass is unusually large, rapidly growing, firm, or fixed.
Moles (nevi)
Moles, or melanocytic nevi, are benign growths of the cells that give our skin color. They typically appear as uniform brown or tan flat spots to small, raised bumps, may evolve over time. Most people have multiple moles that develop in childhood and adolescence. While the majority are benign, some moles can transform into melanoma, a serious form of skin cancer.
Genetic factors and ultraviolet (UV) radiation exposure are major contributors to mole development and melanoma risk. Moles in high-sun-exposure areas or those with atypical features warrant careful surveillance.
Sebaceous hyperplasia
Sebaceous hyperplasia (SH) refers to enlargement of sebaceous glands, resulting in small, soft, yellowish papules with a central dell or umbilication. They are most commonly found on the forehead and cheeks of middle-aged and older adults with oily skin. SH is not premalignant.
The cause of SH is increased sebum production and glandular enlargement, often related to aging and hormonal factors. Lesions are typically asymptomatic but may be cosmetically concerning.
Seborrheic keratosis
Seborrheic keratoses (SK) are benign epidermal tumors that commonly appear after middle age. They present as well-demarcated, “stuck-on” plaques that may be tan, brown, or black with a waxy or verrucous surface. SKs can occur anywhere on the body except the palms and soles and are extremely common in older adults.
The exact cause is unknown, though genetic factors and age-related epidermal proliferation play roles. Unlike actinic keratoses, SKs do not progress to squamous cell carcinoma, but they can be cosmetically undesirable.
Skin tags
Skin tags are small, soft, harmless, skin colored projections and may be on a stalk. They most often occur in areas of friction such as the neck, underarms, groin, and under breasts. Skin tags are very common in middle-aged and older adults and may increase in number with weight gain, diabetes, or pregnancy.
The cause of skin tags is friction and chronic rubbing of skin folds, combined with genetic predisposition. They can also be caused by a virus or insulin resistance. They do not have malignant potential.
The general approach to diagnosis
Evaluation of skin growths begins with a detailed history, including onset, duration, changes in size or color, symptoms (pain, bleeding, itching), and risk factors such as sun exposure, family history of skin cancer, and prior skin cancers. Physical examination assesses size, shape, color, texture, and mobility. Dermoscopy enhances visualization of subsurface structures and vascular patterns, improving diagnostic accuracy for many lesions.
When clinical features are unequivocally benign, observation with periodic re-examinations may suffice. However, any lesion with features of malignancy—rapid growth, irregular borders, variegated color, ulceration, bleeding, or associated symptoms—should be biopsied. Biopsy techniques include shave, punch, or excisional sampling, depending on the lesion and diagnostic needs.
Benign skin growths such as cherry angiomas, cysts, lipomas, moles, sebaceous hyperplasia, seborrheic keratosis, and skin tags are prevalent in dermatologic practice. While most are harmless, accurate diagnosis is essential to differentiate benign lesions from malignancies, guide management, and address cosmetic or symptomatic concerns. Clinical evaluation supported by dermoscopy and, when necessary, histopathology enables precise diagnosis and appropriate care for patients at Modern Dermatology in Annapolis, Maryland.
If you have a new or changing skin growth, or a spot that concerns you, a professional evaluation is the only reliable way to determine whether it is benign or requires further attention. Our team at Modern Dermatology in Annapolis, Maryland, provides thorough skin examinations and expert diagnosis of all types of skin growths. Early evaluation matters, especially when changes are subtle and easy to overlook. To schedule a comprehensive skin check or consultation, contact Modern Dermatology today and take a proactive step in protecting your skin health.