Angiokeratomas are benign proliferations of capillaries in association with thickening of the keratin layer of skin. They are often mistaken for hemangiomas. Although there may be some visual similarities, they are quite different from hemangiomas. Angiokeratomas do not disappear as do hemangiomas. They also do not necessarily grow, although they can swell and ulcerate with hormonal fluctuations, for example, during puberty and menstrual periods. Laser therapy may help lighten the red discoloration; however, angiokeratomas can be thick and unresponsive to lasers. Surgery to excise the red marks is preferred. This option needs to be weighed with tradeoff of extensive scars or skin grafts.