Petechiae When To Worry

Things to look for are spots that:

When to See a Doctor About Petechiae

You may notice red, brown, or purple spots on your skin and wonder the cause. These spots may be petechiae if they are small and don’t change color when you press on them.

It’s important to see your doctor to determine the underlying cause of petechiae, because the spots occur when your blood vessels bleed into the skin.

There are many possible reasons you may have petechiae, including viral and bacterial infections, use of certain medications, and serious health conditions that affect your blood.

Your doctor can examine the spots and conduct any needed tests to diagnose and treat the cause of petechiae.

You should consult with your doctor if you notice petechiae appear, but some cases require more prompt treatment than others.

If you have petechiae, you should contact your doctor right away or seek immediate medical care if:

  • you also have a fever
  • you have other worsening symptoms
  • you notice the spots are spreading or getting bigger
  • your heart rate increases
  • your pulse changes
  • you have trouble breathing
  • you feel sleepy or have little energy
  • you have other bruising

At an appointment, your doctor will:

  • conduct a physical exam
  • ask you about your medical history, including:
    • recent illnesses
    • diagnosed health conditions
    • current medications
    • physical trauma

    Petechiae may be a symptom of a serious medical condition. Here are a few serious conditions that may be causing the spots:

    Meningitis This infection affects your brain and spinal cord and can be very serious. Some other symptoms include fever, a stiff neck, vomiting, and headaches.
    Leukemia This is a type of cancer that affects your blood as well as your bone marrow. Other symptoms may include weight loss, fever, swollen lymph nodes, bruising, and nosebleeds.
    Thrombocytopenia This condition occurs when your blood platelets decrease. Children often have immune thrombocytopenic purpura. Symptoms include bruising and bleeding in the mouth and nose.
    Henoch-Schölein purpura This occurs when your blood vessels become inflamed. Other symptoms include abdominal pain, kidney inflammation, and arthritis.
    Sepsis You may develop sepsis if your body’s response to the release of chemicals to fight infection is out of balance. You may experience changes to your blood pressure as well as your breathing.
    Rocky Mountain Spotted Fever You may get this bacterial infection from a tick bite. Some other symptoms include fever, chills, headaches, muscle aches, and confusion.
    Vitamin K deficiency Lack of vitamin K may cause this symptom to appear because it affects bleeding. Other symptoms include bruising, a pale completion, yellow eyes, and nosebleeds. Vitamin K deficiencies may occur in infants because they aren’t born with enough of the vitamin and may not get enough until they begin eating solid foods at 4 to 6 months old.
    Scurvy You may get scurvy if you don’t get enough vitamin C. Other symptoms include fatigue, weaknesses, joint pain, and bleeding gums.
    Straining Coughing, vomiting, and lifting heavy objects for long periods of time may cause this symptom.
    Medications Some medications that cause the symptom include penicillin, phenytoin (Dilantin), quinine, aspirin (Bufferin), nonsteroidal anti-inflammatories, lidocaine/prilocaine cream (Lidopril), and furosemide (Lasix).
    Pressure Experiencing pressure to a certain area of the body from trauma or a tourniquet may cause the symptom.

    Share on Pinterest A common cause of petechiae is low platelets, also known as thrombocytopenia.

    Here are some images that show how petechiae looks on different areas of the body:

    Things to look for are spots that:

    • are less than 2 millimeters in size
    • are flat against your skin
    • are round like a pinpoint
    • generally appear in clusters
    • don’t discolor when you press on them
    • are red, brown, or purple in color
    • turn purple or rust-colored as they fade
    • can appear anywhere on the body

    You may be able to tell the spots on your skin are petechiae instead of a rash if you press on them and they don’t turn lighter in color.

    Spots that are larger than 2 millimeters caused by bleeding under the skin are known as purpura.

    You should seek a doctor’s diagnosis for your petechiae so you can be treated for the underlying condition causing the symptom.

    Your doctor can recommend a treatment plan for the condition or advise you to keep an eye on them, as they may disappear on their own.

    Neglecting to treat the cause of petechiae could be serious if there is an underlying health condition causing it.

    You can’t do anything to treat petechiae, as it’s a symptom of something else.

    You may notice that the spots fade as you recover from an infection or stop taking a medication. They may also go away as you treat the underlying condition causing the spots.

    The time it takes for the petechiae to fade can vary based on the cause. For example, if you have Henoch-Schölein purpura, you may have the condition for about a month, and the spots will fade during that time.

    Some treatments for serious conditions associated with petechiae include:

    • Meningitis. Treatment will depend on the type of infection. You may be prescribed antibiotics or need prolonged rest and increased fluids to fight the infection and build up strength.
    • Immune thrombocytopaenic purpura. Often this condition clears up on its own after six months in children; adults generally need treatment.
    • Henoch-Schönlein purpura. Your doctor will try to determine the cause of the condition. It may resolve on its own. Treatments may include:
      • avoiding allergic triggers
      • getting dialysis
      • using nonsteroidal anti-inflammatories
      • taking antibiotics or steroids.

      There are many reasons why you may have petechiae. Talk to your doctor about the symptom so you can determine the underlying cause. Several serious health conditions, as well as more minor conditions, can be the cause of the spots.

      It’s important to seek immediate medical care if petechiae are accompanied by other symptoms or they are spreading on your body.

      Last medically reviewed on April 26, 2019

      Petechiae

      Petechiae are pinpoint-sized spots of bleeding under the skin or mucous membranes. The purple, red or brown dots are not raised or itchy, and they’re not a rash. Many different things can cause petechiae, and some are serious. If you or your child have petechiae that spread quickly, or if you have dots plus other symptoms, seek medical attention.

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      Overview

      What are petechiae?

      Petechiae are tiny spots of bleeding under the skin or in the mucous membranes (mouth or eyelids). They are purple, red or brown dots, each about the size of a pinpoint. They’re not raised or bumpy.

      Are petechiae a rash?

      Petechiae may look like a rash, but they’re not. These pinpoint red dots on the skin are caused by broken capillaries, tiny blood vessels under the skin. They are not itchy or painful.

      If you press on petechiae, they’ll stay purple, red or brown. But if you press on a rash, it will turn pale or lighter.

      Where can petechiae happen?

      Petechiae can appear anywhere on the body but are usually found on or in the:

      • Arms.
      • Butt.
      • Inside the eyelids.
      • Legs.
      • Mouth.
      • Stomach.

      Possible Causes

      What are the possible causes of petechiae?

      Several things can lead to petechiae, ranging from simple and reversible causes to serious illnesses:

      • Endocarditis:Endocarditis is an infection in the lining of the heart. Other signs include fever, chills, fatigue, body aches and shortness of breath.
      • Infection: Illnesses from bacteria, such as strep throat with scarlet fever, or Rocky Mountain spotted fever (spread by ticks) can cause petechiae. So can viral infections, such as cytomegalovirus or hantavirus. Other signs of infection may include fatigue, fever, sore throat, swollen glands and tonsils, body aches, nausea and vomiting.
      • Injury: Damage to the skin can cause petechiae. Examples include a car accident, bite, friction on the skin or even sunburn.
      • Leukemia:Leukemia is cancer in the blood and bone marrow. Other signs of this disease may include weight loss, swollen glands, easy bleeding or bruising, nosebleeds and night sweats.
      • Medications: Some medications may cause petechiae, including certain antibiotics, antidepressants and medications that thin the blood.
      • Mononucleosis: Also called mono, this viral infection is common among young people. It often causes fatigue, headache, sore throat, swollen glands and tonsils, and fever.
      • Straining: When you strain, you can break blood vessels under the skin. Examples include when you’re throwing up, lifting something very heavy or giving birth.
      • Thrombocytopenia: With thrombocytopenia, you have low levels of platelets, which help your blood clot. It may also cause easy bruising, bloody noses or gums, blood in pee or poop, and yellowish skin and eyes.
      • Vasculitis:Vasculitis is inflammation (swelling) in the blood vessels. It also causes fever, headache, weight loss and nerve problems (pain, weakness or numbness).
      • Viral hemorrhagic fevers:Viral hemorrhagic fevers, such as Ebola and dengue fever, make it hard for the blood to clot. Other symptoms may include high fever, easy bruising or bleeding, body aches and weakness.
      • Vitamin C deficiency: When your body doesn’t get enough vitamin C, you can develop scurvy. Other signs include swollen gums, achy joints, easy bruising and shortness of breath.

      Care and Treatment

      How are petechiae treated?

      Treatment for petechiae varies depending on the cause. For straining or a skin injury, you may not need any treatment. If there is a more serious cause, you may need:

      • Antibiotics to treat a bacterial infection.
      • Chemotherapy, radiation, immunotherapy or bone marrow transplant to treat leukemia.
      • Corticosteroids to reduce swelling in the blood vessels.
      • Drugs that suppress the immune system.
      • Vitamin C supplements.

      What can I do at home to treat petechiae?

      If you have petechiae, you should call your doctor. Some home remedies that may help include:

      • Cold compresses.
      • Lots of fluids.
      • Nonsteroidal anti-inflammatory drugs (NSAIDs).
      • Rest.

      How can I prevent petechiae?

      It’s not possible to prevent all causes of petechiae. But you can help prevent infections that lead to petechiae with some simple strategies:

      • Avoid anyone who’s sick.
      • Clean countertops, door handles and other high-touch surfaces frequently.
      • Don’t share items that may have touched someone else’s mouth or nose (like a cup or toothbrush).
      • Protect your skin from sun damage with clothing, sunscreen and shade.
      • Use insect repellant in grassy areas and the woods to prevent tick bites. Also, wear long-sleeved shirts and pants, and make sure to check your body for ticks afterward.
      • Wash your hands often.

      When to Call the Doctor

      When should I call my doctor?

      Petechiae can be a sign of a severe illness or medical emergency, especially in children. Seek medical attention if you have pinpoint red dots on the skin and:

      • Confusion, dizziness or loss of consciousness (syncope, or passing out).
      • Fever.
      • Spots that spread quickly.
      • Trouble breathing.

      A note from Cleveland Clinic

      Petechiae are tiny spots of bleeding under the skin. They can be caused by a simple injury, straining or more serious conditions. If you have pinpoint-sized red dots under your skin that spread quickly, or petechiae plus other symptoms, seek medical attention.

      Last reviewed by a Cleveland Clinic medical professional on 06/29/2021.

      References

      • Britannica. Petechia. (https://www.britannica.com/science/petechia) Accessed 9/13/2021.
      • DermNet AZ. Bleeding and bruising. (https://dermnetnz.org/topics/bleeding-and-bruising/) Accessed 9/13/2021.
      • Government of Alberta, Canada. Bruises and Blood Spots Under the Skin. (https://myhealth.alberta.ca/health/pages/conditions.aspx?Hwid=bruse) Accessed 9/13/2021.
      • Government of Western Australia Child and Adolescent Health Service. Petechiae. (https://pch.health.wa.gov.au/For-health-professionals/Emergency-Department-Guidelines/Petechiae) Accessed 9/13/2021.
      • McGrath A, Barrett MJ. [Updated 2020 Nov 20]. Petechiae. (https://www.ncbi.nlm.nih.gov/books/NBK482331/) In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Accessed 9/13/2021.

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Alex Koliada, PhD

Alex Koliada, PhD

Alex Koliada, PhD, is a well-known doctor. He is famous for his studies of ageing, genetics and other medical conditions. He works at the Institute of Food Biotechnology and Genomics NAS of Ukraine. His scientific researches are printed by the most reputable international magazines. Some of his works are: Differences in the gut Firmicutes to Bacteroidetes ratio across age groups in healthy Ukrainian population [BiomedCentral.com]; Mating status affects Drosophila lifespan, metabolism and antioxidant system [Science Direct]; Anise Hyssop Agastache foeniculum Increases Lifespan, Stress Resistance, and Metabolism by Affecting Free Radical Processes in Drosophila [Frontiersin].
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