Anemia Rash

Anemia rashes appear as itchy skin or tiny red dots under your skin called petechiae. The rashes are symptoms of iron deficiency anemia and aplastic anemia. Both types of anemia can be serious, but they are very treatable.


What is anemia rash?

Anemia rash is a general term that describes itchy skin or a rash that looks like red dots that can develop in people with certain types of anemia.


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What is anemia?

In anemia, you have a low number of red blood cells. These are the cells in your blood that carry oxygen. Without enough oxygen, people with anemia often feel tired or cold. They can also develop skin rashes.

The two types of anemia that are most commonly associated with skin rashes are:

  • Aplastic anemia: This type of anemia results from problems with blood cell production in your bone marrow — the inner part of your bones that makes blood cells. This can affect the production of red blood cells, white blood cells (that fight infections) and platelets (that help with clotting).
  • Iron deficiency anemia: Your body needs iron to be able to produce hemoglobin (a protein in red blood cells that carries oxygen). Without sufficient iron, your body produces less hemoglobin and red blood cells.

How common is anemia rash?

The frequency of anemia rash varies with the conditions that cause it. For example:

  • Aplastic anemia is very rare. Some studies show that between 1 and 6 out of every 1 million people develop this condition each year.
  • Iron deficiency anemia is the most common type of anemia. It affects about 13% of people worldwide, particularly in developing countries.

But not every person with these conditions will develop anemia rash.


Symptoms and Causes

What are the signs of anemia rash?

Symptoms of anemia rash are different depending on the underlying cause. People with iron deficiency anemia may experience itchy skin (pruritus) that can become red, bumpy and sore when scratched.

Rashes associated with aplastic anemia usually appear as tiny red or purple dots under your skin (petechiae). The dots can form large patches but aren't usually itchy or painful.

These skin changes can occur anywhere on your body.

What causes anemia rash?

In iron deficiency anemia, researchers aren't sure how the itching develops. One theory is that low iron levels can make skin thinner, causing more water loss. This can cause itching.

Skin changes in aplastic anemia are due to low platelets (blood cells that help with blood clotting). This condition is also known as thrombocytopenia. When your platelet levels are low, the small blood vessels under your skin can bleed, causing the telltale red dots. You may also bruise easily or experience other types of bleeding, such as nosebleeds or bleeding gums.


Diagnosis and Tests

How is anemia rash diagnosed?

Your provider will perform a physical exam to evaluate your rash and symptoms. Additional tests your provider may order to identify what is causing the rash include:

  • Complete blood count (CBC): This is the main test providers use to tell if you have anemia. Healthcare providers use the CBC test to study the components of your blood, including hemoglobin, red blood cells, white blood cells and platelets.
  • Bone marrow biopsy: This test can help your provider determine if you have aplastic anemia. In a bone marrow biopsy, your provider uses a needle to remove a sample of bone marrow for examination under a microscope.

Management and Treatment

How is anemia rash treated?

Your provider will treat the rash as well as what is causing it.

To relieve itchy skin associated with iron deficiency anemia, your provider may recommend topical corticosteroids or oral antihistamines. There's no treatment for the dotted rash (petechiae), but your provider will treat the cause (aplastic anemia).

For iron deficiency anemia, treatment may include increasing your iron levels with supplements, dietary changes or a blood transfusion.

The most effective treatment for aplastic anemia is a bone marrow transplant. This procedure replaces damaged cells with healthy ones. Other treatments to manage aplastic anemia include:

  • Bone marrow stimulants (medications that stimulate your bone marrow to make more blood cells).
  • Blood transfusions.
  • Immunosuppressants.


How can I prevent anemia rash?

You can prevent iron deficiency by eating an iron-rich diet. There's no way to prevent aplastic anemia.

Outlook / Prognosis

What is the prognosis for people with anemia rash?

Both iron deficiency and aplastic anemia are highly treatable. Once these conditions improve, so will your anemia rash.

Living With

When should I see my healthcare provider?

You should call your provider if you experience any skin changes that:

  • Appear suddenly with no clear cause.
  • Cover a large part of your body.
  • Last longer than two weeks and don’t respond to home treatments.
  • Occur along with other new symptoms, such as fatigue, shortness of breath, bruising or bleeding that doesn’t stop.

A note from Cleveland Clinic

Itchy skin and petechiae rashes may be a sign of other more serious conditions. Tell your provider if you develop a rash along with other symptoms of iron deficiency anemia or aplastic anemia. Your provider can help you find the cause and identify a plan for treatment.

Medically Reviewed

Last reviewed on 05/02/2022.

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