Petechiae

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.

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.

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 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.