Petechiae, When to Worry: Causes, Symptoms, and More

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.

When to see a doctor

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
  • conduct any laboratory tests needed to diagnose the underlying condition
Serious conditions

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

MeningitisThis infection affects your brain and spinal cord and can be very serious. Some other symptoms include fever, a stiff neck, vomiting, and headaches.LeukemiaThis 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. ThrombocytopeniaThis 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 purpuraThis occurs when your blood vessels become inflamed. Other symptoms include abdominal pain, kidney inflammation, and arthritis. SepsisYou 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 FeverYou may get this bacterial infection from a tick bite. Some other symptoms include fever, chills, headaches, muscle aches, and confusion.Vitamin K deficiencyLack 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. ScurvyYou may get scurvy if you don't get enough vitamin C. Other symptoms include fatigue, weaknesses, joint pain, and bleeding gums.
Nonserious conditions
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.
What petechiae looks like
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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.

Why treatment is important

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.

Treatment options

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.
  • Vitamin K deficiency. Most infants get a vitamin K shot at birth to prevent a deficiency. You should make sure you get enough vitamin K in your diet to prevent a deficiency.
The bottom line

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.

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