Petechiae: Causes, Treatments, and Signs to Watch for

Petechiae on the skin can be alarming. These tiny red spots appear when small blood vessels break and bleed. They’re not always a cause for concern, but they can point to a serious underlying condition. So, it’s important to figure out what’s going on. 

Usually, there’s an identifiable cause for petechiae. If you develop new spots on your skin, your healthcare team can help find the reason for your skin changes. 

What are petechiae?

Petechiae are tiny, pinprick-sized red dots on the surface of your skin that aren’t itchy or painful. Petechiae appear when small blood vessels bleed underneath your skin. This usually happens from damage to your capillaries — the smallest blood vessels in your skin.

Petechiae are less than 2 mm in size (about the size of the tip of a crayon). Sometimes they’re in a group and may look like a rash on your skin. On darker skin tones, petechiae may appear brown or purple in color. 

What do petechiae look like?

Petechiae don’t typically have symptoms other than looking like tiny blood spots on your skin. They’re usually flat and not raised or bumpy. On rare occasions, they can be tender to touch. But in general, petechiae aren’t painful. 

The most common areas where petechiae appear include the:

• Arms

• Legs 

• Torso

• Inside of the mouth

• Eyelids

EXPERT PICKS: WHAT TO READ NEXT

• Vasculitis symptoms: Vasculitis means inflammation of the blood vessels, and it’s one possible cause of petechiae. Learn how this condition affects your health. 

• Vitamin K foods: There’s a link between petechiae and vitamin K deficiency. From leafy greens to cruciferous veggies, here are some of the best vitamin K foods.

• Medication rashes: Certain medications can trigger petechiae and other types of rashes. Here are some drugs that can cause skin reactions.

Another feature of petechiae is that they don’t blanch. This means if you press down on the spots, they don’t fade away or turn white. This helps to tell the difference between petechiae and other common skin disorders like viral rashes and hives.

What causes petechiae?

There are quite a few things that can play a role in the small blood vessel damage that causes petechiae. Some common petechiae causes include:

• Vitamin deficiency 

• Infections (bacterial and viral)

• Blood disorders 

• Vasculitis (inflammation of blood vessels)

• Seizures

• Medications (like penicillin)

• Trauma (like vomiting, straining, or accidents) 

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Vitamin deficiencies

Not getting enough vitamins and minerals (malnutrition) can increase the risk of petechiae. Low vitamin C and vitamin K are two of the most common vitamin deficiencies associated with petechiae: 

• Vitamin C is an important building block for collagen in the walls of healthy blood vessels. Low levels of vitamin C can weaken the walls of blood vessels, making them more prone to damage. This can cause the capillaries under the skin to bleed. 

• Vitamin K plays an important role in blood clotting. A deficiency in vitamin K can also lead to petechiae. This often occurs in newborns, but it’s sometimes associated with malnutrition. Some of the best vitamin K foods are leafy greens and cruciferous vegetables.

Infections

Infections can cause blood vessel damage that leads to petechiae. Some viral infections associated with petechiae include: 

• Infectious mononucleosis (usually on the roof of the mouth)

• Dengue fever

• Influenza

• Respiratory syncytial virus (RSV)

• Measles

• Mumps

• Rubella

• COVID-19

• Fifth disease (parvovirus B19)

Bacterial infections can also cause petechiae. These may include:

• Streptococcal infections (like strep throat)

• Bacterial meningitis

• Rocky Mountain spotted fever 

Blood disorders

Many blood disorders that cause petechiae involve issues with platelets. Platelets are the blood cells that form clots and stop bleeding. You may not have enough platelets, or they may not be working properly.

Blood disorders that can cause petechiae include:

• Idiopathic thrombocytopenic purpura 

• Hemolytic uremic syndrome 

• Disseminated intravascular coagulation 

• Splenomegaly (enlarged spleen)

• Leukemia

• Fanconi’s anemia 

Vasculitis

Vasculitis, or blood vessel inflammation, can cause petechiae. This can occur with autoimmune diseases, medications, or infections. It’s a serious condition that needs treatment to avoid severe organ damage.

Systemic lupus erythematosus (SLE) is an example of an autoimmune disease in which your body’s immune system attacks parts of your body. SLE can cause inflammation in the small blood vessels, which leads to petechiae. SLE can also lead to petechiae by causing low platelets.

Seizures

Seizures can cause involuntary convulsions and damage small blood vessels. Petechiae around the eyes and eyelids are common in people who have seizures. Interestingly, both seizures and some of the medications that treat seizures cause petechiae. If you have seizures, your healthcare team can help you find the source of your petechiae.

Medications

Adverse reactions to medication can also lead to bleeding from small blood vessels. Medications that can trigger petechiae include:

• Penicillin

• Quinine

• Seizure medications (like valproic acid and phenytoin)

• Furosemide

• Blood thinners (like warfarin and heparin)

• Anti-inflammatory medications (like aspirin)

Trauma

Sites of trauma can sometimes cause petechiae. This can include accidental trauma such as falls or car accidents. Physical trauma from coughing, vomiting, or straining for extended periods of time can also cause petechiae.

Petechiae can also occur from intentional injury. This may be a sign of possible physical abuse when it occurs in children who also have bruises.

Are there petechiae treatment options?

Petechiae don’t typically need treatment. That’s because they’re usually a symptom of another condition. They’ll usually resolve on their own within 2 to 3 days but could last 1 to 2 weeks. 

If the petechiae are the result of a medical condition, they’ll go away when you treat the underlying medical issue. For example, if you have petechiae because of improper nutrition or a medication reaction, correcting your diet or stopping your medication will treat them.

Can you prevent petechiae?

You can’t prevent all the potential underlying causes of petechiae. But there are some things within your control. For example, you can follow a balanced diet to make sure you get enough important vitamins, like vitamins C and K. To prevent viral infections that can lead to petechiae, stay on top of your vaccines. 

Is it petechiae, purpura, or cherry angioma?

There are different types of blood vessel abnormalities that people sometimes mistake for petechiae. These abnormalities are grouped based on the size of the blood vessel affected: 

• Petechiae involve damage to the smallest blood vessels — capillaries.

• Purpura are broken vessels that involve larger and mid-size blood vessels. The spots on your skin tend to be larger. Purpura are usually 4 mm to 10 mm in size (about the size of a popcorn kernel to the length of a staple).

• Cherry angioma are small, noncancerous tumors of small blood vessels. A cherry angioma usually looks like a tiny red spot or mole. Because of their similar size, people sometimes mistake them for petechiae. But a cherry angioma will blanch and lose its color if you apply pressure.

Are petechiae life-threatening?

Petechiae alone aren’t life-threatening. And many times, there’s no reason to worry about petechiae. But in some cases, they can be a sign of a serious, life-threatening medical condition. That’s why it’s important to let your primary care provider know if you notice these skin changes.

Some life-threatening causes of petechiae can include:

• Leukemia

• Vasculitis

• Meningitis

• Endocarditis (bacterial infection of the heart)

When should you get medical attention?

You should always contact your primary care provider if you have petechiae. They can help you figure out the source of your skin changes. This is important because sometimes a serious medical condition causes petechiae. 

Serious causes of petechiae often have other symptoms to look out for. Get medical attention right away if you notice petechiae along with:

• Fevers 

• Weight loss 

• Change in alertness

• Extreme fatigue

• Sudden high blood pressure 

• Fast heart rate

• Swollen lymph nodes 

Why trust our experts?

Written by:

Stephanie Reese, DO, MS

Dr. Reese is board-certified in family medicine and resides in Savannah, Georgia. She received her undergraduate degree from the Florida Institute of Technology and master’s in hematology/immunology from Long Island University.

Edited by:

Alex Eastman, PhD, RN

Alex Eastman, PhD, RN, is a California-based registered nurse and staff medical editor at GoodRx, where he focuses on clinical updates and Latino health.

Reviewed by:

Karen Hovav, MD, FAAP

Karen Hovav, MD, FAAP, has more than 15 years of experience as an attending pediatrician in a variety of clinical settings. She has worked in a large academic center in an urban city, a small community hospital, a private practice, and an urgent care clinic.

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