What s Causing Pinprick Red Dots on Your Skin

National Center for Biotechnology Information: “Petechiae.”

Petechiae

Petechiae are tiny red, flat spots that appear on your skin. They’re caused by bleeding. They sometimes appear in clusters and may look like a rash. If you have tiny red, purple, or brown spots on your skin, they could be petechiae. They’re not a disease, but a symptom. A number of things can cause them to happen, from a severe coughing fit to an infection.

Often, petechiae are nothing to worry about. Still, it’s always a good idea to check with your doctor if you’re not sure where these spots came from. Some conditions that cause petechiae are very serious.

Petechiae are more common in kids. If your child has this rash, especially with a fever, take them to a pediatrician right away.

Causes of Petechiae

Petechiae are a sign of blood leaking from capillaries under your skin. Capillaries are the tiniest blood vessels that connect arteries to veins. They help move oxygen and nutrients from your bloodstream to your organs and tissues. They also carry waste away from your organs and tissues.

Leaking in the capillaries could be due to an illness or a medicine you take. Petechiae may also form on your face, neck, or chest if you strain intensely or for a long time when you do things like:

Americans see their primary care doctors less often than they did a decade ago. Adults under 65 made nearly 25% fewer visits to primary care providers in 2016 than they did in 2018, according to National Public Radio. In the same time period, the number of adults who went at least a year without visiting a primary care provider increased from 38% to 46%.

• Cough hard
• Vomit
• Give birth
• Lift heavy weights

Many infections with bacteria, viruses, or fungi can cause these spots, too, including:

• Viral infections like cytomegalovirus (CMV), endocarditis, mononucleosis, and the flu
• Bacterial infections such as meningitis, Rocky Mountain spotted fever, scarlet fever, and strep throat
• Henoch-Schonlein purpura, a disease that causes inflammation in the small blood vessels
• Sepsis , a serious, body-wide response to an infection
• Viral hemorrhagic fevers like dengue, Ebola, and yellow fever

Blood and immune disorders can also cause petechiae, such as:

• Hemolytic-uremic syndrome (HUS), a group of blood disorders
• Idiopathic thrombocytopenic purpura (ITP), an immune disorder that affects blood clotting
• Leukemia , a type of blood cancer
• Thrombocytopenia , low levels of platelets that help your blood clot
• Vasculitis, or blood vessel inflammation

A lack of vitamin C (scurvy) or vitamin K in your diet can also lead to petechiae.

Reactions to certain medicines can cause these spots, too. Petechiae may be a side effect of drugs like:

• Penicillin , an antibiotic
• Quinine (Qualaquin), a malaria drug
• Phenytoin and valproic acid, which are seizure medications
• Blood thinners (warfarin/heparin)
• Antidepressants (desipramine)
• NSAIDs (naproxen/indomethacin)
• Heart rhythm drugs (atropine)
• Sedatives (chloral hydrate)

What Does Petechiae Look Like?

Petechiae are flat and look like pinpoint-sized red, brown, or purple dots. Clumps of them on your skin look like a rash. But unlike many rashes, when you press on the spots they don’t turn white. And if the spots are larger and red or purple, you may have another type of bleeding problem called purpura.

Petechiae can form just about anywhere on your body, even your eyelids or inside your mouth.

Petechiae Diagnosis

Petechiae with a fever in children can be a sign of a serious infection like meningococcal disease. Have a doctor check these symptoms right away.

The doctor will examine your child, look at the rash, and ask about their symptoms and recent illnesses. Blood and urine tests may help pinpoint the cause of the spots.

Other serious illnesses can also cause petechiae in your child. If your child has the spots, look out for these other symptoms:

• Trouble breathing: If your child has shortness of breath or trouble breathing along with petechiae, it can be a sign of a serious condition called endocarditis. Endocarditis means there’s an infection in the lining of the inner chambers of the heart and the valves.
• Confusion: Petechiae — along with confusion — could indicate that your child has Rocky Mountain spotted fever, an infection caused by the bite of a tick.
• Change in consciousness: Some infections caused by viruses, known as viral hemorrhagic fevers, can cause changes in consciousness as well as show signs of petechiae. These diseases include dengue, yellow fever, lassa, marburg, and ebola. They’re found in tropical countries and cases in the U.S. are usually from people who traveled to these areas.

Call their doctor right away if you have any concerns.

Petechiae Treatment and Home Remedies

The rash itself doesn’t need treatment. If it’s caused by a virus, the spots should clear up as soon as the infection goes away.

If you think your petechiae might have been caused by a minor incident, like strenuous coughing, vomiting, or weightlifting, you may be able to take care of it at home by doing the following;

• Resting
• Taking extra fluids to prevent dehydration

However, since petechiae may be the result of a serious underlying condition it is best to consult your doctor when these spots appear.

If you have a bacterial infection, you may need to take antibiotics. Make sure you take the full dose of medicine, even if you start to feel better.

More serious diseases such as meningococcal infections, blood disorders, or cancer may need treatment in a hospital. Your doctor may suggest you see a specialist in infections, blood diseases (hematologist), or cancer (oncologist) to oversee your care.

Petechiae Prevention

The only way to avoid getting petechiae is to try to prevent the various conditions that can cause it. Take good care of yourself:

• Practice good hygiene such as washing your hands, brushing your teeth, and sanitizing your living environment. Don’t share personal items (straws, utensils, tooth brushes etc).
• Avoid procedures that can lead to skin infections like getting tattoos and piercings. Pay close attention to your health and see your doctor about fevers and infections that don’t resolve quickly.
• Eat fruits and vegetables or take supplements to ensure you get enough vitamins in your diet.
• Get vaccinated (immunized) to prevent certain types of bacterial meningitis.
• Avoid mosquitoes and ticks by wearing long pants and long-sleeve shirts if you’re in an affected area and use insect repellents containing DEET.

Show Sources

DermNet NZ: “Cutaneous adverse effects of anticonvulsant drugs.”

Government of Western Australia Child and Adolescent Health Service: “Petechiae.”

Mayo Clinic: “Petechiae.”

National Center for Biotechnology Information: “Petechiae.”

Pediatric Annals: “Petechiae and Purpura: The Ominous and the Not-So-Obvious?”

The Franklin Institute: “Blood Vessels.”

MedlinePlus: “Naproxen: What Side Effects Can This Medication Cause,” “Indomethacin: What Side Effects Can This Medication Cause.”

FDA.gov Label: “Atropine Injection, 2 mg,” “Adverse Reactions,” “Dermatologic.”

Mount Sinai: “Bleeding Into the Skin.”

Saudi Dental Journal: “Oral manifestations of thrombocytopenia.”

What’s Causing Pinprick Red Dots on Your Skin?

Kelly Burch is a freelance journalist who has covered health topics for more than 10 years. Her writing has appeared in The Washington Post, The Chicago Tribune, and more.

Corinne Savides Happel, MD, is board-certified in allergies/immunology, with a focus on allergic skin disorders. She is a part-time assistant professor at Johns Hopkins School of Medicine.

Table of Contents
Table of Contents

Pinpoint red dots on the skin can be caused by many things, including heat rash, contact dermatitis, or simply scraping your skin against a rough surface. But the appearance of a cluster of pinprick red dots that are flat against the skin and not itchy may be due to a condition known as petechiae .

Petechiae occurs when tiny blood vessels beneath the surface of this skin (called capillaries) suddenly burst, causing a localized grouping of tiny red, brown, or purple dots.

Petechiae is not a condition but a symptom of other conditions, including liver disease, bacterial meningitis, blood-clotting disorders, sepsis, and leukemia. Even prolonged straining and certain medications can cause skin capillaries to spontaneously rupture.

This article looks at some common and uncommon causes of petechiae, including the signs you should worry about and those that require immediate medical care.

What Is Petechiae?

Petechiae are red or purple dots appearing on the skin. They occur when blood vessels break beneath the surface of the skin, creating what is known as a petechial rash.

Petechiae are usually less than 2 millimeters in diameter. The spots are non-blanching, which means they do not disappear when you apply pressure to them.

Petechial rash is a dangerous situation because it is caused by internal bleeding and often indicates a serious underlying medical condition. Petechiae can be caused by a host of conditions that affect the cardiovascular or circulatory systems, including:

• Meningitis
• Liver disease
• Cancer
• Viral infection
• Blood or clotting disorder

Because many of these are serious disorders that require acute medical care, you should contact a healthcare provider immediately if you or your child have a pinprick rash that is not itchy.

How to Tell If You Have Petechiae

If you’re wondering whether a rash is petechial, you can press a clear glass to the surface of the skin. If the spots disappear under pressure, they are blanching, and therefore not petechiae. If the spots remain even under the pressure of the glass, they are non-blanching and likely petechiae.

Bacterial Meningitis and Petechiae

Meningitis is the infection of the meninges, the membranes that surround the brain and spinal cord.

One symptom of meningococcal meningitis is a headache accompanied by a petechial rash, known as the meningitis rash. Although the rash is common, it doesn’t always occur, so if you have other symptoms of meningitis—like a stiff neck and headache—be sure to seek medical care immediately.

The meningitis rash is a petechial rash. At first, you might notice petechiae on the arms or other areas of the body. These may be blanching if you try the clear glass test mentioned above, but as the rash becomes more pronounced it will become non-blanching. The meningitis rash can progress from petechial to a purpuric rash, which looks more like bruising than pinpricks.

Petechial rashes can be hard to spot on people with darker skin tones. Look for the rash on lighter areas like the soles of the feet and the palms of the hands. It can also appear on the roof of the mouth or the inside of the eyelids.

Meningitis is a serious disease that progresses quickly. If you have a petechial rash, especially if it is paired with other meningitis symptoms like headache or stiff neck, seek immediate medical attention.

Sepsis and Petechiae

A petechial rash is a common symptom of sepsis, a bacterial blood poisoning that can turn deadly quickly. As with meningitis, a sepsis rash can begin with a pinprick appearance, before progressing into a more bruise-like appearance.

Other symptoms of sepsis, also known as septicemia, include:

• Fever
• Sweating
• Rapid heart rate and breathing rate
• Lethargy
• Changes to alertness or consciousness

People in the following categories are at higher risk of sepsis:

• Those with recent infections of the lungs, skin, intestine, or urinary tract
• Those with chronic health conditions, such as diabetes
• Babies less than 1 year old
• Adults more than 65 years old

Sepsis is extremely serious and can lead to septic shock, which is deadly. If you have petechiae or any other symptoms of sepsis, reach out to a healthcare provider immediately.

A Word From Verywell

Rashes are often harmless, more irritating than dangerous. However, a rash that presents as pinprick red dots on your skin that don’t itch can indicate a serious, potentially deadly, cause.

If you or your child have this type of rash, reach out to your healthcare provider immediately. They can determine whether you have a dangerous infection causing the rash and can help treat the rash and any underlying health conditions that may be causing it.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. Thomas AE, Baird SF, Anderson J. Purpuric and petechial rashes in adults and children: initial assessment. BMJ. 2016 Mar 22;352:i1285. doi:10.1136/bmj.i1285
2. MedlinePlus. Bleeding into the skin.
3. Meningitis Research Foundation. What is the ‘meningitis rash?’
4. Johns Hopkins Health. Septicemia.

By Kelly Burch
Kelly Burch is has written about health topics for more than a decade. Her writing has appeared in The Washington Post, The Chicago Tribune, and more.