Petechiae: What They Are and What to Do About Them

Medically Reviewed By Raechele Cochran Gathers, MD
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Petechiae are tiny, flat, typically round spots on the skin caused by bleeding. The bleeding can have many different causes, including physical trauma, a reaction to a drug, or a more serious condition, such as thrombocytopenia. The treatment for petechiae will depend on what is causing them. If the cause is a drug reaction, your doctor may change or stop your medication. If the cause is a serious infection, IV antibiotics may be required.

Read on to learn more about the causes, symptoms, and treatment options associated with petechiae.

What are the causes of petechiae?

A woman coughing
The Good Brigade/Stocksy United

Petechiae occur when blood under the skin causes small dots to appear. There are many conditions and diseases that can cause the bleeding. They include the following.

Trauma

Physical trauma can cause petechiae. Examples of physical trauma include:

  • injury
  • heavy lifting with extreme straining
  • violent coughing
  • vomiting

Blood disorders

There are a few blood disorders that can cause petechiae, including:

Infections

There are several infections that can cause petechiae, including:

Other conditions

Some other causes of petechiae include:

What are the symptoms of petechiae?

Petechiae are small, often round spots on the skin. They can be red, brown, or purple.

The spots are less than 2 millimeters in diameter, and they do not disappear if you press down on your skin.

Petechiae may accompany other symptoms, which vary depending on the underlying disease, disorder, or condition. These symptoms can include:

What do petechiae look like?

Petechiae should be evaluated by a physician to find the underlying cause.

A rash showing petechiae

How do doctors diagnose petechiae?

To diagnose petechiae, your doctor will perform a thorough visual examination.

In order to diagnose the underlying condition that is causing the petechiae, your doctor will need a detailed account of your medical history. Depending on where the petechiae are and the presence of any other symptoms, your doctor may order blood tests or urine tests.

Diagnosis may be a lengthy process due to the wide range of conditions that can cause petechiae. The symptoms of petechiae may also look very similar to those of other conditions, including purpura and ecchymosis.

Purpura are also spots caused by bleeding in the skin, but they are larger than petechiae. Ecchymosis is a small bruise resulting from bleeding under the skin.

What are the treatments for petechiae?

Treatment for petechiae will depend on the cause.

If the cause is temporary, such as excessive straining or coughing, your doctor may recommend observation and allow the petechiae to resolve without treatment.

If the cause is more serious, your doctor may recommend treating it. When treatment is necessary, it will change based on the underlying cause.

If your doctor suspects an infection, for example, they may start IV antibiotics. Other causes may also involve hospitalization for expert consultation. If your doctor diagnoses a blood disorder or cancer, they may refer you to a hematologist or an oncologist, respectively, for evaluation and treatment.

If petechiae result from a drug reaction, your doctor may stop or change your medication.

What are the potential complications of petechiae?

Petechiae originating from physical trauma should resolve on their own. Petechiae related to an underlying blood clotting disorder or another serious condition can result in severe complications and require prompt treatment.

Once your doctor has identified the underlying cause, it is important for you to follow the treatment plan that they design for you.

When should you contact a doctor for petechiae?

If you develop petechiae, contact your doctor. They can help you decide if you need immediate treatment based on your medical history.

Call 911 or go to your nearest emergency room when petechiae occur along with:

  • a change in consciousness
  • fever, especially in a child
  • a rapid heart rate

Summary

Petechiae are tiny, flat, typically round spots on the skin caused by bleeding. Many things can cause this bleeding, including physical trauma, reactions to drugs, infections, and blood disorders. The spots can be red, brown, or purple.

Doctors will use physical examinations, blood tests, and urine tests to identify the underlying cause of petechiae. Treatment can involve antibiotics, specialist care, or simple observation.

Talk with your doctor if you think you have petechiae.

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Medical Reviewer: Raechele Cochran Gathers, MD
Last Review Date: 2022 Apr 26
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