The varicella-zoster virus causes these infections, which produce red, itchy, fluid-filled blisters that can appear anywhere on the body.
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:
- 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 can cause red dots to appear on the skin?
A person may notice red dots on their skin for a number of reasons, ranging from allergic reactions to heat exposure.
Many causes of red dots on the skin are harmless and resolve on their own. Others may require at-home or over-the-counter (OTC) treatment.
In this article, we discuss some of the possible causes of red dots on the skin, their treatment options, and when to contact a doctor.
Skin rashes come in a variety of sizes, colors, and textures.
Not all rashes require emergency medical treatment. However, people should seek immediate medical attention if they have a rash and notice any of the following symptoms:
- a rash that covers the entire body
- fever
- blisters or open wounds
- difficulty breathing, speaking, or swallowing
- swelling of the face, eyes, or lips
- stiff neck
- light sensitivity
- seizures
- drowsiness or unresponsiveness
People should also seek immediate attention for any new rashes that are painful and that affect the eyes, inside of the mouth, or genitalia.
When in doubt, a person should seek the opinion of a primary care provider or board-certified dermatologist.
Heat rash, or miliaria, occurs when the sweat glands become blocked, trapping sweat in the deep layers of the skin.
While anyone can have heat rash, this condition is most common among infants and young children with immature sweat glands.
Symptoms of heat rash include:
- clusters of small red bumps called papules
- firm, flesh-colored bumps
- itchy or prickly sensation
- mild or absent sweating in the affected area
- inflammation and soreness
- dizziness
- nausea
Treatment
Heat rash usually goes away within 24 hours .
Treatment typically involves using lotions to soothe the itching, irritation, and swelling.
People can also keep the skin cool and avoid tight-fitting clothing.
Keratosis pilaris (KP) is a common skin condition that causes tiny red, white, or flesh-colored bumps on the skin.
It most often affects the outer parts of the upper arms. It can also affect the forearms and upper back, but this is less common.
Symptoms of KP include:
- skin that feels rough or dry
- patches of small, painless bumps on the skin
- itching
Treatment
People can treat the symptoms of KP with:
- moisturizers containing urea or lactic acid
- alpha hydroxy acid
- glycolic acid
- lactic acid
- retinoids
- salicylic acid
- laser or light therapy
Contact dermatitis occurs when a person comes into contact with a substance that irritates their skin or triggers an allergic reaction.
Contact dermatitis symptoms vary depending on the trigger and the severity of the reaction.
Symptoms of contact dermatitis include:
- a rash that appears in geometric patterns or shapes
- dry skin that flakes and cracks
- a bright, flushed skin rash
- clusters of small red dots on the skin
- hives, or extremely itchy welts on the skin
- intense itching, tightness, or burning sensation
- fluid-filled blisters that ooze and crust over
- dark, thickened skin
- sensitivity to sunlight
Treatment
Treatment for contact dermatitis depends on the cause and severity of a person’s symptoms.
Mild to moderate symptoms improve when a person avoids contact with the irritant or allergen. If possible, people should:
- avoid skin care products that contain harsh or irritating chemicals
- avoid nickel- or gold-plated jewelry
- avoid foods or medicines that cause allergic reactions
- wear protective clothing in work environments or areas with poisonous plants
If the dermatitis is limited to a small area, a person can apply 1% hydrocortisone cream.
A doctor can prescribe stronger topical or oral antihistamines for people who do not respond to OTC medication.
Atopic dermatitis, also known as eczema, is a chronic inflammatory skin condition.
There are many different types of eczema, including:
- Follicular eczema: This type of eczema affects the hair follicles.
- Papular eczema: This presents as small red bumps on the skin that healthcare professionals refer to as papules.
Alongside red bumps on the skin, eczema can cause:
- extremely itchy skin
- warmth and swelling of the skin
- dry, flaky skin
- clusters of small, fluid-filled blisters
- blisters that leak fluid and crust over
Treatment
People can manage atopic dermatitis symptoms and even prevent flare-ups with the following treatments:
- taking prescription medications, such as steroids and antihistamines
- undergoing phototherapy or light therapy
- applying a moisturizer to treat dry, cracking skin
- using unscented, nonirritating laundry detergent
- avoiding triggers, such as dry air, stress, and allergens
For severe atopic dermatitis that does not respond to the above treatment options, a person should see a board-certified dermatologist.
Taking bleach baths, which require using half a cup of bleach per 40-gallon tub, 1–2 times per week may also help.
Rosacea is a skin condition that causes skin irritation, redness, and small pimples.
Although anyone can develop rosacea at any point in their lives, this condition most often occurs among adults aged 30–60 years , people with fair skin, and those going through menopause.
Symptoms of rosacea include:
- irritated or red skin on the forehead, nose, cheeks, and chin
- blood vessels that are visible under the skin
- clusters of small bumps or pimples
- thick skin on the face
- red, itchy, or watery eyes
- inflammation of the eyelids
- blurred vision
Treatment
People can treat rosacea with various strategies and medication. Some strategies that can help relieve rosacea include:
- avoiding triggers, such as ultraviolet light, alcohol, and harsh chemicals
- washing the face with pH-balanced cleansers
- frequently using moisturizers
- wearing a broad-spectrum sunscreen with SPF 30 or higher
People should also avoid caffeinated products and spicy foods, as these can also trigger rosacea.
Medical treatments for rosacea include:
- brimonidine tartrate
- azelaic acid
- metronidazole
- electrosurgery
- light therapy
- topical ivermectin
- oral tetracyclines
Certain infections can also lead to red dots on the skin.
If a person suspects an infection of the skin, they should consult a doctor.
Examples of these include:
Chickenpox or shingles
The varicella-zoster virus causes these infections, which produce red, itchy, fluid-filled blisters that can appear anywhere on the body.
Chickenpox usually occurs in infants and young children. However, adolescents and adults can also develop chickenpox.
Shingles occurs in adults who have already had chickenpox. According to the National Institute on Aging , shingles usually affects one area on one side of the body.
Rubella
This contagious viral infection causes a distinctive rash of small red or pink dots.
The rash usually starts on the face before spreading to the trunk, arms, and legs. Rubella infections also cause a fever, a headache, and swollen lymph nodes.
The Centers for Disease Control and Prevention (CDC) note that rubella is a relatively rare infection in the United States due to the widespread use of the MMR vaccine. The vaccine is available for infants and children aged between 9 months and 6 years.
Meningitis
Meningitis is a medical emergency. It is the inflammation of the membranes that cover the spinal cord and brain. It typically occurs due to a bacterial or viral infection.
Symptoms of meningitis include:
- fever
- stiff neck
- headache
- nausea
- light sensitivity
- confusion
- vomiting
A rash does not always appear. However, if it does, a person might notice small pink, red, brown, or purple pinpricks on the skin. Also, it will not fade when a person rolls a glass over it.
MRSA (staph) infection
The CDC define Methicillin-resistant Staphylococcus aureus (MRSA) as “a type of bacteria that is resistant to several antibiotics.”
MRSA often infects the skin, leading to painful areas of inflamed skin. People may also experience pus drainage from the affected skin and fever.
Other bacterial infections of the skin may also cause painful and inflamed areas of the skin. If a person suspects that they are experiencing a skin infection, they should consult a doctor.
Scarlet fever
Streptococcus bacteria cause this infection.
These bacteria naturally inhabit the nose and throat. They cause a red rash on the neck, under the armpit, and on the groin. The rash consists of small red dots that are rough to the touch.
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