Petechiae are tiny dots that appear as red, brown, or purple in color beneath the skin. They are usually seen in clusters on the stomach, buttocks, arms, and legs. However, they may also appear inside the mouth or on the eyelids. Petechiae may indicate different conditions, which can range from minor or serious ones. They can also occur as a side effect of certain types of medications.
Causes of Petechiae
When capillaries or tiny blood vessels bleed and leak blood into the skin, petechiae appear. A number of causes can cause this bleeding, and they include:
- Certain medications
- Medical conditions
- Prolonged straining
Petechiae may occur as a side effect of certain types of medications. Some of these drugs include:
- Antibiotics (penicillin, nitrofurantoin)
- Blood thinners (heparin, warfarin)
- Anticonvulsants (phenytoin, carbamazepine)
- Antidepressants (desipramine)
- Anticholinergic or antimuscarinic drugs (atropine)
- Sedatives (chloral hydrate)
- Nonsteroidal anti-inflammatory drugs (naproxen, indomethacin)
- Anti-malarial drug (quinine)
There are also harmless types of petechiae due to excess or prolonged straining from coughing, weightlifting, childbirth, and vomiting. They may appear as tiny rash-like spots on the face, around the eyes, neck, and chest. Strain-induced petechiae usually go away after a few days.
The formation of petechiae can also be due to several medical conditions, which can be infectious or non-infectious. A few examples of non-infectious causes of petechiae are:
- Vitamin C Deficiency (Scurvy): Scurvy is caused by a long-term deficiency of vitamin C in your diet. Aside from petechiae, its symptoms include bruising, swollen gums, joint pain, fatigue, and shortness of breath.
- Vasculitis: This condition is characterized by blood vessel inflammation, scarring, and narrowing. Its other symptoms are nerve problems, headache, fever, fatigue, body aches, weight loss, and night sweats.
- Leukemia: Leukemia is a type of cancer caused by an excessive production of damaged white blood cells (WBCs). Its other symptoms are unexplained weight loss, fatigue, fever, chills, nosebleeds, bleeding, bruising, swollen glands, and night sweats.
- Thrombocytopenia: This condition means you have a below normal platelet count. Its other symptoms are jaundice (yellowing of the skin and eyes), bruising, fatigue, the presence of blood in the stool or urine, and bleeding from the nose or gums.
The following conditions can also cause petechiae:
- Injuries: Petechiae can form when there is damage to the skin or blunt force caused by a vehicular accident, biting, or hitting. Wearing tight clothing with straps or carrying a heavy backpack may cause friction against the skin and lead to the formation of petechiae. In some cases, petechiae can also form due to sunburn.
- Endocarditis: This is the inflammation of the endocardium or the heart's inner lining. Its symptoms include pale skin, fatigue, fever, chills, muscle and joint pain, and shortness of breath.
- Cytomegalovirus (CMV): CMV is a viral infection, which is characterized by fever, sore throat, fatigue, and muscle pain.
- Hantavirus Pulmonary Syndrome (HPS): HPS is a type of respiratory disease caused by hantaviruses. Its symptoms include breathing difficulty and flu-like symptoms, such as fever, joint and muscle pain, and fatigue.
- Strep Throat: This bacterial infection causes a sore throat. Other symptoms of strep throat are fever, headache, body aches, swollen tonsils or glands, nausea, and vomiting.
- Infectious Mononucleosis (Mono): Also called as kissing disease or glandular fever, mono is a viral infection caused by the Epstein-Barr virus (EBV). The infection is usually transmitted through direct exposure to infected bodily fluids, such as saliva. Its symptoms include fever, swollen lymph nodes and tonsils, sore throat, headache, and extreme tiredness or fatigue.
- Scarlet Fever: People who have had strep throat can develop this type of bacterial infection. The symptoms of scarlet fever include fever, sore throat, red lines on the skin, a rash, red tongue, and skin flushing.
- Viral Hemorrhagic Fever: These infections include yellow fever, dengue, and Ebola. These viral hemorrhagic fevers make it difficult for the blood to clot. Their symptoms include weakness, high fever, dizziness, bleeding under the skin, and body aches.
- Meningococcemia: This type of infectious disease is caused by bacteria. Its symptoms include headache, fever, nausea, and muscle pain.
- Rocky Mountain Spotted Fever (RMSF): RMSF is an infectious disease transmitted by ticks. Its symptoms include high fever with chills, muscle pain, severe headache, nausea, and vomiting.
Petechiae caused by certain viral or bacterial infections often clear up when the infection gets better. When certain medications are the cause of petechiae formation, stopping these medications can make the symptoms go away. You should also check the tiny spots if they change. If these spots increase in number, it's recommended to see a doctor right away to rule out bleeding disorders.
Depending on the main cause of your petechiae, your healthcare provider may prescribe any of the following medications or therapy to help treat your condition:
- Antibacterial medications or antibiotics for bacterial infections
- Corticosteroids to relieve inflammation
- Immunosuppressive medications such as methotrexate, azathioprine, and cyclophosphamide
- Radiation, chemotherapy, or biological therapy for the treatment of cancer
To help relieve your symptoms, you can also try certain remedies at home. They include:
- Getting enough rest.
- Drinking plenty of fluids to help prevent dehydration.
- Taking over-the-counter pain relievers such as acetaminophen or ibuprofen.
When to See a Doctor
There are some serious underlying causes of petechiae that require immediate medical attention. It is recommended to see a doctor if you or your child has petechiae for proper diagnosis and necessary treatment.
You should also seek emergency medical help if you develop serious symptoms, such as:
- Widespread and unexplained petechiae
- Difficulty breathing
- High fever
- Changes in consciousness
Although not all underlying causes of petechiae can be prevented, you can follow some preventive measures to prevent the formation of petechiae.
Inform your healthcare provider if you have had petechiae in the past after taking a certain type of medication. To help prevent infections that can cause petechiae, you can follow these recommendations:
- Develop good handwashing habits and wash your hands using soap and water. You can also use an alcohol-based hand sanitizer if don't have access to soap and water for handwashing.
- Avoid direct contact with anyone who appears to be ill.
- Clean and disinfect common surfaces such as countertops.
- Do not share personal items, utensils, or glasses.
- Always practice safe sex.
- Before going into grassy or wooded areas, apply an insect repellant that contains DEET. You can also wear long pants and long-sleeved shirts while outside these areas.