What Are Petechiae?

Having petechiae is not a disease, but a symptom of something else.

“Petechiae” (puh-TEE-kee-ee) isn’t a disease. It’s a symptom of something else. The causes can range from minor injuries to life-threatening diseases. Because of that, you should always have a doctor check petechiae, especially in children.

Here is information that can help you understand what petechiae are and what you need to know to work with your health care team.

Capillaries are tiny blood vessels. If they start to leak for any reason, small round red spots called petechiae will show up on your skin.

These little spots:

• Are less than 2 mm wide (about the size of the point of a new crayon)
• Can be red, purple, or brown
• Show up without warning
• May show up in a cluster and can look like a rash
• Are flat, not raised
• Stay the same color when you press your finger on them and then release
• Don’t itch

In children, petechiae most often appear on the arms, legs, stomach, and bottom. You can also get them on other parts of your body, even inside your mouth and on your eyelids.

Petechiae show up for many different reasons that include the following.

Infections: Viral, bacterial, and fungal infections can all cause petechiae. Those infections can include:

• Flu
• Strep throat
• Scarlet fever
• Sepsis
• Mononucleosis
• Rocky Mountain spotted fever
• Endocarditis
• Meningococcemia
• Viral hemorrhagic fevers (VHFs) like Ebola and Hantavirus

Physical force: A sudden or severe strain can make capillaries in that area of your body start to leak. You might have a strain this severe when you:

• Give birth
• Lift weights
• Cough a lot
• Throw up

Injury: If you hurt yourself, you may notice petechiae around the area.

Drug reaction: Tiny red spots can be a sign that your immune system has overreacted to a drug. Some common culprits include:

• Penicillin
• Phenytoin (a drug that prevents seizures)
• Quinine (a malaria drug)

Other medical issues that can cause petechiae to include:

• Insufficient vitamin C or K
• Leukemia
• Vasculitis (inflamed blood vessels)
• Chronic liver disease
• Ehlers-Danlos Syndrome (a connective tissue disorder)
• Bleeding disorders or low platelet count

Your doctor will know you have petechiae after a quick look at your skin. But, it’s important to figure out the cause. Your doctor will ask many questions about your health. She will want to know about any recent injuries you’ve had or drugs you may take. She’ll do a physical exam to see if the petechiae are anywhere else.

Your doctor will also look for other symptoms that could point to a cause. If the cause isn’t clear, you might need urine or blood tests. This will provide more details about your health.

The treatment depends on the cause.

If the spots came from a virus or drug reaction, they may go away on their own. When they do, they shouldn’t leave scars. If it’s because of something more serious, they may not go away until you get treatment for that condition.

That could mean you’ll need antibiotics. Or, your doctor might refer you to a specialist who can treat the medical issue that you have.

While some of the reasons for petechiae are minor, it’s always wise to let a doctor have a look. Children with petechiae should always see a doctor.

Call your doctor right away if your child has petechiae and:

• A fever of 100.4 or higher
• The spots get bigger or spread to other body parts
• Long streaks appear under her nails
• A drastic change in mood (for instance, your child is crying and you can’t soothe him)
• Seems very sleepy
• Has trouble breathing