Petechiae

What are petechiae?

Petechiae are little spots that appear on your skin, caused by a small amount of bleeding from blood vessels called capillaries. Capillaries are very small blood vessels that join an artery and a vein. This is why they appear red, purple or brown in colour.

The bleeding happens under the skin and can sometimes look like a rash. They can appear anywhere on the body and the cause can range from minor reasons to serious conditions.

What are the symptoms of petechiae?

The key symptom of petechiae are little spots on the skin's surface. They don’t lose colour when you press them.

These petechiae blood spots are usually:

• Red, purple or brown – they can look like a bruise or rash

• Between 1-2 mm

• Non-itchy

• Flat to the touch

• They do not fade under pressure

What causes petechiae?

Petechiae can be caused by a number of things. You may have broken a capillary vessel because you have been straining. For example:

• Straining when pooing

• Straining during coughing or vomiting

They can also be caused by infections, including:

• Cytomegalovirus – a common virus, closely related to the one that causes chickenpox

• Group A streptococcus – a type of bacterial infection

• Candida – a type of fungal infection

• Flu

• Meningitis

Other conditions that may cause petechiae include:

• Bone marrow problems including leukaemia

• Vasculitis

• Liver disease

• Vitamin deficiencies

• A connective tissue disorder

How are petechiae diagnosed?

Petechiae is diagnosed by looking at your skin. Your doctor will look at:

• The size of the spots

• The colour of your spots

• Whether the spots go white when a finger is pressed on your skin

• The area that the spots are covering

You will also be asked some questions about any current conditions or infections you may have. If the doctor suspects you have a meningitis infection, you’ll be referred to urgent care.

What’s the difference between petechiae and purpura?

Spots that appear larger than petechiae (which look like little pinpricks) and are red or purple are called purpura.

Purpura are also caused by blood leaking under the skin. They can sometimes be formed from groups of petechiae which have joined together.

When these larger patches heal, they usually change colour and can become brown, orange, blue or green.

If you have petechiae or purpura across large areas of your body, this may be caused by a more severe condition. Speak to a doctor as soon as possible if this is the case.

How are petechiae treated?

Some people may not need treatment for petechiae because the spots go away themselves, or when their infection resolves.

If the spots are caused by a more serious condition, a doctor can help to identify the underlying cause and may prescribe the following:

• Antibiotics for a bacterial infection

• Steroids to reduce inflammation

• Immune-suppressing medication

If your spots are caused by medication affecting your blood, your medication will be stopped.

How long do petechiae last?

Depending on the cause, petechiae usually goes away within a few days. If they’re caused by a more severe problem, the spots may spread and stay until the underlying cause is treated.

How can I prevent petechiae?

The best way to prevent petechiae is by avoiding the potential infections that cause them.

You can do this by:

• Washing your hands thoroughly

• Not sharing drinks or food

• Keep a distance from anyone who has an infection

When should I speak to a doctor?

It’s important that you see a doctor urgently as petechiae can be a sign of a serious infection. This is particularly important if you or your child are unwell.

How can Livi help?

A Livi doctor will ask you questions about your symptoms. They’ll make an individual assessment, recommend a treatment or refer you to a specialist if needed.