Although some causes are harmless, petechiae could be a symptom of a more serious condition. Getting a prompt diagnosis is always important, but especially so if you or your child experiences fever along with petechiae.

You may notice red, brown, or purple spots on your skin and wonder about the cause. If they are small and don’t change color when you press on them, they may be petechiae.

It’s important to see a doctor to determine the underlying cause of petechiae because the spots occur when your blood vessels bleed into the skin.

Petechiae have several causes, including viral and bacterial infections, the use of certain medications, and serious health conditions that affect your blood.

A doctor can examine the spots and conduct any needed tests to diagnose and treat the cause of petechiae.

Consulting with a doctor is important if you notice petechiae appear, but some cases require more prompt treatment than others.

Experts recommend seeking immediate medical care for any child who experiences a fever along with petechiae. According to a 2023 study, that combination of symptoms could be a warning sign of a serious infection like meningitis and complications like sepsis.

It’s also best to contact a doctor right away if you or your child:

  • experience other worsening symptoms
  • notice the spots are spreading or getting bigger
  • have an increasing heart rate
  • have trouble breathing
  • feel sleepy or have little energy
  • have other bruising

At an appointment, a doctor will:

  • conduct a physical exam
  • ask you about your medical history, including:
    • recent illnesses
    • diagnosed health conditions
    • current medications
    • physical trauma
  • conduct any laboratory tests needed to diagnose the underlying condition

Petechiae may be a symptom of a serious medical condition. Here are a few serious conditions that may be causing the spots:

  • Meningitis: About 50% to 60% of people with meningitis develop petechiae. Meningitis is an often serious infection that affects your brain and spinal cord. Other symptoms include fever, a stiff neck, vomiting, and headaches.
  • Leukemia: People with leukemia, a blood and bone marrow cancer, often experience petechiae. They sometimes call it “leukemia rash” or “leukemia spots.” Other symptoms may include weight loss, fever, swollen lymph nodes, bruising, and nosebleeds.
  • Thrombocytopenia: Thrombocytopenia occurs when your platelets (cells that help blood clot) are low. Children often have immune thrombocytopenic purpura. (Petechiae are smaller purpura.) Symptoms include bruising and bleeding in the mouth and nose.
  • Lupus: People with lupus may develop petechiae, often due to thrombocytopenia, a common complication of lupus.
  • Chronic liver disease: Liver cirrhosis can also cause low platelets, leading to petechiae.
  • Henoch-Schölein purpura (HSP): HSP presents as raised purplish dots that develop on children’s skin when blood vessels become inflamed. Other symptoms include abdominal pain, kidney inflammation, and arthritis.
  • Sepsis: You may develop sepsis if your body’s response to the release of chemicals to fight infection is out of balance. You may experience changes to your blood pressure as well as your breathing.
  • Rocky Mountain spotted fever (RMSF): You may get RMSF from a tick bite. Other symptoms include fever, chills, headaches, muscle aches, and confusion.
  • Viral infections: Viruses known to cause petechiae include enteroviruses, human parvovirus, and dengue.
  • Vitamin K deficiency: A lack of vitamin K may cause petechiae because it affects bleeding. Other symptoms include bruising, paleness, yellow eyes, and nosebleeds. This may be more common in infants who aren’t born with vitamin K and may not get enough until they begin eating solid foods.
  • Scurvy: You may get scurvy if you don’t get enough vitamin C. Other symptoms include fatigue, weakness, joint pain, and bleeding gums.

Petechiae isn’t always due to a serious medical condition. Other causes include:

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Petechiae are small red, brown, or purple dots that appear due to bleeding under the skin. They may also affect your eyes or mucus membranes like your mouth. (Hercules Robinson / Alamy Stock Photo)

When detecting petechiae, things to look for are spots that:

  • are less than 2 millimeters in size
  • are flat against your skin
  • are round like a pinpoint
  • generally appear in clusters
  • don’t discolor when you press on them
  • are red, brown, or purple in color
  • turn purple or rust-colored as they fade
  • can appear anywhere on the body

You may be able to tell the spots on your skin are petechiae instead of a rash if you press on them, and they don’t turn lighter in color.

Spots larger than 2 millimeters caused by bleeding under the skin are known as purpura.

Seeking a doctor’s diagnosis for your petechiae can help ensure you receive treatment for the appropriate underlying condition.

A doctor can recommend a treatment plan for the condition or advise you to keep an eye on symptoms, as they may disappear on their own.

Neglecting to treat the cause of petechiae could be serious if there’s an underlying health condition causing it.

You may have petechiae for several reasons. Talking with a doctor about your symptoms can help identify the underlying cause. Several serious health conditions, as well as more minor conditions, can cause these spots.

It’s important to seek immediate medical care if other symptoms accompany petechiae or the dots spread on your body.