If you notice tiny red or purple dots on your skin, you might think it’s a rash - but it could be a condition called petechiae (puh-TEE-kee-ee). Knowing how to tell the difference can help you understand what’s causing the spots and when to seek care.
What are petechiae?
Petechiae are tiny, pinhead-sized spots that may be red, brown or purple. They happen when small blood vessels bleed under the skin. These spots are flat, not itchy or painful and often appear in clusters. They are most common on the lower body but can also show up on the arms, inside the mouth or on the eyelids.
“They can be so clustered together that it can look more like a rash,” said Jayne Peterson, MD, an internal medicine physician with Banner – University Medicine.
Petechiae vs. rash: how to tell the difference
One way to tell the difference between petechiae and a rash is by pressing on the spots. Petechiae stay red, brown or purple, while most rashes will turn pale or lighter in color.
What causes petechiae?
“Petechiae are caused by having low or poor-functioning platelets,” Dr. Peterson said. Platelets, or thrombocytes, are a type of blood cell that helps you heal after an injury, and petechiae can appear when your platelets are not working well or are too low.
“Many things cause low platelets. It is important that you see your doctor to help you find the cause,” Dr. Peterson said. Petechiae can fade on their own in two to three days, but even if they go away, it’s still important to see your doctor so you can be treated for whatever caused them.
Low platelets and petechiae can be caused by many different things, some of which are serious. Conditions that cause petechiae include:
- Low levels of vitamin C (scurvy) or vitamin K
- Some viral infections such as mononucleosis, viral hemorrhagic fevers, cytomegalovirus (CMV) infection and hantavirus
- Some bacterial infections, such as strep throat with scarlet fever and Rocky Mountain spotted fever
- Common medications like nonsteroidal anti-inflammatory drugs (NSAIDs), antibiotics, antidepressants and blood thinners
- Leukemia or blood cancers
- Liver disease
- An infection of the heart lining called endocarditis
- Inflammation in the blood vessels called vasculitis
- Bleeding disorder
Petechiae are often linked to problems with platelets, which help your blood clot.
Are petechiae dangerous?
Petechiae themselves are not harmful, but they can be a sign of an underlying condition. Some causes are mild, while others may be serious and require medical care.
How long do petechiae last?
Petechiae may fade within a few days, especially if the cause is mild. However, they can persist or return if the underlying issue is not treated.
How are petechiae treated?
At home, you can help petechiae clear up by getting plenty of rest, applying cold compresses and drinking fluids. But even if petechiae go away, you’ll still need to see your doctor. Because petechiae are a sign of an underlying condition that’s causing problems with your platelets, treating them means treating whatever is causing them. Your doctor might recommend:
- Vitamin C or vitamin K supplements if you’re deficient
- Immunosuppressing drugs
- Antibiotics, if you have a bacterial infection
- Steroids, which can help lower swelling in blood vessels
- Treatment for leukemia, such as chemotherapy, radiation, immunotherapy or bone marrow transplant
When should you seek emergency care for petechiae?
If you have petechiae and any of these other symptoms, call 911 or have someone take you to the emergency room:
- Spots that spread quickly
- Fever
- Trouble breathing
- Dizziness or confusion
Can petechiae be prevented?
You can’t prevent all causes of petechiae. But good hygiene practices can help you avoid some of the infections that can trigger them:
- Wash your hands frequently.
- Clean high-touch surfaces like door handles, light switches, phones and countertops regularly.
- Wear long-sleeved shirts and long pants and use insect repellant if you’re in an area where you could be exposed to tick bites. Diseases like Rocky Mountain spotted fever, which is caused by tick bites, can lead to petechiae.
- Don't share objects that might have come into contact with someone else's mouth or nose, such as a cup or toothbrush.
Petechiae vs. cherry angiomas
Petechiae can look like cherry angiomas, which are small, red areas that are usually raised, so you can feel them. Cherry angiomas can appear when you get older or when you are pregnant, and they tend to be more common in people who have had a lot of sun exposure, though they aren’t cancerous. Cherry angiomas don’t go away on their own and don’t need to be removed unless they are larger and begin bleeding, or you don’t like the way they look.
The bottom line
Petechiae are small spots caused by bleeding under the skin and can sometimes be mistaken for a rash. But these pinprick-sized dots, which are caused by bleeding under the skin, could be a sign of a serious, even life-threatening, medical condition. Even if petechiae go away, it’s essential to see your doctor to find out what was causing them.
Have concerns about diagnosing and treating petechiae?
Schedule an appointment with a primary care provider near you.
Frequently asked questions about petechiae
What do petechiae look like?
They appear as small red, brown or purple spots that do not fade when pressed.
Are petechiae the same as a rash?
No. Petechiae do not blanch when pressed, while most rashes do.
What causes petechiae to suddenly appear?
They can appear due to infections, medications or low platelet levels.
When should I worry about petechiae?
You should seek care if they spread quickly or occur with symptoms like fever, breathing problems or confusion.
Other useful articles
- How to Prevent and Manage Tick Bites: Expert Tips and Advice
- Mottled Skin (Livedo Reticularis): What to Do About Blotchy Skin
Content in this article was updated on April 8, 2026.
