How Petechiae Are Treated

The first step is determining the underlying cause

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Petechiae are tiny red spots that appear on the skin and mucous membranes, which line the inside of your body. They indicate bleeding into the skin and usually appear red, brown, or purple.

Petechiae often appear in clusters and may look like a rash. They can happen to anyone, but are most common in children. In order for the spots to be considered petechiae, they must be smaller than two millimeters wide. 

What Causes Petechiae to Appear?

Petechiae appear on the skin when your capillaries bleed. Capillaries are tiny blood vessels that connect the smallest part of your arteries to the smallest part of your veins. When they leak blood into the skin or mucous membranes, petechiae appear. 

There are several possible causes of petechiae, including straining, medications, infections, or other medical conditions. Treatment for petechiae involves treating the underlying cause.

Petechiae may resolve on their own or may be a sign of a serious health condition. If you or your child has developed a rash of red spots, see your doctor to determine the cause and appropriate treatment. 

Hand touching a rash on the arm

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Home Remedies and Lifestyle

There are times when petechiae are harmless and can be treated or even prevented by making certain lifestyle changes. 

Prevention 

Petechiae are sometimes caused by intense straining and often appear around the eyes or on the chest. When petechiae are caused by straining, they can be prevented by avoiding the actions that cause straining.

For example, petechiae can appear after straining to lift heavy weights. To prevent petechiae, switch to lighter weights or stop working out when you feel tired. Other activities that may lead to straining include coughing, vomiting, passing stool, and giving birth.

Petechiae caused by straining typically heal on their own without needing further treatment. 

Supportive Care 

If your petechiae are caused by a virus, you may not need any treatment. For example, mononucleosis, or mono, is caused by the Epstein-Barr virus (EBV), and sometimes presents with petechiae. Treatment for mono includes plenty of rest and fluids, as well as avoiding contact sports. If the petechiae do not improve as you heal from the virus, see your doctor.

Diet

Petechiae sometimes appear on the skin when your body cannot clot blood with platelets, the blood cells responsible for clotting. Vitamin K is an essential fat-soluble vitamin that is required for several clotting factors. Deficiency of vitamin K leads to low levels of these clotting factors, which may present with purpura or more systemic bleeding.

Vitamin K is a fat-soluble vitamin that we can obtain through our diets. Good sources of vitamin K include dark, leafy greens, soybean oil, canola oil, and fortified meal replacement shakes. Because vitamin K is fat-soluble, it’s best to take it with a healthy fat such as olive oil. If you are concerned that you have a platelet deficiency, known as thrombocytopenia, see your doctor. 

Over-the-Counter (OTC) Therapies

Petechiae sometimes present with a viral infection. If the virus itself does not require treatment, the petechiae should resolve as your body recovers from the infection. If you are uncomfortable during the course of the virus, ask your doctor about OTC pain medications or fever reducers such as acetaminophen (Tylenol)

When you are experiencing petechiae, it is important to avoid nonsteroidal anti-inflammatory drugs (NSAIDs) because they can make bleeding worse. 

Prescriptions

Petechiae may be caused by certain prescription medications. When this occurs, the only effective treatment is discontinuing the medication and finding a safe alternative. Medications that may lead to petechiae include penicillin, phenytoin, and quinine. 

Antibiotics 

When a bacterial infection spreads to the bloodstream, petechiae may appear on the skin. Bacterial infections such as meningococcal disease, scarlet fever, and infective endocarditis can cause petechiae and need to be treated with antibiotics and additional therapies as needed. 

Rocky Mountain spotted fever (RMSF) is a bacterial infection spread through a tick bite and also leads to petechiae. RMSF must be treated right away with the antibiotic doxycycline. If you develop petechiae after spending time in wooded areas or being bitten by a tick, see your doctor right away. RMSF can quickly become life-threatening when left untreated. 

If you develop petechiae with a high fever, see your doctor right away as this could be a sign of a serious bacterial infection. 

Steroids

Petechiae sometimes occur when the blood vessels become inflamed. This inflammation is known as vasculitis and can be caused by a variety of factors. Steroid therapy may be helpful in reducing swelling and reversing the petechiae. 

Steroids may also be used to treat certain types of thrombocytopenia because they stimulate the body to produce more platelets in the blood. Immune thrombocytopenic purpura (ITP) is usually treated with the steroid prednisone. ITP occurs when the body's immune system attacks the platelet cells in the blood.

Antivirals

Viral infections caused by viruses like cytomegalovirus (CMV) can lead to petechiae. These infections may require treatment with antivirals such as valganciclovir. 

When petechiae present with a fever, it’s important to see your doctor right away. This could be a sign of meningococcal disease, which can be deadly. 

Surgeries and Specialist-Driven Procedures

When petechiae are caused by thrombocytopenia, they must be treated by addressing the underlying cause of the condition. When platelets are low, bleeding is more likely. If you have been diagnosed with thrombocytopenia, your doctor will work with you to determine what is causing the low platelet levels.

Possible treatments include platelet transfusions, prescription steroids, and additional treatments as needed. 

Chemotherapy 

Blood cancers, such as leukemia, can cause petechiae. If you or your child has been diagnosed with blood cancer, treatment will depend on your specific type of cancer and how advanced it is.

Treatment options may include chemotherapy, radiation therapy, surgery, and immunotherapy. It should be noted that many cancer treatments also cause petechiae. 

Surgery

If your case of petechiae is due to low platelets, your doctor may recommend a splenectomy, where your spleen will be removed.

Removing the spleen in a person with certain types of thrombocytopenia can increase the level of platelets in the blood. This is because the spleen filters the blood and sometimes traps platelets, keeping them from circulating in the blood and clotting the blood. People with ITP may benefit from removing the spleen if steroids have been unsuccessful.

Summary

The treatment for petechiae depends on their cause, and will look different for each person with this symptom. Some cases can be treated or prevented with lifestyle changes, while others may require surgical treatment. If you have petechiae and a fever at the same time, talk to your doctor because it could be a sign of a serious infection.

A Word From Verywell

Petechiae are tiny dots on the skin that indicate bleeding from the capillaries. The first step in treating petechiae is identifying the underlying cause. Many cases of petechiae resolve on their own once the cause is addressed. 

If you notice petechiae on your skin or mucous membranes like those in your mouth, see your doctor. If you develop a fever as well, seek treatment right away.

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Article Sources
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