What's Causing Pinprick Red Dots on Your Skin?

Pinpoint red dots on the skin can be caused by many things, including heat rash, contact dermatitis, or simply scraping your skin against a rough surface. But the appearance of a cluster of pinprick red dots that are flat against the skin and not itchy may be due to a condition known as petechiae.

Petechiae occurs when tiny blood vessels beneath the surface of this skin (called capillaries) suddenly burst, causing a localized grouping of tiny red, brown, or purple dots.

Petechiae is not a condition but a symptom of other conditions, including liver disease, bacterial meningitis, blood-clotting disorders, sepsis, and leukemia. Even prolonged straining and certain medications can cause skin capillaries to spontaneously rupture.

This article looks at some common and uncommon causes of petechiae, including the signs you should worry about and those that require immediate medical care.

What Is Petechiae?

Petechiae are red or purple dots appearing on the skin. They occur when blood vessels break beneath the surface of the skin, creating what is known as a petechial rash.

Petechiae are usually less than 2 millimeters in diameter. The spots are non-blanching, which means they do not disappear when you apply pressure to them.

Petechial rash is a dangerous situation because it is caused by internal bleeding and often indicates a serious underlying medical condition. Petechiae can be caused by a host of conditions that affect the cardiovascular or circulatory systems, including:

• Meningitis
• Liver disease
• Cancer
• Viral infection
• Blood or clotting disorder

Because many of these are serious disorders that require acute medical care, you should contact a healthcare provider immediately if you or your child have a pinprick rash that is not itchy. 

Bacterial Meningitis and Petechiae

Meningitis is the infection of the meninges, the membranes that surround the brain and spinal cord.

One symptom of meningococcal meningitis is a headache accompanied by a petechial rash, known as the meningitis rash. Although the rash is common, it doesn’t always occur, so if you have other symptoms of meningitis—like a stiff neck and headache—be sure to seek medical care immediately. 

The meningitis rash is a petechial rash. At first, you might notice petechiae on the arms or other areas of the body. These may be blanching if you try the clear glass test mentioned above, but as the rash becomes more pronounced it will become non-blanching. The meningitis rash can progress from petechial to a purpuric rash, which looks more like bruising than pinpricks. 

Petechial rashes can be hard to spot on people with darker skin tones. Look for the rash on lighter areas like the soles of the feet and the palms of the hands. It can also appear on the roof of the mouth or the inside of the eyelids. 

Meningitis is a serious disease that progresses quickly. If you have a petechial rash, especially if it is paired with other meningitis symptoms like headache or stiff neck, seek immediate medical attention. 

Sepsis and Petechiae

A petechial rash is a common symptom of sepsis, a bacterial blood poisoning that can turn deadly quickly. As with meningitis, a sepsis rash can begin with a pinprick appearance, before progressing into a more bruise-like appearance.

Other symptoms of sepsis, also known as septicemia, include:

• Fever
• Sweating
• Rapid heart rate and breathing rate
• Lethargy
• Changes to alertness or consciousness

People in the following categories are at higher risk of sepsis:

• Those with recent infections of the lungs, skin, intestine, or urinary tract
• Those with chronic health conditions, such as diabetes
• Babies less than 1 year old
• Adults more than 65 years old

Sepsis is extremely serious and can lead to septic shock, which is deadly. If you have petechiae or any other symptoms of sepsis, reach out to a healthcare provider immediately.  

A Word From Verywell

Rashes are often harmless, more irritating than dangerous. However, a rash that presents as pinprick red dots on your skin that don’t itch can indicate a serious, potentially deadly, cause.

If you or your child have this type of rash, reach out to your healthcare provider immediately. They can determine whether you have a dangerous infection causing the rash and can help treat the rash and any underlying health conditions that may be causing it.