Petechiae - Symptoms, Causes & Treatment
Medically reviewed by Dr. Anand S. Urhekar, MD, MD Pathology, Clinical Advisor · Last updated July 2026
Tiny (1–2 mm) red, purple or brown spots caused by bleeding from small capillaries into the skin. Their defining feature is that they do not blanch — they stay visible when pressed with a glass or finger. Causes range from harmless straining or tight clothing to low platelets, infection and meningococcal sepsis.
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Quick Answer
Petechiae are pinpoint red-purple spots from bleeding into the skin. The key test is the glass test: petechiae do not fade when pressed. Harmless causes include coughing, vomiting or tight straps, but sudden widespread petechiae with fever, headache, drowsiness or unexplained bruising is a medical emergency and needs same-day assessment for sepsis or a platelet disorder.
Symptoms
- Flat pinpoint red, purple or brown spots, 1–2 mm
- Do not blanch under glass or finger pressure
- Often in crops on the legs, or above the collar line after straining
- No itch or scale
- May be accompanied by bruising or bleeding gums when platelets are low
Causes & Risk Factors
- Straining — violent coughing, vomiting, childbirth, weight-lifting
- Low platelet count (immune thrombocytopenia, leukaemia, chemotherapy)
- Severe infection including meningococcal sepsis
- Medications such as anticoagulants, quinine and some antibiotics
- Vasculitis and vitamin C or K deficiency
Treatment & Management
- Urgent assessment and blood tests to find the cause
- Emergency antibiotics if sepsis is suspected
- Treating the underlying platelet or clotting disorder
- Stopping or changing a causative medication under medical advice
- No treatment needed for straining-related petechiae, which fade in days
When to See a Doctor
Seek emergency care immediately for petechiae with fever, headache, neck stiffness, drowsiness, confusion or a rapidly spreading rash. Seek same-day review for unexplained petechiae with bruising, nosebleeds or bleeding gums.
Frequently Asked Questions
What is the glass test?
Press a clear glass firmly against the spots. A normal rash blanches (fades) under pressure. Petechiae and purpura remain visible — which, together with fever or feeling very unwell, means emergency assessment.
Are petechiae always serious?
No. Petechiae above the neckline after severe coughing or vomiting are usually harmless and settle within a week. It is the combination with fever, bruising or feeling unwell that signals danger.
Related Conditions
Medical References
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Medical Disclaimer: This information is for educational purposes only and is not intended as medical advice. The content on this page should not be used to diagnose or treat any health problem. Always consult with a qualified healthcare professional for proper medical evaluation, diagnosis, and treatment of your condition.