Purpura - Symptoms, Causes & Treatment
Medically reviewed by Dr. Anand S. Urhekar, MD, MD Pathology, Clinical Advisor · Last updated July 2026
Purple or red-brown discolouration caused by blood leaking from vessels into the skin, larger than petechiae (over 3 mm). Purpura does not blanch on pressure. Causes include fragile ageing skin and steroids (senile and steroid purpura), low platelets, vasculitis, infection and clotting disorders.
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Quick Answer
Purpura are purple, non-blanching patches larger than 3 mm caused by bleeding into the skin. Common benign causes are age-related skin fragility on the forearms and long-term steroid use. Concerning causes include low platelets, vasculitis and sepsis. Purpura accompanied by fever, joint pain, abdominal pain or feeling very unwell requires urgent medical assessment.
Symptoms
- Purple, red or brown patches larger than 3 mm
- Do not fade under glass pressure
- Flat (macular) or raised and palpable in vasculitis
- Often on forearms, hands and lower legs
- May turn brown-yellow as they resolve
Causes & Risk Factors
- Senile (actinic) purpura from thin, sun-damaged skin
- Long-term topical or oral corticosteroids
- Low platelet counts and clotting disorders
- Small-vessel vasculitis including Henoch–Schönlein purpura
- Severe infection and anticoagulant medication
Treatment & Management
- Identifying and treating the underlying cause
- Blood tests for platelets, clotting and inflammation
- Protecting fragile skin from knocks and friction
- Reviewing anticoagulant or steroid medication with the prescriber
- Immunosuppressive treatment for vasculitis under specialist care
When to See a Doctor
Get urgent care if purpura appears suddenly with fever, is raised and tender, or comes with joint pain, abdominal pain, blood in the urine, or bleeding elsewhere.
Frequently Asked Questions
Is purpura just bruising?
A bruise follows an injury and fades through green and yellow. Purpura often appears without trauma and can indicate a platelet, vessel or clotting problem — unexplained purpura should always be investigated.
What does palpable purpura mean?
Purpura you can feel as raised bumps suggests inflammation of the blood vessel wall (vasculitis), which needs prompt medical assessment and often blood and urine tests.
Related Conditions
Medical References
Information on this page is sourced from and verified against reputable medical resources:
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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.