Petechiae (puh-TEE-kee-ee) are pinpoint, round spots that form on the skin. They're caused by bleeding, which makes the spots look red, brown or purple. The spots often form in groups and may look like a rash. The spots are often flat to the touch and don't lose color when you press on them. Sometimes they appear on the inner surfaces of the mouth or the eyelids.

Petechiae are common and can be caused by many different conditions. Some may be very serious.

Tiny blood vessels, called capillaries, link the smallest parts of your arteries to the smallest parts of your veins. Petechiae form when capillaries bleed, leaking blood into the skin. The bleeding may be caused by:

• Prolonged straining
• Medicines
• Medical conditions

Prolonged straining

Tiny spots on the face, neck and chest can be caused by straining for a long time from coughing, vomiting, giving birth or lifting weights.

Medicines

Petechiae may result from taking some types of medicine, including phenytoin (Cerebyx, Dilantin-125, others), penicillin and quinine (Qualaquin).

Infectious diseases

Petechiae may be caused by infection with a fungus, virus or bacteria. Examples of these types of infection include:

• Cytomegalovirus (CMV) infection
• Coronavirus disease 2019 (COVID-19)
• Endocarditis
• Meningococcemia
• Mononucleosis
• Rubella
• Scarlet fever
• Strep throat
• Viral hemorrhagic fevers

Other medical conditions

Petechiae may be caused by other medical conditions. Examples include:

• Cryoglobulinemia
• Immune thrombocytopenia (ITP)
• Leukemia
• Scurvy (vitamin C deficiency)
• Thrombocytopenia
• Vasculitis

Some of the causes of tiny round spots on the skin, called petechiae, can be potentially serious. See a member of your health care team soon if you develop petechiae all over the body, or you can't identify the cause of the petechiae.