Updated on  November 7, 2023
6 min read

Red Dots Around Eyes (Petechiae)

6 sources cited
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What are the Red Dots Around My Eyes (Petechiae)?

Petechiae manifest as tiny red dots under the eyes (less than 2 mm in diameter). They resemble a rash with the potential to also look purple or brown.

Aside from under the eyes, petechiae can also appear on the neck or the chest. It can also show up as dark brown spots on darker skin tones. Different things trigger this condition, and their appearance is typically attributed to bleeding beneath the skin.

Petechiae usually isn't a serious problem, but it can sometimes indicate a more serious condition.

If a child develops petechiae with a fever, seek immediate medical attention.

Difference Between Petechiae and Purpura

The main difference between petechiae and purpura is their size. Purpura is larger and is the result of petechiae joining together. Unlike petechiae, purpura spots can merge together, creating larger patches of discolored skin.

Petechiae and purpura are caused by blood vessels breaking under the skin. They can also indicate other health concerns if a person is sick. While similar factors cause petechiae and purpura, the latter is generally linked to more significant bleeding beneath the skin.

Since purpura is larger and potentially indicates more severe bleeding, healthcare professionals take this condition usually taken more seriously. You'll require more thorough medical evaluation and additional diagnostic tests to identify and address the underlying cause.

Watch Our Podcast On Petechiae

What Causes Petechiae?

There is a wide range of causes of petechiae. The most common causes include:

  • Strong coughing
  • Vomiting
  • Labor and childbirth
  • Lifting heavy weights
  • Viral infections (cytomegalovirus (CMV), endocarditis, and mononucleosis)
  • Bacterial infections (meningitis, Rocky Mountain spotted fever, scarlet fever, and strep throat)
  • Small blood vessel inflammation (Henoch-Schonlein purpura) 
  • Sepsis
  • Viral hemorrhagic fevers (dengue, Ebola, and yellow fever)
  • Blood and immune disorders (leukemia, thrombocytopenia, and vasculitis)
  • Lack of vitamins C, K, or B12
  • Reaction to medications (penicillin, quinine, seizure medications, blood thinners, antidepressants, NSAIDs, sedatives, and/or heart rhythm drugs)

Summary

Petechiae are small, red dots that usually appear around the eyes. They may be caused by activities, illnesses, and medicines. They are not indicative of eye disease.

Pictures of Petechiae

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Can Petechiae be a Sign of Something Serious? 

Red dots around the eyes usually aren’t a symptom of anything serious. However, there are times when they can be a cause for medical concern. 

A study showed that 25% of people who developed a fever and petechiae on their upper torso had a bacterial infection.5 In most cases, petechiae are one of many symptoms indicating a serious condition.

When to Seek Help

Contact your doctor immediately if you develop red spots while experiencing:

  • A fever of 100.4 or higher
  • Vomiting
  • Headache
  • Stiff neck
  • Streaks under your nails
  • Trouble breathing
  • Sleepiness or fatigue
  • Drastic mood changes, especially in children

Seek medical guidance if you notice the spots are turning into purpura. Blood clots or bleeding into the skin can be a concern when red dots appear underneath the eyes. 

Sick children who develop petechiae or purpura should also seek immediate medical care. Meningococcal infection is a common cause of petechiae in 50% to 70% of cases.4

Summary

Petechiae in itself is not dangerous. However, when it is accompanied by other symptoms such as fever, vomiting, headache, or stiff neck, it can indicate a serious underlying condition. See a doctor immediately.

Petechiae Treatment

Petechiae usually resolve on their own after about two to three days. In some cases, doctors prescribe the following to treat petechiae:

  • Corticosteroids
  • Antibiotics
  • Immunosuppressants
  • Vitamin C supplements

These medicines treat infections and reduce inflammation. Doctors may also refer you to a specialist if they suspect your petechiae is related to another disease.

For instance, if red dots are caused by skin conditions or an allergic reaction, you might need to see a dermatologist for treatment.

At-Home Petechiae Remedies

Some home remedies prevent spots or help them quickly ease after they form. These include:

  • Cold compresses. Applying a cold compress to the affected area helps reduce inflammation and eases the appearance of petechiae.
  • Rest, relaxation, and plenty of water. If petechiae aren't linked to an infection or underlying condition, resting is important to help the dots subside.
  • Over-the-counter pain relievers. Medication like acetaminophen and ibuprofen can help with discomfort and pain associated with petechiae.

How to Prevent Petechiae Around the Eyes

Identifying petechiae's underlying cause helps avoid and/or treat it. However, they're not always possible to control if they're related to illness. 

Here are some tips on how to prevent petechiae around the eyes:

  • Regularly clean and disinfect countertops, doorknobs, and other surfaces
  • Wash your hands frequently with soap and water for at least 20 seconds
  • Avoid people who are sick
  • Avoid too much sun exposure and wear sunscreen when you go outside
  • Discuss possible alternative medication options with your doctor if petechiae is a side effect of your current treatment
  • Don't share personal items, such as toothbrushes and razors, with others
  • Use an insect repellent when going to grassy or wooded areas
  • If you develop petechiae after vomiting or coughing violently, do what you can to avoid these activities

Summary

There are many ways to prevent petechiae. If petechiae are related to illness, or if you're taking medications that cause petechiae, talk to your doctor about it. They may recommend home remedies if it's nothing serious. They may also prescribe medication to treat the problem's root cause.

Frequently Asked Questions


Why do I have red dots around my eyes after vomiting?

The red circles that appear under your eyes after vomiting are petechiae. They are caused by broken blood vessels that cause minor bleeding under the skin. The blood vessels burst because of the strain of vomiting. This condition is more likely to arise when vomiting is intense. Vomiting-induced petechiae tend to clear up on their own.

Why do I have red dots around my eyes after drinking?

Red dots tend to develop under your eyes after drinking alcohol because of how alcohol affects the body. The alcohol also enters your bloodstream and travels into your eyes. This strains the small blood vessels or capillaries in your face. Petechiae also form if you vomit after drinking, just as they can when you vomit for any other reason.

Drinking alcohol also affects the nutrient balance in your body. Petechiae are linked to a vitamin B12 deficiency, so indirectly, if your alcohol consumption has affected your body’s B12 level, it could cause red dots to form.

Can stress cause red dots under the eyes?

Indirectly, yes, stress can cause petechiae to form under the eyes. This is because so many people cry when they feel stressed. The harder you cry, and the puffier your eyes get from crying, the more likely red dots will form. Elevated blood pressure, which is a symptom of stress, also causes red spots.

What deficiency causes petechiae?

People with vitamin B12 deficiencies tend to have a higher risk of petechiae forming. If you believe a vitamin deficiency could be the cause of red spots, seek medical advice and discuss possible supplements or treatment options with your doctor.

Should I worry about petechiae?

Petechiae are often nothing to worry about. They eventually go away on their own. However, if you're experiencing other symptoms, like fever, breathlessness, or weakness, consult your doctor immediately.

Updated on  November 7, 2023
6 sources cited
Updated on  November 7, 2023
  1. Desai, R. et al. "719: Fever with Petechiae in an Infant: Diagnostic and Treatment Conundrum." Critical Care Medicine, Society of Critical Care Medicine, 2018.

  2. "Henoch-Schönlein Purpura." NORD Rare Disease Database.

  3. McGrath, A. and Barrett, MJ. "Petechiae." StatPearls [Internet], StatPearls Publishing, 2021.

  4. Oakley, A. "Meningococcal disease." DermNet NZ, 2014.

  5. Reyes, MA. “71 - Purpura.” Principles and Practice of Pediatric Infectious Diseases (Fifth Edition), Elsevier, 2018.

  6. Thomas, A., et al. "Purpuric and petechial rashes in adults and children: initial assessment." BMJ, 2016.

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