Pinpoint red dots on the skin can be caused by a variety of causes. Depending on the cause, these dots can be non-itchy or itchy.
The appearance of these red dots can vary – some can be flat and some raised to form tiny bumps on the skin.
Pinprick red dots on the skin that are not itchy can be due to serious underlying conditions like infections leading to petechiae or they can be harmless like keratosis pilaris and cherry angioma.
This article reviews different causes of pinprick or pinpoint red dots on the skin, their pictures, and treatment.
Table of Contents
1. Petechiae
Tiny pinprick red dots on the skin which are flat and not itchy are usually petechiae. Petechiae occur due to bleeding from small blood vessels called capillaries in the skin. It is often called blood spots.
Appearance and associated symptoms
Petechiae usually appears as red, reddish brown, or purple dots on the skin. These are less than 2 mm; blood spots larger than 2 mm but smaller than 1 cm are called purpura.
Petechiae can appear as a single spot or in a group or cluster and may look like a pinprick rash. If you press them, they will not fade as compared to skin rashes. One can see petechiae both on the skin and the mucosal surfaces like inside the mouth.
Petechiae are not itchy; however, depending on the underlying cause, one may have other symptoms. For example, petechiae due to an infection may be accompanied by symptoms like fever, fatigue, loss of appetite, etc.
Petechiae along with fever in a child requires immediate medical care.
Causes
Petechiae is not a skin condition but a sign of other medical conditions. It can occur due to various reasons. These may include:
- A minor injury like rubbing of skin against a rough surface.
- Straining: Due to exercise, vomiting, coughing, or giving birth (in these cases, one usually sees petechiae on the upper part of the body like the neck and upper arms).
- Thrombocytopenia: Decrease in platelets (Platelets are a type of blood cells that are required for normal blood clotting).
- Infections like meningococcemia, infectious mononucleosis, infective endocarditis, and viral hemorrhagic fevers like Ebola or dengue.
- Autoimmune conditions like lupus.
- Leukemia (blood cancer)
- Deficiency of vitamins:
- Vitamin C deficiency can lead to weakened blood vessels and scurvy.
- Vitamin K is required for the production of some clotting factors and proteins required for blood clotting.
- Vasculitis: Inflammation of blood vessels.
Diagnosis
Your doctor may perform a physical examination followed by some diagnostic tests to find the cause. This may be followed by additional tests if needed.
Treatment
Petechiae due to straining or minor injury usually go away on their own in a few days. Petechiae which occur due to underlying medical conditions will require treatment.
The treatment will depend on the medical condition.
- For infectious causes, your doctor may prescribe antibiotics or antiviral medications.
- For autoimmune disorders, steroids or immunosuppressants may be prescribed.
- If these occur due to a medication, your doctor may recommend dose modification or may recommend some other medication.
- Blood cancer/leukemia may require chemotherapy, radiation therapy, or bone marrow transplant.
- Petechiae due to vitamin C or K deficiency, will require diet modification or supplementation.
- If an enlarged spleen is destroying the platelets and causing petechiae, the spleen may be removed with a surgical procedure.
2. Cherry angiomas
Cherry angiomas are non-cancerous skin lesions that consist of proliferating small blood vessels called capillaries. They are usually seen in adults over the age of 30 years and their incidence increases with age.
Cherry angiomas are also known by other names: red moles, senile angiomas, and Campbell de Morgan spots.
Symptoms
Cherry angiomas may appear as tiny red spots on the skin. They can range from pinprick to 5 mm in size. They can be flat lesions, although more often one may find them slightly raised to form bumps.
They are usually bright red in color, but they can be dark red, purple, or blue in color. They can occur anywhere on the body although most often, they are seen on the trunk and arms.
One may see variations in the size of cherry angiomas, some can be pinprick size while some can be a little larger.
Cherry angiomas are not itchy or painful. They may bleed if traumatized.
Cause
The exact cause of cherry angiomas is not known. Cherry angiomas are associated with several factors. These include:
- Aging.
- Genetics.
- Hormonal changes like pregnancy.
- Exposure to certain medications or chemicals.
- Suppressed immune system.
- Diabetes.
- Tropical climate.
Diagnosis
Cherry angiomas can be usually diagnosed by a doctor after an examination of the red dots.
If they appear unusual or suspicious, your doctor may take a biopsy or cut out the red mole. The sample is sent to the lab and examined by a pathologist to confirm the diagnosis.
Treatment
Cherry angiomas are harmless and do not become cancerous. They do not necessarily require treatment.
However, if they look unusual, bleed frequently or a person does not like their appearance, cherry angiomas can be removed in a doctor’s office.
One should not try to cut or remove them at home due to the risk of bleeding, infection, and scarring. Topical creams or products cannot remove cherry angiomas.
They can be removed via the following procedures by a doctor:
- Lasers: These use a concentrated beam of light to target the blood vessels in the angioma.
- Cryotherapy: This involves freezing the angiomas.
- Electrodesiccation: It involves the use of electric current to target the angioma.
- Excision: Cherry angioma can be shaved off at the level of the skin or it can be cut out of the skin and the wound is closed with sutures.
3. Keratosis pilaris
Keratosis pilaris is a common skin condition that is usually seen in children, teenagers, and females (with hormonal changes like in pregnancy).
Symptoms
Keratosis pilaris leads to raised bumps on the skin which can be red, skin-colored, purple, brown, or black in color (depending on the person’s skin tone). They have rough surfaces and can feel like sandpaper.
Sometimes, one can see coiled hair in the bump of keratosis pilaris. All the bumps usually look more or less the same.
The bumps may look like goose bumps or the plucked skin of a chicken (that’s why it is called chicken skin). They appear on skin that has hair follicles. They are commonly seen on the arms, legs, buttocks, or cheeks.
Keratosis pilaris usually does not hurt or itch. It may get worse in dry climates.
Related: Is keratosis pilaris itchy?
Cause
The exact cause behind keratosis pilaris is not clear. There are a few theories that are thought to cause it:
- Abnormal hyper-keratinization may lead to the blocking of the hair follicle with excess keratin.
- The structure of the hair shaft may play a role.
It is commonly seen in individuals with a family history of keratosis pilaris or a personal history of atopic dermatitis, allergies, dry skin conditions, diabetes, or obesity.
Diagnosis
Keratosis pilaris can be usually diagnosed by a doctor after a physical examination.
Treatment
Keratosis pilaris is harmless and usually does not require treatment. However, if the appearance of the rough bumps bothers you, you can use topicals to improve them. These include:
- Gentle skin care products which are free of irritants like essential oils or fragrances.
- Moisturizers.
- Urea-based skincare products.
- Exfoliants like salicylic acid, lactic acid, and glycolic acid.
- Retinoids like over-the-counter retinol.
If over-the-counter topical options fail to improve the bumps, your doctor may recommend prescription-strength retinoids like tretinoin or procedures like lasers, microdermabrasion, or chemical peels.
Keratosis pilaris cannot be cured; however, the condition usually may improve or disappear by the age of 30.
4. Other causes
Pinprick red dots may occur due to several other conditions but these conditions are usually associated with itching. Some of these conditions include:
- Heat rash: These are tiny itchy red spots that appear due to the trapping of sweat under the skin.
- Contact dermatitis: This is a skin rash that may appear after contact with an irritant or allergen. It may present with red dots; however, it is usually associated with itching.
- Atopic dermatitis: It is the most common type of eczema which can lead to pinpoint red dots on the skin, dryness, cracking, and itching.
- Folliculitis: It is the infection or inflammation of hair follicles. It can lead to tiny pinpoint red dots on the skin which are usually associated with itching.
When to see a doctor
One should see a doctor immediately, if along with red dots on the skin:
- You have systemic symptoms like fever, fatigue, enlarged lymph nodes, etc.
- You have difficulty breathing.
- You are dizzy or confused.
In addition, see a doctor if you are not sure what is causing the red dots on the skin or the red dot changes in appearance (shape, size, or color).
Preventative tips
One cannot always prevent these tiny red dots on the skin. However, the following measures may help in reducing the chances of getting them:
- Follow good hand hygiene practices.
- Eat a healthy diet rich in omega fatty acids, vitamins, and antioxidants.
- Get the immunizations recommended by your doctor.
- Wash your hands and use a face mask when taking care of someone who is sick.
- Use insect repellents or wear full-length clothes when outside in grassy or wooded areas.
- Always protect your skin from the sun and avoid tanning beds.
Key points
Pinprick red dots on the skin that are not itchy can be petechiae or they can be caused by skin conditions like keratosis pilaris or cherry angiomas.
It is important to differentiate these skin lesions as petechiae can be caused by serious medical conditions like infections or leukemia.
If you are not sure what is causing the red dots on your skin, it’s best to see a doctor.
Further reading
References
McGrath A, Barrett MJ. Petechiae. 2022 Sep 12. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. PMID: 29493956.
Kim JH, Park HY, Ahn SK. Cherry Angiomas on the Scalp. Case Rep Dermatol. 2009 Nov 11;1(1):82-86. doi: 10.1159/000251395. PMID: 20652121; PMCID: PMC2895217.
Disclaimer: This blog post is for information purposes only and does not replace medical advice.