Affinity Health, a leading provider of high-quality health cover, is encouraging people not to ignore unexplained tiny red, purple, or brown spots on the skin, as they could sometimes be an early warning sign of an underlying health condition.

These tiny spots, called petechiae (pronounced puh-TEE-kee-eye), happen when tiny blood vessels under the skin leak a small amount of blood. They can appear after something harmless, such as severe coughing, vomiting, or heavy lifting, but they can also be a sign of a more serious health problem, including an infection, a reaction to certain medicines, low platelet levels, or a blood disorder. Knowing when these spots require medical attention could help ensure serious conditions are diagnosed and treated early.

“Small red spots on the skin are often dismissed because they do not itch or hurt, but they should never be overlooked if they appear suddenly, spread quickly or occur together with a fever or unusual bleeding,” says Murray Hewlett, CEO of Affinity Health.

“Although petechiae are not always serious, it’s best to get them checked out sooner rather than later, just in case.”

What Do Petechiae Look Like?

Petechiae are tiny, flat spots that are usually less than two millimetres across. They may appear red or purple on lighter skin and dark red, brown or purple on darker skin, making them slightly harder to spot.

Unlike most rashes, petechiae do not fade or turn white when pressed, as they are caused by blood leaking beneath the skin rather than irritation on the skin’s surface. They often appear in clusters and may be found on the legs, feet, arms, stomach, chest, face, or even inside the mouth.

One simple way to check is the “glass test”. Press the side of a clear glass firmly against the spots. If they do not fade, seek medical advice, especially if the person also has a fever or feels unwell. The glass test cannot diagnose the cause but may help identify a rash that requires urgent assessment.

Common Everyday Causes

Petechiae are not always caused by illness. Sometimes, increased pressure inside the tiny blood vessels can cause them to burst.

Common everyday causes include:

• Severe or prolonged coughing.
• Repeated vomiting.
• Heavy lifting.
• Intense exercise.
• Straining during childbirth.
• Tight straps or clothing pressing against the skin.
• Minor injuries or friction.

When caused by physical strain, people usually feel well, and the spots often fade over several days. However, unexplained or recurring petechiae should always be assessed by a doctor or healthcare professional.

When Petechiae May Signal Something More Serious

Petechiae can sometimes be one of the first visible signs of a serious medical condition. Certain bacterial and viral infections can damage blood vessels or interfere with the body’s normal clotting process.

Serious illnesses that may be associated with petechiae include meningococcal disease, severe bloodstream infections (sepsis), and other infections that affect blood clotting. These illnesses can worsen rapidly and require immediate medical treatment.

Warning signs that should never be ignored include:

• Fever.
• Severe headache.
• Neck stiffness.
• Confusion or unusual drowsiness.
• Difficulty breathing.
• Rapidly spreading spots.
• Unusual bleeding from the gums or nose.
• A person who appears seriously ill.

The Link with Low Platelets

Platelets are tiny blood cells that help stop bleeding after an injury. If platelet levels become too low, the body may struggle to prevent small blood vessels from leaking.

People with low platelet counts may notice petechiae together with easy bruising, bleeding gums, frequent nosebleeds, or heavier-than-normal menstrual bleeding.

Low platelet counts, known as thrombocytopenia, can develop for many reasons, including viral infections, autoimmune diseases, liver disease, certain medicines, and disorders affecting the bone marrow. In rare cases, blood cancers such as leukaemia may also cause petechiae, but these spots alone do not mean someone has cancer.

Can Medicines Cause Petechiae?

Yes. Some medicines may affect blood clotting or reduce platelet levels, making petechiae more likely to develop. Certain antibiotics, anti-seizure medicines, blood-thinning medicines, and some anti-inflammatory medicines have all been linked to petechiae in some people.

Anyone who notices new petechiae after starting medication should speak to their doctor before stopping treatment, as the medicine may need to be reviewed or safely changed.

How Doctors Find the Cause

Because petechiae can have many different causes, doctors look at the person’s overall health rather than the spots alone.

They may ask about recent illnesses, injuries, medications, and any unusual bleeding. Blood tests are commonly used to check platelet levels, look for signs of infection, and assess how well the blood is clotting. Additional tests may be needed depending on the person’s symptoms.

Treatment depends on the underlying cause. Some cases need no treatment at all, while others require antibiotics, changes to medication, or specialist medical care.

Know When to Seek Help

Petechiae should never be ignored if they appear suddenly without an obvious cause or are accompanied by a fever, unusual bruising or bleeding, difficulty breathing, confusion, or rapidly worsening symptoms. Even without other symptoms, recurring or unexplained petechiae should still be checked by a doctor to rule out an underlying condition.

Affinity Health’s Day-to-Day Plan gives eligible members access to unlimited 24/7 telephonic nurse consultations, 24/7 telehealth GP consultations, and unlimited managed visits to a Medical Society via GP referral, making it easier to get professional medical advice when unexpected symptoms such as petechiae need prompt assessment.

Although petechiae are often harmless, they can sometimes be an early warning sign of a more serious health problem. Paying attention to these tiny spots and seeking medical advice when necessary can lead to earlier diagnosis, timely treatment, and better health outcomes.

About Affinity Health

Affinity Health is South Africa’s leading health cover provider, offering you a range of options at affordable rates, including access to the widest national provider network. We understand the importance of having medical insurance that meets your needs, budget, and lifestyle. Our healthcare products are designed to protect you and your family when it matters the most. We strive to give our members peace of mind and the highest standard of service. For more information, follow us on Facebook, Instagram and X.