What are the Causes of a Petechial Hemorrhage?

A petechial hemorrhage is a type of bruise-like bleeding under the skin that has causes ranging from simply hitting a shin on the edge of a coffee table to serious illnesses that require medical care. Unlike a typical bruise, a petechial hemorrhage creates a pattern of small red dots called petechiae. This condition may be mistaken for a rash, although it does not produce the chronic itching, blistering and swelling that often accompany a rash.

Injuries are among the least serious causes of a petechial hemorrhage. Women are more likely than men to develop bruising on the skin after an injury, though genetics also plays a role in determining how easily a person bruises. The intense journey from the womb during a vaginal birth also may cause these hemorrhages as pressure is placed on a newborn baby's delicate skin.

After a bump or blow, bleeding occurs beneath the skin. For older adults, even a minor bump can cause this type of damage as aging capillaries become prone to rupturing and thinning skin loses the protective fatty layer that once helped shield the blood vessels. Depending on the severity of the injury, the hemorrhage generally disappears within a short period of time as the body reabsorbs the blood.


Another minor cause of a petechial hemorrhage is medication. Some drugs, such as aspirin and warfarin, thin the blood and reduce clotting. Herbal medications may also affect clotting, increasing a person’s chances of developing bruises and petechiae. Before taking herbal medications, people should always discuss the side effects with a doctor or pharmacist.

Disease is among the most serious causes of a petechial hemorrhage. Lupus, leukemia and multiple myeloma are some examples of conditions that cause these hemorrhages. In most cases, however, other symptoms also exist, and those symptoms — not the petechial hemorrhage — are typically what prompt a person to seek treatment.

For example, a person who has lupus may have joint pain, vision problems and bouts of diarrhea. Early signs of leukemia include high fevers, infections, swelling in various parts of the body and bleeding of the nose or gums. Bone pain, chronic fatigue and shortness of breath are indicative of multiple myeloma. If any these symptoms occur, especially in tandem with petechiae, a person should seek medical attention. Generally, doctors take a medical history, perform a physical exam and evaluate blood work to determine the cause of a petechial hemorrhage.

Petechiae as a symptom of disease may not be treatable without also treating the underlying illness, but preventing injury-related petechial hemorrhages is possible. Recommendations for preventing such injuries include reducing household clutter and removing objects that can lead to accidents that result in bruising. People also are advised to avoid prolonged sun exposure that can further damage the skin.


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I had a petechial hemorrhage in my eye a few weeks ago that came on so suddenly I didn't even know it had happened. It looked horrible and felt like something was on my eyeball making it feel scratchy. My doctor said it was the result of a coughing spell, which made sense because I had a cold. It was not pleasant, but it healed pretty quickly.

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