red spots on skin

Red Spots on Skin: What’s Causing Them and How Can They Be Treated?

Red spots on your skin can be caused by a number of things, and you’ll need to pinpoint the cause to treat the spots effectively. In this blog, we discuss common reasons for red spots on the skin and how to treat them. 

What Causes Small Red Spots on the Skin? 

There are many reasons you may be seeing red spots, splotches, marks, or dots on your skin, either in isolated spots or as wide breakouts. Red rashes can emerge due to allergic reactions like contact dermatitis, or for numerous other reasons. Pityriasis rosea, acne, atopic dermatitis, and psoriasis are some of the most common skin conditions that may cause small red spots. In addition to skin conditions, there are many infections, including viral, bacterial, and fungal infections, that can cause red spots on your skin. These infections include chickenpox, rubella, ringworm, and impetigo, which we’ll cover later on this blog. Finally, the small red dots on your skin may not be an external rash at all, but petechiae, or tiny spots of bleeding under your skin. We’ll cover that in more detail later on in this blog. 

It can be a bit overwhelming to learn there are so many possible causes, so we will begin by breaking down some of the most common conditions that cause red spots first. 

7 Conditions that Cause Red Spots on the Skin 

1. Pityriasis Rosea

Pityriasis rosea is a rash that is most commonly recognized by a herald patch (also known as a “mother” patch), which is the only noticeable red patch for one to two weeks. A herald patch can appear pink to violet in color depending on your skin tone, and it can range from very small up to four inches. 

Following the mother patch, other patches will appear on your torso, upper arms, thighs, or neck. These newer patches, known as daughter patches, are smaller than the mother patch and are oval shaped. Patches caused by pityriasis rosea can last up to ten weeks. This condition is neither contagious nor especially serious, and although it usually clears up on its own, your dermatologist may prescribe medications to ease your symptoms. 

2. Acne

Acne is an extremely common skin condition that affects millions of Americans. Although teenagers in particular are more likely to experience acne, people of all ages may be affected by it. The four types of acne are comedones, papules or pustules, nodules, and cystic acne. Acne has many possible causes, including excess oil production, clogged pores, bacteria, and inflammation, or a combination of these factors. Acne can lead to skin discoloration and permanent scarring. While acne is not harmful, it can affect a person’s self esteem. 

The color of the acne may indicate which type of acne it is. If the bumps are white, it may be merely a clogged pore, while red bumps signal inflamed acne, including papules, pustules, or nodules.

3. Keratosis Pilaris

Like acne, keratosis pilaris is a frequent pediatric skin condition that also affects adults. This outbreak of excess keratin, a protein that protects the skin from infections, creates a sandpaper-like texture on the skin that can sometimes have a reddish tinge to it, particularly when irritated or scratched. It often develops on the upper arms, the front of the thighs, and the buttocks. 

Keratosis pilaris is harmless, and many people may have it without even realizing it if they never bother to get it diagnosed. There are a variety of at-home ways to decrease the effects of keratosis pilaris, including exfoliation, using a loofah to remove the top layer of dead skin, and keeping your skin moisturized.

4. Atopic Dermatitis (Eczema)

If you frequently find yourself breaking out in red spots, you may have atopic dermatitis, the most common type of eczema. This is a skin condition that affects the skin’s ability to protect from allergens, irritants, and bacteria. Atopic dermatitis causes itchy reddish rashes on areas like the neck, wrists, and arms and legs. It also is a common pediatric skin condition. As a chronic condition, atopic dermatitis doesn’t necessarily “go away,” but since its flare-ups are usually triggered by some type of allergen or irritant, they can be managed with proper care.

If you have a family history of atopic dermatitis or suspect you have it, reach out to your dermatologist. Although atopic dermatitis cannot be cured, there are ways to manage it and to reduce the discomfort caused by symptoms. 

5. Contact Dermatitis (Allergies or Irritants-Caused)

Another form of rash that may cause red spots or patches is contact dermatitis. The difference between atopic and contact dermatitis is that unlike atopic dermatitis, which is a genetic underling condition, contact dermatitis is triggered by external substances, like irritants or allergens, and can happen to anyone. Most “allergic reactions” that affect the skin are actually contact dermatitis. 

  • Allergic contact dermatitis is a skin reaction to an allergen, and it often results in a red rash. Allergens that trigger allergic contact dermatitis will probably vary based on someone’s own allergies, but common allergens may include (but are not limited to) ingredients in food, medications, fragrances, cosmetic products, latex, pollen, pet dander, and certain metals in cheap jewelry. 
  • Irritant contact dermatitis is a skin reaction to an irritant, resulting in a rash. Irritants can include things like soap, detergents, or cleaning products with strong ingredients or acids. Because anything that irritates the skin can result in a rash, this form of contact dermatitis is even more common. 

Contact dermatitis can prove to be very miserable if left untreated, as the leathery red welts that result can bleed, ooze, and become infected easily. Both atopic and contact dermatitis can be treated with home remedies, but you should visit your dermatologist if symptoms persist. 

6. Psoriasis 

Psoriasis is an autoimmune skin condition that causes skin cells to multiply 10 times faster than necessary, creating skin cell build-up that shows up as bumpy red patches and scaly white skin. 

There are many types of psoriasis that can leave you with red spots on your skin. However, the most common type of psoriasis is plaque psoriasis, affecting approximately 6.7 million adults in the US. Plaque psoriasis can be considered mild, moderate, or severe depending on the percentage of the body affected. 

Psoriasis isn’t the only autoimmune condition known to cause rashes. Some other diseases that may cause rashes include lupus, lichen planus, and dermatomyositis.

7. Rosacea

Rosacea is an ongoing skin condition that provokes redness on the face and cheeks. Although it can affect anyone, it most commonly affects fair-skinned women. Rosacea’s appearance can vary in different people and there are at least four main types of rosacea. For many, rosacea causes either persistent redness (like a blush), or frequent blushing that comes or goes. Others may experience either bumps that resemble acne, or red patches that look like a rash. 

The cause of rosacea is unknown, although it is thought to possibly be an autoimmune condition. If you think you may have rosacea, your dermatologist may be able to diagnose the condition and suggest rosacea treatment options if needed.

What Viruses Cause Small Red Spots? 

Certain viruses can cause red spots on your skin, and you’ve probably heard of many of them. These include (but are not limited to) chickenpox, roseola, rubella, measles, fifth disease, and cold sores. While they all produce red spots, there are other ways to tell the difference between these viruses.

  • Chickenpox

We all know about chickenpox, but did you know the fluid-filled blisters start out as an itchy, red rash? This rash starts on the face, back, and chest, but can quickly spread to other areas of the body. 

  • Roseola

Roseola first starts as a high fever that often lasts up to a week. Once the fever has set in, a spotty pink rash, which is slightly raised, begins to cover the stomach or chest. This rash often fades within 24 hours.

  • Rubella

Rubella, which is also known as German measles, starts as a rash on the face before spreading to other areas of the body. This rash only lasts about three days but may be accompanied by a fever.

  • Measles

Measles, not to be confused with German measles, starts with a rash forming around the ears and mouth. The rash begins as red, flat spots, but can later turn into white spots that are raised on top of existing red spots. These start to form one large spot as the measles progress.

  • Fifth Disease

Fifth disease, which is often referred to as slapped cheek disease, is first noticeable when a red rash appears on your cheek (hence the nickname). Once the rash on the face has disappeared, a light pink rash that looks like lace appears on the chest and arms. 

  • Cold Sores

Cold sores, also called fever blisters are caused by the herpes simplex virus (HSV) and are small red blisters that appear around the mouth. Occasionally, they may form on the nose or cheeks as well. They often are gained through contact with another person carrying the virus, but other factors like colds, allergies, and even stress can trigger them. Cold sores usually go away on their own within a couple weeks, but people with compromised immune systems may want to seek medical attention if they get this virus.

Fungal Infections that Cause Rashes

Ringworm is a highly contagious, fungal skin infection that appears as a red blotchy rash with a raised border around it. This fungus causes rashlike conditions like athlete’s foot and jock itch, and it may require prescription or over-the-counter antifungal medication or topical cream for treatment.

Bacterial Infections that Cause Rashes

The following bacterial infections may cause red rashes, among other symptoms:

  • Scarlet fever
  • Impetigo
  • Lyme disease
  • Boils
  • Cellulitis

Several of these skin infections are common in children, with impetigo being very contagious, especially for children in contact sports. If you or your child appears to have a rash that may be connected to a bacterial skin infection, you should contact your dermatologist right away. Depending on the infection, topical or oral antibiotics may be prescribed to manage symptoms. 

What Are Other Causes of Rashes? 

Rashes consisting of small red spots on skin may form for many reasons that have nothing to do with underlying skin conditions, viruses, or infections. Because they are primarily a response to the skin being irritated, rashes can be caused by medications, or by irritants (such as weather or poison ivy). If your skin pores get clogged while sweating, you may develop a heat rash, although it usually goes away once the skin cools down. There are a variety of common skin rashes that affect children specifically, and rashes are often the cause for spots on toddlers. Some medications most known for causing rashes include antibiotics, NSAIDs, and antiseizure medication. 

Irritants that may trigger a rash can be difficult to identify because they can affect people very differently, but dust mites, latex, and animal dander are often found to be the cause of allergic rashes. Certain cosmetics, plants, and nickel may also be to blame. See the contact dermatitis section above for more details about rashes that occur due to allergies or irritants. 

What are Petechiae, and How Are They Different from a Rash? 

Petechiae, which develop underneath the skin, are not a rash, and they are not caused by one sole condition. These red or purple dots on your skin are caused by broken capillaries and may be a sign of an underlying condition, like leukemia. However, other factors, such as medication side effects, infections, or vitamin deficiencies can cause petechiae, so it is not always a sign that something is seriously wrong. 

Petechiae spots are typically flat and can be purple, red, or brown in color. These red spots on the skin are caused by broken blood vessels and are often found on the legs, mouth, stomach, butt, eyelids, legs, and arms. 

Petechiae vs. Purpura

Petechiae are usually very small and dotlike (less than 2 mm in size), so if the red or purple discoloration area is larger, the spots may actually be purpura. Both petechiae and purpura result from similar causes and are related to blood leaking under the skin. As its name indicates, purpura very often looks more purple than red, the color changing as the blood cells are broken down.

How can you tell the difference between petechiae (or purpura) and a rash? Because a rash is on the surface of the skin, it will turn pale or lighter if pressed on, while petechiae (which is underneath the skin) will remain the same color. There are many reasons petechiae may appear, but because it may be the sign of a more serious underlying condition, you should seek medical attention if you spot signs of it, especially if it appears to be spreading quickly.

Can Stress Cause Tiny Red Spots or Rashes?

Yes, stress can cause tiny red spots or rashes. Hives can occur anywhere on your body and can range in size, from a small pen mark to the size of a dinner plate. Hives can last up to six weeks, but there are treatment options to relieve your symptoms, especially if you experience chronic hives

Stress can also be related to acne breakouts, as heightened cortisol triggers the skin to increase oil production, which can result in breakouts in people already prone to them.

How Do I Treat Red Spots on My Skin?

How you treat the red spots on your skin will be based on their cause, which we now know can be anything from a virus to a persistent skin condition like psoriasis to contact dermatitis from an external irritant. The first step to effectively treating red spots on the skin is to have your dermatologist conduct a skin exam. This will help identify the cause of the red spots so that an appropriate treatment plan can be implemented.

For many causes of red spots on skin, at-home treatments can help alleviate symptoms. The most common way to reduce the need to itch your skin (which can lead to tears and infection), is to avoid overheating. This means avoiding intense exercise and taking lukewarm showers until the rash has disappeared. It’s also important to protect the affected skin from sunlight and to use fragrance-free soaps and moisturizers to keep your skin hydrated.

Antihistamines are one of the most common medications prescribed to treat red spots. This can help alleviate itching and discomfort. Other medications, like corticosteroids and skin barrier creams, are used to control itching, reduce redness, and repair the skin’s barrier. Depending on the cause of your red spots, antibiotics, prednisone, or immunosuppressants may be prescribed.

When Should I be Worried About a Rash or a Red Spot on My Skin?

Although skin rashes are often more annoying than harmful, there are some that can be serious. You should seek immediate medical attention if: 

  • The rash affects the eyes
  • The rash is oozing or blistering
  • Blue, red, or purple dots appear in the affected area
  • The rash is accompanied by a fever, dizziness, shortness of breath, a stiff or swelling neck, or vomiting. These symptoms, along with rapid spread, may be an indicator of a serious infection or an allergic reaction

Even if your rash doesn’t seem to require emergency medical help, your dermatologist may be able to provide some insights on the source of the rash or red spots and offer helpful advice for how you can care for it at home. 

Book Your Appointment

If you have red spots on your skin, our expert dermatologists here at Vujevich Dermatology Associates can conduct a skin examination to identify the cause and recommend the appropriate treatment.

Vujevich Dermatology Associates offers medical, surgical, and cosmetic dermatology from some of the most highly trained physicians and clinicians in the greater Pittsburgh area. You can reach our team at 412-429-2570 or visit our contact page to see all of our locations. You may also use the form below to book your appointment. You can also follow us on Facebook to see what’s new in the world of dermatology. 

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