Two terms which refer to bleeding that takes place in the skin are purpura and petechiae. In general, petechiae refer to a small lesion while purpura is a term that refers to a large lesion. In specific conditions, purpura might be blatant. In all conditions, petechiae don’t lighten once pressed.

Even if bleeding under your skin, diagnosed by experts as one of the various conditions like purpura and petechiae, is a sign of an extensive number of medical turmoil. It can be the sign of the progress of the serious medical condition. Both are caused by small amounts of bleeding under the surface of your skin and emerge as red spots, sooner or later fading to brown and blue.

Purpura Overview

Purpura is characterized by tiny spots on your skin’s surface, usually four to 10 millimeters in size. Some develop bigger patches of one centimeter or more than. Most of the time, the tiny spots can emerge on mucous membranes, like for example inside your mouth.

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Purpura is likely to happen in bunches, which are found in one area. Sometimes it covers a huge portion of your body. The bigger the rash is, the more bleeding will be.  Not like other types of rashes, this will not change color or go pale once pressed. The rash looks like a small cluster of bruises. However, the skin shouldn’t be irritated or itchy.

Purpura is not a condition, rather a symptom. To know the cause, a doctor should run an array of medical examinations. These examinations will check the nutrition of the patients, the platelet levels, and a possibility of infection, inflammation as well as the wellbeing of the blood vessel.  Treatment for this symptom normally needs treating the underlying cause.

Kinds of Purpura

General practitioners break rashes into two classifications based on the level of platelets. Platelets are fragments of cells that play an important role in blood clotting, preventing perilous bleeding.

  1. Nonthrombocytopenic Purpuras: Normal platelets level, indicating another cause.
  2. Thrombocytopenic Purpuras: Low counts of platelet, indicating an underlying blood clotting disorder.
  3. Low level of blood platelet can cause too much bleeding that can be caused by many factors such as:
  • HIV infections
  • Bone marrow transplant
  • Cancer
  • Chemo
  • Some treatments

Henoch-Schonlein Purpura is the most-researched type of purpura. It is common amongst children. Respiratory infections often precede this kind of purpura. Signs often vanished after a few days. However, some people experiencing this type of purpura experience dangerous inflammation, which results in kidney problems.

ITP or Idiopathic thrombocytopenic purpura is a kind of purpura with a mysterious cause. People with ITP experience platelet destruction in their bloodstream that leaves them more susceptible to bleeding, which creates a typical rash.

Purpura: What are the Causes?

To cure purpura, general practitioners should verify its cause. Purpura that doesn’t lower platelet counts has many causes. It also has risk factors like:

  • Infections and disorders present from birth, which cause abnormalities in the production of blood like rubella and Ehler’s –Danlos syndrome.
  • Amyloidosis that causes amyloid plaque to gather in your body
  • Blood vessel decline related to age.
  • Scurvy or Vitamin C deficiency like Hepa C and HIV

ITP happens once your body attacks its platelet, augmenting the possibility of bleeding as well as purpuric rashes. In a newborn with ITP mother, reduced platelet level can also result in purpura.

Disorders which damage the function of bone marrow might limit the capability of the body to make platelets, and attack bone marrow, like:

  • Aplastic anemia
  • Bone marrow tumors
  • Myeloma
  • Leukemia

Symptoms and Signs of purpura

The symptom of this condition is a red rash on the surface of your skin. The rash can emerge anywhere on your body like on mouth lining. Sometimes the signs that accompany purpura can assist determine its cause.

People who experience purpura with the following signs must seek medical treatment right away:

  • Low level of platelet, which may result in increased bleeding after a wound, bleeding nose or gums, or blood in bowel movements or urine.
  • Swollen, sore joints, specifically in the knees and ankles
  • Gut issues like vomiting, nausea, stomach pain as well as diarrhea
  • Excessive tiredness
  • Kidney issues, specifically blood or protein present in your urine

Purpura Complications

Because this condition can signal a more complicated issue, it may result in complications when taken for granted. If purpura is due to blood clotting condition, the uncured chaos can lead to life-threatening bleeding. Immediate diagnosis and cure of the main cause can minimize the risk of complications.

People suffering from Henoch-Schonlein purpura have the possibility of damaging their kidney. It can result in dialysis or kidney transplant.

Prevention and Risk Factors of Purpura

Purpura is not an illness, but a sign of another medical issue. The only efficient way of preventing this condition is to avoid the conditions which cause. As some of the conditions aren’t because of lifestyle factors, there are things you can do to minimize the risk of this condition.

Purpura Risk Factors

  • Blood clotting issues because of disease or medication
  • Infectious illnesses, specifically amongst kids and senior
  • Poor nutrition if it results in Vitamin C deficiency
  • Some types of cancer like myeloma and leukemia
  • Advanced age

Diagnosing Purpura 

The red spots are relatively easy to distinguish from other types of rashes. Normally purpura isn’t accompanied by itching or other skin problems. But, finding the cause of this condition can be complicated.

  • General practitioners often ask questions like:
  • Do your loved ones experience the same signs?
  • Aside from this, do you have other signs?
  • How long have you had the rash for?
  • Do you experience this condition before?
  • Do you take some form of medications?

A routine examination, starting from CBC help assess the cause of this condition. A complete blood count will show whether you have low platelets count and whether other underlying infections are happening.

Purpura Treatments

Not all types of purpura need an immediate cure. General practitioners often opt to see the patient for other signs to know if they vanish on their own. Kids experiencing HS purpura gets well on their own without treatment. When a cure is needed, it’s not because of the rash. Treatment is required for causes like leukemia.

Cure for Other Types of Purpura

The cure for other types of purpura focuses on handling the underlying cause such as choices like antiviral drugs, chemo, steroid medications, surgery as well as antibiotics.

Corticosteroids: This help increases the level of platelet through minimizing immune system activity. This drug is given for two to six weeks to make sure the platelets go back to a safe level. The harmful effects of using this drug for a long span of time include bone loss, cataracts as well as weight gain.

Intravenous immunoglobulin: Once the cause of purpura is significant bleeding, this drug can help augment platelet count. Normally this treatment is only effective in short term.

Side effects of this drug include a headache, fever, and nausea.

Romiplostim and eltrombopag: These are the newest treatments administered to people with ITP. They encourage bone marrow to generate more platelets.

Harmful effects include headaches, dizziness, muscle pain and joint pain, vomiting, nausea, increased the risk of blood clot, as well as acute respiratory distress syndrome.

Rituxan: This helps in reducing the immune response. It is utilized to cure thrombocytopenic and patients don’t respond to corticosteroid. Harmful effects include low blood pressure, rash, fever and sore throat.

In case the purpura is due to medical condition, which can’t be treated, continuing checking of platelet counts and organ functioning is highly advisable.

Petechiae Overview

Petechiae is a small red, purple spots like purpura usually take place on your stomach, legs and arms, as well as buttocks.  That also happens on the eyelids or inside the mouth. This spot can be a symptom of many diverse conditions, some are serious, and some are minor. Spots also emerge as respond to some treatments.

Though this condition appears like a rash, they are actually due to bleeding under your skin surface. Petechiae will not turn white once you press it, not like a rash that turns pale.

What are the Possible Causes of Petechiae

This condition is developed when capillaries or small blood vessels break open. Once capillaries break, blood escapes into the skin. Reactions to drugs and infections are common causes of this condition.

Some conditions that might lead to petechiae include:

Endocarditis: An infection of the inner lining of your heart includes signs of chills, fever, achy joints, fatigue, pale skin, cough and muscle pain.

Hantavirus Pulmonary Syndrome: A viral infection that causes flu-like signs and breathing issues. Other signs include muscle aches, fever, and fatigue.

CMV: A medical disorder due to a virus. Other signs include fever, fatigue, muscle aches and sore throat.

Injury: Skin damage such as from car accident, hitting or biting can lead to petechiae to form, skin friction from carrying heavy stuff, tight strap from garments can cause petechiae. Sunburn can also result in petechiae.

Leukemia: A cancer of bone marrow, other signs include fatigue, chills, fever, weight loss, bleeding, swollen glands, night sweat, and nosebleeds.

Meningococcemia: Type of bacterial infection. Other signs include a headache, fever, and nausea as well as muscle pain.

Mononucleosis: This is a viral infection which is transmitted via saliva as well as other fluids present in your body. Other signs include a sore throat, extreme fatigue, swollen tonsils, swollen lymph nodes as well as headaches.

Are there any complications?

This condition doesn’t cause complications, not like the purpura. What is more, they would not leave scars. A number of the condition which causes petechiae can have complications take account of the following:

  • Kidney, liver, heart, lungs, spleen damage, aside from this, it can also damage other body organs.
  • Heart issues
  • Infection in other portions of the body

What are the Treatment Options Available?

When a viral or bacterial infection causes this condition, your skin must clear up when the infections get better. Once a treatment or drug is the cause of this condition, this sign must vanish the moment you stop using the drug.

Check the spot over and over again to determine if there are some changes happen. In case the number of spots augments, there is a possibility that you are suffering from a bleeding disorder.

Before recommending a cure, your general practitioner will determine what is causing your condition and other signs. Your physician might recommend any of the drugs listed below to cure the cause of the petechiae:

  • Your doctor might recommend some antibiotics to cure a viral or bacterial infection
  • Corticosteroid to reduce swelling and inflammation
  • Your doctor may give you drugs that suppress the immune system such as methotrexate like Rheumatrex and Trexall, azathioprine like Imuran and Azasan as well as cyclophosphamide.
  • Biological therapy, chemotherapy, as well as radiation to cure cancer

Aside from the treatments mentioned above, you can also try some of these home remedies to ease the symptoms:

  • Take enough rest
  • Take OTC pain relievers such as acetaminophen and ibuprofen
  • Drinks lots of water to avoid dehydration

Ways to Avoid Petechiae from Occurring

To avoid this condition from taking place, you have to keep away from the conditions which can cause petechiae. However, you cannot stop all of the potential underlying causes of the spots.

If you have had this reaction to a medication in the past, make sure to tell your doctor about it. Your physician will perhaps suggest that you stop using this drug.

  • To avoid infections that lead to petechiae:
  • Wash hands often using anti-bacterial soap, or use a hand sanitizer that is alcohol based
  • Keep away from sick people
  • Avoid sharing sunglasses, personal utensils as well as items
  • Ensure to clean countertops
  • Safe sex is highly advisable


In general, purpura and petechiae are small areas of bleeding on your skin surface because of a dysfunctional or low level of platelets and other bleeding issues. These also occurred with swelled blood vessels. Other causes include drug allergy and diverse blood diseases; however, it’s not normal. So it is important to visit your doctor right away if these conditions happen to you.


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