One of the most commonly discussed causes of tiny red or purplish dots is petechiae. These spots are usually very small, often described as pinpoints, and they sit flat against the skin rather than forming raised bumps. Petechiae occur when tiny blood vessels called capillaries rupture and leak small amounts of blood beneath the skin’s surface. Unlike many rashes or allergic reactions, these spots do not fade or turn pale when pressed. This feature alone often helps distinguish them from other skin changes. In many everyday situations, petechiae develop due to increased pressure inside the body. Intense coughing fits, vomiting, heavy lifting, prolonged sneezing, or even crying can create enough pressure to cause capillaries to break. They can also appear after childbirth, strenuous workouts, or activities that strain the body more than usual. Heat exposure, sunburn, and friction from tight clothing or repetitive rubbing can also contribute. Certain medications, such as blood thinners, aspirin, or long-term steroid use, may increase susceptibility by making blood vessels more fragile. In these cases, petechiae are not dangerous and usually resolve on their own as the body reabsorbs the leaked blood.
