What they look like: Tiny, flat, pinprick-sized red or purple dots. They don’t turn white when you press on them (unlike a rash that blanches). They often appear in clusters.
What causes them: Petechiae are tiny broken blood vessels under the skin. Common causes include:
Straining (from coughing, vomiting, or heavy lifting)
Certain medications (like blood thinners)
Infections (viral or bacterial)
Injury or friction
Vitamin deficiencies (C, K)
In rare cases, underlying bleeding disorders or blood cancers
When to worry: If petechiae appear suddenly, spread, or are accompanied by fever, bruising, or other symptoms, see a doctor promptly.
2. Cherry Angiomas
What they look like: Small, bright red, raised bumps. They look like little ruby domes on the skin. They’re usually harmless and become more common with age.
What causes them: Benign growths of blood vessels. They’re genetic and often run in families. No treatment is needed unless they bleed or you want them removed for cosmetic reasons.
When to worry: If a red spot changes rapidly, bleeds, or looks different from other spots on your body, have it checked.
3. Folliculitis (Infected Hair Follicles)
What they look like: Small red bumps, often centered around a hair follicle. May be itchy or tender. Sometimes have a white head like a pimple.
What causes them: Inflammation or infection of hair follicles. Common triggers include:
Friction from tight clothing
Shaving
Sweating
Hot tubs or pools
Bacteria, yeast, or fungi
When to worry: If spots are spreading, painful, or accompanied by fever.
4. Heat Rash (Miliaria)
What they look like: Tiny red bumps, often in clusters, appearing in areas where you sweat (neck, chest, groin, under breasts, in skin folds).
What causes them: Sweat ducts become blocked, trapping perspiration under the skin.
When to worry: Usually resolves on its own with cooling and drying. If it becomes infected or doesn’t improve, see a doctor.
5. Contact Dermatitis or Allergic Reaction
What they look like: Red, itchy patches or spots. May be raised, dry, or blistered. Appears after contact with an irritant or allergen.
Common triggers:
Poison ivy, oak, or sumac
New soaps, lotions, or detergents
Jewelry containing nickel
Latex
Certain fabrics
When to worry: If rash is widespread, severe, or accompanied by swelling of the face or difficulty breathing (seek emergency care).
6. Hives (Urticaria)
What they look like: Raised, red, itchy welts that can appear anywhere on the body. They often change shape, move around, and come and go.
What causes them: An allergic reaction to food, medication, insect bites, or environmental triggers. Sometimes the cause is unknown.
When to worry: If hives are accompanied by swelling of the lips, tongue, or throat, or difficulty breathing—seek emergency care immediately.
7. Keratosis Pilaris (“Chicken Skin”)
What they look like: Small, rough, red or skin-colored bumps, usually on upper arms, thighs, cheeks, or buttocks. Often looks like permanent goosebumps.
What causes them: A buildup of keratin blocking hair follicles. It’s harmless, genetic, and often runs in families.
When to worry: It’s not dangerous. Moisturizing and gentle exfoliation can help.
8. Spider Angiomas
What they look like: A bright red spot with tiny blood vessels radiating outward like spider legs. They can appear on the face, neck, or chest.
What causes them: Benign in most cases. Sometimes linked to hormonal changes (pregnancy, birth control). In rare cases, multiple spider angiomas can indicate liver disease.
When to worry: If you have many of them, especially if you have other symptoms like fatigue, yellowing skin, or abdominal swelling.
9. Viral Rashes
What they look like: Varies widely. Many viral illnesses cause red spots or rashes. Examples include:
Measles: flat red spots that start on the face and spread
Chickenpox: itchy, fluid-filled blisters
Hand, foot, and mouth disease: red spots on hands, feet, and mouth
Fifth disease: “slapped cheek” rash on face
When to worry: If rash is accompanied by fever, difficulty breathing, or confusion.
10. Skin Cancer (Less Common, But Important)
Some skin cancers can appear as red spots or growths:
Basal cell carcinoma: Pearly, pink, or red bump that may bleed
Squamous cell carcinoma: Scaly red patch, firm bump, or sore that doesn’t heal
Melanoma: Can be red, pink, or colorless, not always dark
When to worry: If a spot is new, changing, bleeding, not healing, or looks different from other spots on your body—see a dermatologist.
How to Tell What You’re Dealing With
Feature Possible Causes
Flat, tiny, non-blanching Petechiae
Raised, bright red, dome-shaped Cherry angioma
Around hair follicles Folliculitis
Itchy, raised welts that come and go Hives
After new product or plant contact Contact dermatitis
Rough bumps on arms/thighs Keratosis pilaris
Spider-like red spot Spider angioma
With fever Viral rash, infection
Bleeding or not healing Possible skin cancer
When to See a Doctor
Make an appointment if:
Spots appear suddenly and spread rapidly
You have fever, fatigue, or other symptoms
Spots are painful, bleeding, or not healing
You’re concerned about skin cancer
You have petechiae that don’t go away or are accompanied by bruising
You have other signs of allergic reaction (swelling, difficulty breathing—this is an emergency)
A Gentle Reminder
Your skin is your body’s largest organ—and it’s remarkably good at sending signals. Most red spots are harmless, but paying attention to changes is always wise.
When in doubt, get it checked out. A few minutes with a dermatologist can give you peace of mind—or catch something early when it’s most treatable.
