Although the question of whether or not stress causes petechiae often remains unanswered, many people do feel that in certain cases there may be a link between the two.
What is Petechiae?
Petechiae appears as a rash that develops anywhere on the body when small blood vessels, called capillaries, break causing superficial bleeding under the skin or in the body's mucus membranes. The resulting round spots are very small, typically measuring between one or two millimeters, which are about the size of a pinpoint. The tiny hemorrhages are usually flat to the touch remaining beneath the skin. They are generally red in color but they can also be:
Appearing as one small spot or a cluster of spots, petechiae commonly appears on a person's ankles or feet. However, it can appear on any area of the limbs, torso or face. Other common names for this skin condition include:
- Petechiae rash
- Petechial skin rash
- Purpuric rash
- Plural petechiae
One way to determine if a rash is petechiae is applying pressure to the area. If pressing on the skin does not turn the area lighter, or whitish, the spots are petechiae.
Causes of Petechiae
There are more than eighty known causes of petechiae ranging from coughing to life threatening illnesses or conditions. Examples of the more common causes of petechiae include:
- Localized injury or trauma which typically results in stress petechiae
- Diseases of the autoimmune system
- Allergic reactions
- Very high levels of blood platelets, known as thrombocythemia
- Infections affecting the blood's ability to clot
- Malignances of the bone marrow that cause blood platelet numbers to be very low
- Sepsis or other infections of the bloodstream
- Henoch-Schonlein Purpura - also known as HSP
- Idiopathic Thrombocytopenic Purpura - also known as ITP
- Radiation treatments
- Violent vomiting
- Violent coughing
- Viral infections such as some types of influenza and enteroviruses
- Drugs and medications that are anticoagulants
Stress Causes Petechiae in High Velocity Injuries
A specific type of petechiae, known as stress petechiae, occurs when there is a high velocity impact to the skin. According to Oski's Pediatrics: Principles & Practice by Julia A. McMillan, Ralph D. Feigin, Catherine DeAngelis and M. Douglas Jones, this type of petechiae rash is common in cases of child abuse. It occurs when a child is forcefully hit with an open hand. The impact of the slap on the child's skin leaves a clear outline of petechiae spots of the fingers and hand of the person that struck the child. A petechiae outline typically forms with any injury caused by a high velocity force.
Stress petechiae also occurs when a person has a severe bout of vomiting or coughing.
Petechiae with a Fever in Children
In many cases of children with petechiae, the cause is never fully determined. Often the tiny spots appear on the face after a significant bout of coughing, vomiting or crying and disappear after a short time. However, if a child has a fever with petechiae, take the child to a doctor right away as it could be a sign of a bacterial infection in the bloodstream.
Many people who experience outbreaks of petechiae feel that when they are under times of severe or chronic stress, their episodes of petechiae occur more frequently or to a greater degree. Although there is not any medical evidence to support this, stress affects every system and organ in the body. It causes other types of skin disorders such as stress related hives and possibly cherry angiomas.
Whether or not stress causes petechiae, learning to reduce your stress levels is important to your overall health. Taking the time to learn stress reduction methods such as meditation, deep breathing techniques or progressive muscle relaxation may reduce your stress levels. However, simple activities like taking a walk, listening to relaxing music or playing with your pet also have a positive effect on lowering your levels of stress.