Tiny red or purple spots beneath the eyes, known as petechiae, can be alarming but are often benign. Petechiae are pinpoint areas of bleeding that occur when capillaries, the smallest blood vessels, break and leak blood into the surrounding skin. Because the skin around the eyes is exceptionally thin, these spots become easily visible. Understanding the potential causes, ranging from simple physical strain to less common systemic issues, provides clarity about this concern.
Causes Related to Localized Pressure
The most frequent reason for red dots under the eyes relates to a sudden, intense increase in pressure within the head and chest. This physical stress forces blood pressure to spike momentarily, which can rupture the fragile capillaries in the periorbital area. These spots are often temporary and represent a mechanical injury to the blood vessels.
Common activities that generate high pressure include severe coughing fits, forceful sneezing, or intense vomiting. Strenuous physical exertion involving straining, such as heavy weightlifting, intense crying, or childbirth, can similarly trigger these capillary breaks. Because the blood leaks under the skin, these spots do not blanch or turn white when pressed. Typically, these pressure-induced spots resolve on their own within a few days as the body reabsorbs the leaked blood.
Skin Conditions and Allergic Reactions
Localized inflammation or irritation of the skin around the eyes can also lead to these red spots. One common mechanism is contact dermatitis, an inflammatory reaction that occurs when the skin encounters an irritant or allergen. The delicate skin of the eyelids can react to new makeup, cleansers, fragrances, or laundry detergents, causing irritation and sometimes a rash.
Chronic inflammation from conditions like eczema or atopic dermatitis can also cause flares around the eyes. These flares often cause intense itching, leading to vigorous rubbing of the eyes. The friction from excessive eye rubbing, whether due to a skin condition or an allergic reaction like allergic conjunctivitis, directly damages the superficial capillaries. This mechanical trauma, combined with inflammation, results in the visible red dots.
Underlying Medical Conditions and Medications
While most cases are linked to pressure or irritation, red spots can occasionally signal a less common internal health issue. Certain systemic infections, particularly bacterial ones like strep throat or viral illnesses like mononucleosis, can cause petechiae due to inflammation of the blood vessel walls. When caused by infection, these spots are typically accompanied by other symptoms such as fever, fatigue, or feeling unwell.
Conditions that affect the blood’s ability to clot also increase the risk of capillary leakage, even from minor stress. Thrombocytopenia, a low platelet count, or certain platelet disorders can lead to easy bruising and the appearance of petechiae. Some medications can also contribute to the development of these spots. Blood thinners and antiplatelet drugs, such as warfarin or aspirin, reduce the blood’s clotting ability, making capillaries more vulnerable to rupture.
Guidance on When to Consult a Doctor
Seeking professional medical evaluation is important if the red dots under your eyes do not fade within a few days or if they are accompanied by other symptoms. If the spots begin to spread rapidly across other areas of the body, this may suggest a more widespread issue requiring attention.
A consultation is warranted if the petechiae appear alongside signs of systemic illness. These signs include a high or persistent fever, unexplained bleeding from the gums or nose, or new, severe bruising. Any sudden change in mental status, confusion, or signs of severe infection should prompt immediate medical care. Only a healthcare professional can accurately diagnose the underlying cause and determine if treatment is necessary.