Seeing small red dots appear on your face after intense crying, a bad cough, or vomiting can be startling. This common, localized physiological reaction is due to temporary and intense physical strain. It is a harmless, surface-level effect of pressure on the delicate blood vessels of the face and is usually no cause for concern. These spots are essentially tiny bruises resulting from the body managing a sudden surge of internal pressure.
The Mechanism of Capillary Rupture
The appearance of these red spots is linked to a sudden spike in pressure within the chest and abdomen. When a person cries intensely, coughs, or strains, they often instinctively perform the Valsalva maneuver. This involves forcefully exhaling air while the throat and mouth are closed, significantly increasing internal pressure.
The increased pressure prevents veins in the head and neck from efficiently draining blood back toward the heart, causing blood to pool in the smaller vessels of the face and eyes. Capillaries, the fragile, microscopic blood vessels close to the skin’s surface, are not built to withstand this sudden back-pressure. When the pressure overwhelms the capillary walls, they rupture and leak tiny amounts of blood into the surrounding skin tissue, creating the red dots. The phenomenon is localized to the face and upper chest because these areas contain highly delicate vessels.
Identifying the Spots: Petechiae and Purpura
The small red spots that appear after intense straining have specific medical names based on their size. Pinpoint red dots, measuring less than three millimeters, are known as petechiae. Spots ranging from three to ten millimeters are referred to as purpura. Both are forms of superficial bruising caused by burst capillaries.
A key characteristic distinguishing these spots from a simple rash is that they are “non-blanching.” This means pressing on the spot will not cause it to fade or turn white. This reaction confirms the spots are caused by blood that has leaked out of the vessel and into the skin tissue. In the context of crying or straining, these spots are considered benign signs of temporary pressure trauma.
Duration, Management, and When to Consult a Doctor
Petechiae caused by straining are temporary and fade on their own, much like a small bruise. They typically disappear within a few hours up to a couple of days, depending on the intensity of the strain and skin sensitivity.
Simple management involves gently treating the affected skin area. Applying a cool compress immediately after the episode can help constrict blood vessels and may reduce the spots’ appearance. Trying to maintain steady, deep breathing instead of breath-holding during strain can help minimize the pressure increase.
It is important to know when these spots become a potential medical concern. If petechiae or purpura appear suddenly without preceding intense physical straining (crying, coughing, or vomiting), medical guidance should be sought. The appearance of non-blanching spots accompanied by systemic symptoms like a high fever, severe headache, confusion, or unexplained bleeding warrants immediate professional evaluation.