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Many conditions can lead to the appearance of red spots on skin.
These are usually hard to ignore because they may also appear with
other accompanying symptoms. Different skin conditions have varying
characteristics which may lead to their diagnosis, and the treatment of
red spots on skin will depend on the underlying cause. Common causes
include acne, allergy, herpes sores and Linchen Planus. If skin swelling and hives lasts greater than six weeks, the condition is referred to as being chronic. All skin conditions are described below."
Video: How To Tell If Red Skin Spots or Rash Need Medical Attention
American Academy of Dermatology video on how to tell if a rash, red dots on skin or skin condition needs medical attention.
Causes
Red spots are reddish discolorations in the skin which may
look like tiny or small bumps, flat marks, irregularly shaped lesions, or discrete
dots.
Many factors can cause inflammation, which is the most likely reason
for reddening of the skin. Inflammatory reactions often trigger an
increase in blood flow to an area of the skin where an infection or
irritation occurs. Common factors that can trigger redness and
inflammation include:
Top Causes of Red Skin Spots
Acne
Acne appears as small red spots on skin and bumps on the skin that may also be filled with pus. These usually occur on the face, neck, shoulders and back.
Blood Vessel Disorders
Disorders of the blood vessels beneath the skin can manifest as petechiae (small red dots) or patches of red skin (phlebitis).
Eczema (Atopic dermatitis)
Eczema (also called atopic dermatitis and atopic eczema) occurs in over 17 million people in the United States that are allergic or that have asthma. Symptoms related to eczema are scaly skin, itch and redness.
Atopic dermatitis is through to be caused by a defect in a protein called filaggrin. The defect causes contact between antigens in the environment and immune system cells in the dermis. This contact causes red skin inflammation, red spot, itch and scratching by the patient.
Individuals that have atopic dermatitis have a risk factor to develop herpes simplex virus infection (called eczema herpeticum or Kaposi varicelli-form eruption.)
The atopic dermatitis treatment goal is to reduce the severity and time between any flare-ups. Skin ares are treated with topicals such as corticosteroids. Antibiotics are used to treat any skin infection.
Early treatment can help to prevent issues such as skin infection and interrupted sleep and changes in skin condition due to inflammation.
Before atopic dermatitis is diagnosed, the following possible causes of red spots on skin need to be eliminated:(5)
- Candidiasis
- Contact dermatitis
- Dermatitis herpetiformis
- Impetigo
- Lichen simplex chronicus
- Nummular eczema
- Psoriasis
- Scabies
- Seborrheic dermatitis
- Xerosis
Folliculitis
Folliculitis, or infection of one or more hair follicles, can be seen as small red bumps on the skin.
Skin Allergy
Skin allergy related to common conditions like eczema (atopic dermatitis), contact dermatitis (skin inflammation), and hives (urticaria) can manifest as irregularly shaped red rashes, tiny red bumps and welts that may be flat or slightly raised, scaly, patchy, swollen or blistering.
Causes of contact dermatitis include:
- Clothing surfaces (chemicals, dyes)
- Sumac, oak, Poison ivy
- Rubber
- Elastic
- Latex
- Detergents
- Soaps
- Cosmetics
Symptoms can quickly appear on all body areas. In addition to a rash, symptoms can sting or burn. Hives range in size from tiny to small (less than a pencil eraser) to large, joining together to form what are called plaques.
Swelling can also occur below the skin surface, a condition called angioedema. Angiodema symptoms typically appear at the feet, hands, genitals, lips and areas surrounding the eyes. Swelling subsides within 24 hours.
Allergic reaction to drugs, food, and other environmental elements can also appear as red rashes.
There are several foods that are commonly associated with food allergies:
- Berries
- Soy
- Wheat
- Eggs
- Tomatoes
- Fish
- Chocolate
- Nuts
Infection
Skin rash due to a viral, bacterial or fungal infection: viral infections like measles, chicken pox, shingles, mononucleosis, bacterial infections like scarlet fever or fungal infections like ringworm lead to different forms of red spots.
Signs of skin infection include:
- Red streak coming from the rash
- Warmth in area of rash
- Pain
- Crusts on the rash
- Swollen skin
- Green or yellow fluid
Insect Bites
Insect bites cause red spots that may be found after an ant, scabies mite, mosquito, spider, tick, bed bug or other insect bites into the skin.
Herpes Simplex
Herpes simplex (also called (HSV-1) is an example of a common skin infection caused by a virus. It causes cold sores or herpes on the mouth and genitals. It is possible to also see sores anywhere on the body. The virus is contagious, even when sores are not visible. In infected individuals, an outbreak can be triggered by sunburn. Symptoms include tingling skin, fever, muscle ache, neck lymph nodes that are swollen, trouble with urination and eye infection (herpes keratitis). Outbreaks last on the face from 2 to 3 weeks. In genital areas the outbreak will last from 2 to 6 weeks.
Herpes Simplex diagnosis by a Dermatologist can be confirmed by blood test or skin swab of a sore. Treatment includes use of an antiviral (Valacyclovir, Famciclovir, Acyclovir) and topical to help with symptoms such as tingling or skin burning. The virus does not cause complications in people with normal immune systems. If your immune system has been weakened by surgery, cancer or a transplanted organ than be sure to see a Doctor.
Impetigo
Impetigo is a childhood bacterial infection that manifests in the top skin layers. The condition starts as red skin sores that transform into oozing blisters.
Linchen Planus
Linchen Planus is a condition that occurs in middle age. While the cause is unknown, it is believed to be an autoimmune disease. The condition causes red or red/purple bumps on the skin that can occur anywhere on the body. On the arm bumps are more red, while on the legs the bumps look dark. Symptoms include thick rough scaly skin, itch, blisters (rare) and pain if the red skin bumps are on the genitals. Linchen Planus can also occur inside the mouth (commonly found by dentists) and cheeks, on the nails and scalp.
Treatment involves the use of antihistamines for itch, light therapy and retinoic acid to hep clear the skin. Excema topicals are also used such as Tacrolimus ointment or pimecrolimus cream. Cases usually disappear in 2 years. It can appear and then disappear over the years. Oral linchen planus takes longer to disappear and is more difficult to treat.
Psoriasis and Rosacea
Chronic inflammatory skin conditions like psoriasis and rosacea.
Psoriasis has symptoms that include scaly skin, red skin areas, itchy joints and itchy scalp. Finger nails can also suffer from psoriasis.
Rosacea causes a "red face." Other symptoms include skin swelling, skin sensitivity, and possible burning or stinging. The skin can also experience scaling and roughness.
Video: Video: What is Psoriasis
American Academy of Dermatology video on the causes and treatment of Psoriasis.
Rash
A rash is a skin condition in which the appear appearance of skin changes. It can appear as welts, bumps, spots, dots, lumps or blisters. The skin can also be red or scaly. Have pus or be dry.
Rash can be localized in one area or in multiple areas.
Acute inflammation due to rash, such as heat rash, diaper rash, or prickly heat is common among children.
Other red spots on skin may not be due to inflammation but may just be due to harmless inborn conditions such as birthmarks or cherry angiomas.
The best way to diagnose a rash is to see a dermatologist. While most are not life threatening, see a Doctor immediately if you have any of these symptoms:
- Rash all over the body (indicates something serious such as infection or allergy)
- Body Rash and Fever (can be caused by allergy or infections such as shingles, mononucleosis, measles and shingles)
- Rash appears suddenly and spreads rapdily
- Difficulty breathing
- Rash starts to turn into open sores or blisters (can be caused by allergic reaction or internal cause).
- If eyes, mouth or genitals are involved.
- Rash is painful
- Infection - symptoms include pain or warmth in rash, or rash is crusting, swelling or has green or yellow fluid. Also if blood or a red streak is coming from the rash
Emergencies include:
- Swelling of the tongue or throat
- Difficulty breathing.
Seborrheic Dermatitis
Seborrhea symptoms create red skin areas and scaling around the:
- trunk
- scalp (results in dandruff or cradle cap)
- around the ears
- nose
- mouth
- eyelids
- eye-brows
Causes of seborrheic dermatitis include:
- Lotions that contain alcohol
- Underwashing the hair
- Oily skin
- Weather (extreme cold or heat)
- Fatigue
- Stress
- Age
Shingles
Shingles, a virus that causes chickenpox, results in skin blisters. The virus can be dormant for a long time (years) and then cause shingles.
Diagnosis
The diagnosis of red spots on the skin may be done after a doctor takes a medical history and physical examination. Sometimes laboratory tests may be needed to establish a diagnosis or to rule out other conditions.
In children, in addition to the above, disease that cause red spots on skin include:
- Chicken pox
- Scarlet fever
- Fifth disease
- Hand-food-mouth disease
- Roseola
- Measles
Symptoms
Some skin conditions manifesting as reddish skin
discolorations have no accompanying symptoms such as birthmarks or
cherry angiomas, except that these may be noted to grow in size in
change in shape.Other skin conditions that are caused by inflammation
may be accompanied by various symptoms like fever, itchiness, scaling,
pus formation, oozing, blistering, pain, and discomfort.
If red spots appear with serious symptoms like difficulty in breathing
and swallowing, these may indicate an acute allergic reaction which may
need immediate medical attention.
Treatment
Some conditions do not require treatment and will resolve on their
own. However, most of these conditions, especially those which are
accompanied by other symptoms of inflammation may need simple home
remedies. Keeping the skin clean and healthy, and practicing a healthy
lifestyle are important to skin health.
Some of these conditions are just manifestations of an underlying
health condition which needs medical treatment, such as chicken pox.
Most importantly, one should seek immediate treatment if red spots on
skin are accompanied by symptoms of severe allergic reaction, because
this may be life threatening.
Brochures
by: Rebecca Berke, MD, Arshdeep Singh, MD, Mark Guralnick, MD
References
(1) Rodriguez, D. 5
Skin Symptoms and What They Could Mean. EverydayHealth.
(2) American Academy of Dermatology
(3) Mayo Clinic. Common skin rashes
(4) Skin Rash
(5) Leung DY, Bieber T. Atopic dermatitis. Lancet. 2003;361(9352):151-160.