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Bleeding into the skin

Definition

Bleeding under the skin can occur from broken blood vessels that form tiny pinpoint red dots (called petechiae). Blood also can collect under the tissue in larger flat areas (called purpura), or in a very large bruised area (called an ecchymosis).

Alternative Names

Ecchymoses; Skin spots - red; Pinpoint red spots on the skin; Petechiae

Considerations

Aside from the common bruise, bleeding into the skin or mucous membranes is a very significant sign and should always be checked out. Redness of the skin (erythema) should not be mistaken for bleeding. Petechiae, purpura, and ecchymosis do not become pale (blanch) with pressure. The redness of erythema decreases and then returns when you apply and then release pressure to it.

Causes

Home Care

Protect aging skin. Avoid trauma such as bumping or pulling on skin areas. For a cut or scrape, use direct pressure to stop the bleeding.

If you have a drug reaction, ask your health care provider about stopping the drug. Otherwise, follow your prescribed therapy to treat the underlying cause of the problem.

When to Contact a Medical Professional

Contact your health care provider if:

  • You have sudden bleeding into the skin for no apparent reason
  • You notice unexplained bruising that does not go away

What to Expect at Your Office Visit

Your doctor will examine you and ask questions about the bleeding, such as:

  • Have you recently had an injury or accident?
  • Have you been ill lately?
  • Have you had radiation therapy or chemotherapy?
  • What other medical treatments have you had?
  • Do you take aspirin more than once a week?
  • Do you take Coumadin, heparin, or other "blood thinners" (anticoagulants)?
  • Has the bleeding occurred repeatedly?
  • Have you always had a tendency to bleed into the skin?
  • Did the bleeding start in infancy (for example, with circumcision)?
  • Did it start with surgery or when you had a tooth pulled?

The following diagnostic tests may be performed:

References

Schafer AI. Approach to the patient with bleeding and thrombosis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 178.

Review Date: 5/2/2009
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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