What Deficiency Causes Petechiae?

Vitamin C deficiency, also called scurvy, can make the capillaries fragile. This is because vitamin C plays a crucial role in the formation of the protein called collagen that forms the walls of the blood vessels including arteries, veins, and capillaries. 

When collagen formation is compromised, the capillaries become weak and can rupture with minimal trauma, causing blood leakage. This can cause tiny pinpoint hemorrhages called petechiae, larger spots called purpura, even bigger bruises called ecchymosis, and bleeding gums.

Vitamin K deficiency can also lead to petechiae. Vitamin K is a fat-soluble vitamin required to produce clotting factors and certain proteins that help control bleeding. 

In people with vitamin K deficiency, blood clotting is delayed, which can lead to petechiae, purpura, or frank bleeding. Bleeding can be seen in the nose, stools, and vomitus.

Petechiae are tiny, circular, pinpoint, flat spots under the skin. They may appear red, brown, or purple. Petechiae cannot be blanched, which means that they will not fade away even temporarily when pressure is applied to the skin. 

Apart from the skin, petechiae can form on relatively concealed areas, such as under the eyelids or inside the mouth.

Petechiae can occur in people of any age; however, they are more common in children and older adults. Besides nutritional deficiencies, petechiae can be caused by various other factors, such as:

• Prolonged straining: Excessive straining can cause pressure on the capillaries, leading to petechiae over the affected part. Causes include severe vomiting, childbirth, persistent coughing, straining during bowel movements, and lifting heavy weights.
• Infections: Various viral, bacterial, and fungal infections can cause petechiae, including dengue, flu, Ebola, infectious mononucleosis, human immunodeficiency virus, scarlet fever, bacterial meningitis, and strep throat.
• Skin injury: Injuries can cause petechiae. Even minor injuries such as bites or scratches can lead to pinpoint spots or petechiae.
• Chronic liver disease: The liver performs crucial functions in the body and is the site of the formation of important proteins, including clotting factors. Chronic liver disease can thus present as easy bruises, petechiae, and bleeding tendencies.
• Connective tissue disorders: Connective tissue disorders such as lupus can cause blood vessel inflammation (vasculitis). They are associated with reduced platelet counts, leading to petechiae.
• Certain medications: Reaction to certain medications can cause petechiae, such as: penicillin, anti-seizure medications, nonsteroidal anti-inflammatory drugs, blood thinners, and antidepressants.
• Autoimmune and blood conditions: Conditions that can lead to petechiae include:
  • Idiopathic thrombocytopenic purpura
  • Vasculitis (blood vessel inflammation)
  • Thrombocytopenia (low platelet levels in the blood)
  • Blood cancer

Localized petechiae is usually not a cause for concern and may go away on its own within a few days. If, however, you are on certain medications and develop petechiae, talk to your doctor. 

You should also seek medical treatment if your petechiae:

• Keep increasing in number
• Enlarge to form bigger bruises
• Are accompanied by: 
  • Fever
  • Bleeding from any site
  • Heaviness in the abdomen
  • Neck or axillary swellings