Phenytoin (a drug that prevents seizures) Quinine (a malaria drug) Other medical issues that can cause petechiae to include: Insufficient vitamin C or K. Leukemia. Factor X deficiency is a condition where there isn't enough of the protein factor X in the blood, leading to uncontrolled bleeding. Endocarditis: Symptoms. Here are a few serious conditions that may be causing the spots: Here are some images that show how petechiae looks on different areas of the body: You may be able to tell the spots on your skin are petechiae instead of a rash if you press on them and they dont turn lighter in color. If left untreated, a blood clot can reach your organs and cause potentially life threatening conditions, such as pulmonary embolism, stroke, or a. Sepsis: Symptoms and causes. But did you know that stress can actually cause physical symptoms like petechiae? Accessed March 10, 2015. Rocky Mountain spotted fever. This blood may show up just beneath the surface of the skin. Friction against the skin from carrying a heavy bag/backpack or a tight strap from clothing can lead to petechiae. (2017). Really, it is just broken capillaries under the skin.can be caused by trauma (ie sports). ask you about your medical history, including: conduct any laboratory tests needed to diagnose the underlying condition. For example, emotional stress can cause these clots to occur in people who don't have FVIII or FIX inhibitors, while physical stress may cause them in people who are taking oral anticoagulants.if(typeof ez_ad_units != 'undefined'){ez_ad_units.push([[580,400],'staminacomfort_com-medrectangle-3','ezslot_2',118,'0','0'])};__ez_fad_position('div-gpt-ad-staminacomfort_com-medrectangle-3-0'); Mary's heart-shaped face and large eyes made her appearance sensitively beautiful. 2002-2023 LoveToKnow Media. I have another question now. Pediatric Emergency Medicine. Petechiae here and there really aren't too much of a concern. Everything was within normal limits except the MPV, which was a little high at 10.3. 719: Fever with Petechiae in an Infant: Diagnostic and Treatment Conundrum. Government of Western Australia Child and Adolescent Health Service. Debbie loves to help people understand their own bodies better so that they can take better care of themselves! Immunosuppressants: Immunosuppressants are medications that help to suppress the immune system. The word petechiae has derived from the Greek word for spot, and these spots can be caused by a number of different things. These tiny red spots are sometimes a sign of a serious underlying medical condition. They can be interpreted as Vasculitis, an inflammation of the blood vessels, which requires immediate treatment to prevent permanent damage. health information, we will treat all of that information as protected health Before recommending a treatment, your doctor will identify whats causing your petechiae and other symptoms. Tiny, red, pinpoint dots develop that may cluster and have the appearance of a rash. http://www.uptodate.com/home. It is characterized by immune complex deposition in small vessels. Hoffman R, et al. For instance, if red dots are caused by skin conditions or an allergic reaction, you might need to see a dermatologist for treatment. Petechiae are often nothing to worry about. Because of their similar size, sometimes people mistake them for petechiae. Purpuric and petechial rashes in adults and children: Initial assessment [Abstract]. Debbie Stephenson is a woman with many years of experience in the medical field. While stress might explain some of Mary's skin problems, her petechiae and purpura had been warning signs of a potentially lethal illness. They may recommend home remedies if it's nothing serious. . It is caused by a variety of factors, including: Medications: Certain medications, such as aspirin and other anti-inflammatory drugs, can thin the blood, blood clot and make it more likely to leak from vessels. See a doctor if you think you have petechiae. Centers for Disease Control and Prevention. With normal platelets and everything else, what does this indicate? But in some cases they can be a sign of a serious, life-threatening medical condition. Stress is a common issue that many people face on a daily basis. Petechiae are less than 2mm in size (about the size of the tip of a crayon). We may earn commissions if you purchase something via one of our links. Learn how to avoid, recognize, and treat strep throat. However, if they're accompanied by other symptoms or persist for more than a few days, it's important to seek medical attention. Vomiting-induced petechiae tend to clear up on their own. It occurs when a child is forcefully hit with an open hand. Learn about common, Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. What are the Red Dots Around My Eyes (Petechiae)? information highlighted below and resubmit the form. 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event, (https://www.britannica.com/science/petechia), (https://dermnetnz.org/topics/bleeding-and-bruising/), (https://myhealth.alberta.ca/health/pages/conditions.aspx?Hwid=bruse), (https://pch.health.wa.gov.au/For-health-professionals/Emergency-Department-Guidelines/Petechiae), (https://www.ncbi.nlm.nih.gov/books/NBK482331/), Nonsteroidal anti-inflammatory drugs (NSAIDs). They can also indicate other health concerns if a person is sick. Some life-threatening causes of petechiae can include: Endocarditis (bacterial infection of the heart). Mayo Clinic does not endorse companies or products. Thank you so much for the helpful reply. Make sure to contact your provider if you notice sudden skin changes. Our phase IV clinical studies alone cannot establish cause-effect relationship. They can also appear as a reaction to certain medications. Petechiae, purpura, and a pandemic: A recipe for scurvy. All rights reserved. Lab tests may be used to diagnose certain conditions that cause petechiae. Can anxiety cause petechiae? These infections cause inflammation and break down the walls of small blood vessels, leading to bleeding. From choosing the best eye doctor to managing health issues that affect vision, she hopes to share what she learns through informative content. Vitamin C is an important building block for collagen in the walls of healthy blood vessels. These cells can invade other parts of the body where they don't belong. But the strain of dealing with her family's anger over her failing marriage showed in her haggard complexion and baggy eyes. For example, some medications may bring about petechiae, including penicillin. I noticed after working out and showering that I had 2 new spots on my stomach, and a small line of very small spots which looked like it was from an abrasion. i do have several petechiae dots over my body, but not in a rash. Drug-induced thrombocytopenia. Petechiae may look like a rash, but theyre not. We include products we think are useful for our readers. Many things can cause this bleeding, including physical trauma, reactions to drugs, infections, and blood disorders. Petechiae are red, nonblanching macular lesions produced by intradermal capillary hemorrhage that are tiny (1-3 mm). They can be caused by a simple injury, straining or more serious conditions. We avoid using tertiary references. Other symptoms include fever, headache, muscle pain, and nausea. The spots can be red, brown, or purple. Mayo Clinic Staff. Bleeding and bruising. Theyll usually resolve on their own within 2 to 3 days. When the blood vessels are damaged, they can leak blood into the tissue. Your doctor can examine the spots and conduct any needed tests to diagnose and treat the cause of petechiae. Have you found anything out? If you or your child have petechiae that spread quickly, or if you have dots plus other symptoms, seek medical attention. The information provided on VisionCenter.org should not be used in place of actual information provided by a doctor or a specialist. RMSF is a bacterial infection transmitted by ticks. Blake, J. S., et al. For example, if petechiae are caused by a viral infection, treatment will focus on relieving symptoms and supporting the immune system. You may get scurvy if you dont get enough vitamin C. Other symptoms include fatigue, weaknesses, joint pain, and bleeding gums. Neglecting to treat the cause of petechiae could be serious if there is an underlying health condition causing it. mayoclinic.org/diseases-conditions/cmv/symptoms-causes/dxc-20315449, mayoclinic.org/diseases-conditions/endocarditis/basics/symptoms/con-20022403, mayoclinic.org/diseases-conditions/hantavirus-pulmonary-syndrome/home/ovc-20263774, mayoclinic.org/diseases-conditions/leukemia/basics/symptoms/con-20024914, mayoclinic.org/diseases-conditions/mononucleosis/symptoms-causes/dxc-20165844, mayoclinic.org/symptoms/petechiae/basics/definition/sym-20050724, mayoclinic.org/symptoms/petechiae/basics/causes/sym-20050724, mayoclinic.org/diseases-conditions/rocky-mountain-spotted-fever/basics/symptoms/con-20032780, mayoclinic.org/diseases-conditions/scarlet-fever/basics/symptoms/con-20030976, mayoclinic.org/diseases-conditions/sepsis/symptoms-causes/dxc-20169787, mayoclinic.org/diseases-conditions/strep-throat/symptoms-causes/dxc-20165964, mayoclinic.org/diseases-conditions/thrombocytopenia/basics/symptoms/con-20027170, mayoclinic.org/diseases-conditions/vasculitis/basics/symptoms/con-20026049, mayoclinic.org/diseases-conditions/viral-hemorrhagic-fevers/symptoms-causes/dxc-20180483, fairview.org/HealthLibrary/Article/512082EN, nhs.uk/Conditions/Scurvy/Pages/Symptoms.aspx, Debra Sullivan, Ph.D., MSN, R.N., CNE, COI, How to Recognize and Treat an Anemia Rash, Understanding Rashes and Bruising in Leukemia, Everything You Need to Know About Rocky Mountain Spotted Fever. Chapple, D. (2015). These may include: Streptococcal infections (like strep throat). Roldn-Marin, R, & de-la-Barreda Becerril, F. (2009). These activities include crying, coughing, vomiting, lifting weights, or giving birth. Try these 10 mood-boosting tips to get your happy back, The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. They occur mostly on my stomach, though right now I have 2 on my stomach, 1 on my right leg, and 1 on my chest. Petechiae may be a sign of a serious underlying health condition, such as blood disorders acute leukemia, immune thrombocytopenic purpura ITP (low platelets count) or infection. Some medications that cause the symptom include penicillin, phenytoin (Dilantin), quinine, aspirin (Bufferin), nonsteroidal anti-inflammatories, lidocaine/prilocaine cream (Lidopril), and furosemide (Lasix). These are the blood cells that form clots and stop bleeding. WARNING: Please DO NOT STOP MEDICATIONS without first consulting a physician since doing so could be hazardous to your health. In: Signs and Symptoms in Family Medicine. Petechiae are small, pinpoint-sized red dots on the surface of the skin. The time it takes for the petechiae to fade can vary based on the cause. Petechiae may be a side effect of drugs like . Differential diagnosis. (2017). If the number of spots increases, you might have a bleeding disorder. When shes not working, Dr. Huang loves reviewing new skin care products, trying interesting food recipes, or hanging with her adopted cats. (2014). This can include accidental trauma. Learn about this common type of bruise and how make it heal faster. (2017). The most common causes include: Petechiae are small, red dots that usually appear around the eyes. They may also enter your bloodstream and find their way to other parts of the body where they can block blood vessels. Thomas, A. E., et al. Tobacco's early users thought it would keep them healthy and help them resist disease. This blood may show up just beneath the surface of the skin. They may be present without any other signs of illness or injury. DOI: What is vitamin K deficiency bleeding? Some factors may increase your risk of developing them include: smoking, alcohol use, taking drugs or medications that affect the immune system, having chronic diseases such as diabetes or leukemia, or having genetic conditions such as thrombocytosis (increased number of platelets) or leukocytosis (increased number of white cells). Petechiae wont turn white when you press on them. By providing your email address, you agree to receive emails containing coupons, refill reminders and promotional messages from GoodRx. Purpura are broken vessels that involve larger and mid-size blood vessels. When these vessels break, blood leaks into the surrounding tissue and cause the spots to appear. The Korean Journal of Internal Medicine. Symptoms include bruising and bleeding in the mouth and nose. All information is observation-only. People rarely die from leukemia itself but rather from complications of the disease or its treatment. Red spots (such as heat rash, which are accompanied by a prickly, itchy feeling) are more common in summer when skin is more prone to redness, sensitivity, and irritation,' notes. Mayo Clinic College of Medicine and Science, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Graduate Medical Education, Mayo Clinic School of Continuous Professional Development, Mayo Clinic on Incontinence - Mayo Clinic Press, NEW Mayo Clinic on High Blood Pressure - Mayo Clinic Press, Mayo Clinic on Hearing and Balance - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Financial Assistance Documents Minnesota. Patients with these problems should be treated properly to reduce their symptoms. Talk to your doctor about the symptom so you can determine the underlying cause. Petechiae can appear anywhere on the body but are usually found on or in the: Several things can lead to petechiae, ranging from simple and reversible causes to serious illnesses: Treatment for petechiae varies depending on the cause. This helps to tell the difference between petechiae and other common skin disorders like viral rashes and hives. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. Vitamin K deficiencies may occur in infants because they arent born with enough of the vitamin and may not get enough until they begin eating solid foods at 4 to 6 months old. This is important because sometimes a serious medical condition causes petechiae. However, it can appear on any area of the limbs, torso or face. Why It's Important to Have High Self-Esteem. Learn more here. Healthline only shows you brands and products that we stand behind. This strains the small blood vessels or capillaries in your face. Could the UTI and spots be related? Healthline Media does not provide medical advice, diagnosis, or treatment. (2018). It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. However, there are treatments available to help alleviate the symptoms. She also has an interest in Eastern medicine practices and learning about integrative medicine. They can occur on any part of the body but are most commonly found on the arms, legs, and trunk. Chapter 181: Petechiae and purpura. By signing up, I agree to GoodRx's Terms and Privacy Policy, and to receive marketing messages from GoodRx. Petechiae do not typically need treatment. Norpramin. Eating healthy foods, exercising regularly, and getting enough sleep are all crucial for managing stress levels. Clean countertops, door handles and other high-touch surfaces frequently. Lack of vitamin K may cause this symptom to appear because it affects bleeding. Prevalence and distribution of petechiae in well babies. Trademarks, brands, logos, and copyrights are the property of their respective owners. Scurvy is caused by too little vitamin C in your diet. Haematological manifestations of lupus. If youve had this reaction to a drug in the past, let your doctor know. U.S. Food and Drug Administration. If you have petechiae, you should contact your doctor right away or seek immediate medical care if: Petechiae may be a symptom of a serious medical condition. These pinpoint spots can be a sign of many different conditions some minor, others serious. Elevated blood pressure, which is a symptom of stress, also causes red spots. (2001). You can learn more about how we ensure our content is accurate and current by reading our. I didn't show her the new spots today out of fear that my continued anxiety could cause her to take my concerns in the future less seriously, but after seeing that elevated value, I'm defnitely worried again. They seem to always fade within a few days. Petechiae around the eyes and eyelids are common in people who have seizures. I am on Prozac(12 years, currently weaning off)and this is the only probable explanation that I have come up with for my symptoms. Petechiae can also occur after a person has been severe coughing or vomiting for an extended period of time, as this can put strain on blood vessels and cause them to rupture. Use of this site constitutes acceptance of eHealthMe.com's terms of service and privacy policy. If we combine this information with your protected Scarlet fever: Symptoms. Other symptoms include fatigue, swollen gums, joint pain, shortness of breath, and bruising. Seifer, C. M., et al. I have battling depression & anxiety for many years. Some home remedies that may help include: Its not possible to prevent all causes of petechiae. If you have petechiae that are causing pain or swelling, you should see a doctor to find out if they need to be treated. This is a bacterial infection in the respiratory tract. Often the tiny spots appear on the face after a significant bout of coughing, vomiting or crying and disappear after a short time. Red dots around the eyes usually arent a symptom of anything serious. The Epstein-Barr virus (EBV) is one of the most common viruses to infect people around the world. Petechiae are linked to a vitamin B12 deficiency, so indirectly, if your alcohol consumption has affected your bodys B12 level, it could cause red dots to form. Mononucleosis: Symptoms and causes. While there is a connection between stress and common rashes such as hives, there does not appear to be that same link to stress and petechiae. All rights reserved. 2010;81:735. www.aafp.org/afp. In: Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. Antibiotics: Antibiotics are prescribed if an infection is present. The use of the eHealthMe site and its content is at your own risk. But theyre not always a cause for concern. Petechiae appear when capillaries bleed, leaking blood into the skin. There is a problem with information submitted for this request . Trauma-informed healthcare providers take extra steps to make you feel seen, heard, and understood. Petechiae can also appear in aging skin. One of the reasons you may have petechiae is a viral infection, such as the flu or chickenpox. Rochester, Minn. Mayo Foundation for Medical Education and Research; 2014. You may experience changes to your blood pressure as well as your breathing. Petechiae can be a sign of a severe illness or medical emergency, especially in children. Personal Hygiene: You should also take care to practice good hygiene to avoid getting infections that could cause petechiae. They may also go. Some common causes of petechiae include: Vasculitis (inflammation of blood vessels), Trauma (like vomiting, straining, or accidents). 6th ed. Medications that can trigger petechiae include: Seizure medications (like valproic acid and phenytoin), Blood thinners (like warfarin and heparin), Anti-inflammatory medications (like aspirin). Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Other symptoms include a high fever, fast heart rate, and trouble breathing. Thats why its important to let your provider know if you notice these skin changes. This infection of the inner lining of the heart includes symptoms like fever, chills, fatigue, achy joints and muscles, shortness of breath, cough, and pale skin. (2015). If you have pinpoint-sized red dots under your skin that spread quickly, or petechiae plus other symptoms, seek medical attention. Fever. While there is a connection between stress and common rashes such as hives, there does not appear to be that same link to stress and petechiae. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. In many cases theyre nothing to worry about and resolve on their own. You should seek a doctors diagnosis for your petechiae so you can be treated for the underlying condition causing the symptom. But a cherry angioma will blanch and lose its color if you apply pressure. (2016). Bacterial infections can also cause petechiae. Strep throat is highly contagious and can lead to serious complications. Infections that can cause petechiae include strep throat, meningitis, and Epstein-Barr virus. For example, if you have petechiae because of improper nutrition or a medication reaction, correcting the diet and stopping the medication will treat them. Theyre the result of bleeding under the skin from broken small blood vessels. Sunburn is also a common cause of skin rashes that cause petechiae to form. Trouble breathing. If you think you may have petechiae, it is important to consult with a medical professional to get an accurate diagnosis, medical help, and treatment plan. If a child develops petechiae with a fever, seek immediate medical attention. If a medication caused the petechiae, this symptom should go away once you stop taking the drug. It reduces the symptoms of petechiae and improves the quality of life. Although there is no medical evidence to support this, stress does affect every system and organ in the body in many different ways. A poor diet can lead to an increased risk of petechiae. Petechiae can also be caused by other factors, such as certain medications, infections, and autoimmune diseases. They can also indicate other health concerns if a person is sick. Work with your doctor or other health care professional for an accurate diagnosis. This can occur with autoimmune diseases, medications, or infections. Review/update the Policy. If petechiae are related to illness, or if you're taking medications that cause petechiae, talk to your doctor about it. Lupus Science & Medicine. Vitamin C: Vitamin C can help to boost the immune system and reduce the appearance of petechiae. Petechiae alone arent life-threatening. Some other symptoms include fever, a stiff neck, vomiting, and headaches. Other symptoms include fever, chills, fatigue, unintentional weight loss, swollen glands, bleeding, bruising, nosebleeds, and night sweats. Petechiae are not usually painful or itchy, but they may be accompanied by other symptoms including such as fever, fatigue, shortness of breath, and general ill feeling. Other symptoms include abdominal pain, kidney inflammation, and arthritis. GoodRx works to make its website accessible to all, including those with disabilities. If you believe a vitamin deficiency could be the cause of red spots, seek medical advice and discuss possible supplements or treatment options with your doctor. Petechiae appear when small blood vessels break and superficial bleeding occurs under the skin. Copyright 2020 - 2023 Stamina Comfort Inc. What is the difference between petechiae and purpura? Other symptoms include extreme fatigue, sore throat, fever, swollen lymph nodes, swollen tonsils, and headache. Your doctor can recommend a treatment plan for the condition or advise you to keep an eye on them, as they may disappear on their own. Spots that spread quickly. Inflammatory conditions such as rheumatoid arthritis and lupus can also lead to the formation of petechiae. http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm?fuseaction=Search.Label_ApprovalHistory#labelinfo. Petechial rashes are common and can be a significant cause for concern for parents and the interprofessional team. Immunotherapy: It is a type of treatment that uses substances to stimulate or suppress the immune system. There can be other causes, as well. Summary: Petechiae is found among people with Stress and anxiety, especially for people who are female, 60+ old. Rocky Mountain spotted fever: Symptoms. Mayo Clinic Staff. Cureus. Children often have immune thrombocytopenic purpura. So dont ignore them. Learn what causes petechiae, what they look like, and how to treat and prevent them. Learn the benefits of having healthy self-esteem and simple steps to develop it. Petechiae occurs when capillaries bleed. This is a type of cancer that affects your blood as well as your bone marrow. Accessed March 10, 2015. If you're experiencing petechiae, it's important to see a dermatologist to rule out any underlying medical conditions. Petechiae are tiny, flat, typically round spots on the skin caused by bleeding. A person with leukemia may have rashes, bruising, and other skin symptoms. The EBV test is also known as EBV antibodies. Its. Coming to a Cleveland Clinic location?Hillcrest Cancer Center check-in changesCole Eye entrance closingVisitation and COVID-19 information, Notice of Intelligent Business Solutions data eventLearn more. To establish that the product manufacturers addressed safety and efficacy standards, we: We do the research so you can find trusted products for your health and wellness. (2018). Petechiae: Causes. (2019). All rights reserved. Disseminated intravascular coagulation is a rare, life threatening condition. On darker skin tones, petechiae may appear brown or purple in color. Dikme, O., et al. Mayo Clinic Staff. Sites of trauma can sometimes cause petechiae. I am a 26f, good health besides allergies/chronic sinus issues, normal weight, but I've had history of problems with health anxiety since childhood. Petechiae and purpura are caused by blood vessels breaking under the skin. Should I be having withdrawals symptoms from 10mg of prozac for 9 days? Here's what you need to know to prevent this tick-borne disease. Could the fact that I did not have the CBC until the spots were fading make a difference? These abnormalities are grouped based on the size of the blood vessel affected. Petechiae are small, spherical patches on the skin that occur as a result of bleeding. We offer this Site AS IS and without any warranties. Petechiae are tiny red spots on the skin. Philadelphia, Pa.: Saunders Elsevier; 2015. http://www.clinicalkey.com. Some of the underlying causes of petechiae are serious and need to be treated. Being present in the moment can enhance your appreciation for life and improve well-being. Journal of Emergency and Trauma Care. Petechiae are very small (pinpoint) red dots on the skin that form a skin rash due to an infection, allergic reaction, or other cause. While there is a connection between stress and common rashes such as hives, there does not appear to be that same link to stress and petechiae. Blood disorders that can cause petechiae include: Vasculitis, or blood vessel inflammation, can cause petechiae. Purpura refers to purple-colored spots that are most recognizable on the skin. Seizures can cause involuntary convulsions and damage small blood vessels. But in general, petechiae arent painful. They can help figure out the source of your skin changes. However, if a child has a fever with petechiae, take the child to a doctor right away as it could be a sign of a bacterial infection in the bloodstream. Chemotherapy. But you cant prevent all of the possible underlying causes of petechiae. Other symptoms include fatigue, fever, sore throat, and muscle aches. Petechiae can occur on any part of the body, but they are most commonly found on the face, neck, chest, and legs. We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. I'm having the same exact issue as you for 6 months now with no explanation! In some cases, doctors prescribe the following to treat petechiae: These medicines treat infections and reduce inflammation. A few days later the doctor ordered bloodwork to ease my fears about leukemia (a fear I've had since 8 years old or so), and the CBC was normal. . Otherwise, follow up with your doctor if the symptoms do not go away within a few days. Some malignancies can also cause petechiae to appear. Advertising revenue supports our not-for-profit mission. They may also prescribe medication to treat the problem's root cause. That means if you press down on the spots they dont fade away or turn white. I have had a few petechiae on and off for 2 months now, usually no more than a handful at a time. Journal of Pharmacy & Bioallied Sciences. Here's Why It Matters. Eden, R. E., et al. Try to stay away from anyone who appears to be sick. Leukemia: Symptoms. Platelets, petechiae, and preservation of the vascular wall. The study analyzes which people have Petechiae with Stress and anxiety. All rights reserved. What Is Trauma-Informed Care? More than just a bruise: Recognizing child physical abuse. Bruising happens when blood vessels under the skin break and spread into surrounding tissue. Dr. James Ferguson answered