Red Spots on Face: A Visual Guide to the Common Causes

Red spots on the face are most often acne and the flat red marks it leaves (post-inflammatory erythema), cherry angiomas, spider angiomas and broken capillaries, or the bumps of rosacea. A simple press test helps: redness from inflammation or a widened vessel fades when you press on it, while petechiae, tiny flat dots of bleeding under the skin, stay red or purple. Petechiae that appear with fever, feeling unwell or spots that spread quickly need urgent medical care.

This guide shows each cause with a photo and compares them in a table. Pori does not diagnose skin conditions; its selfie scans and photo diary in Pori can help you keep dated, consistent photos to show a dermatologist and see whether treatment is working.

What causes red spots on the face?

Most red spots on the face come from inflammation (acne, rosacea) or from blood vessels near the surface (red acne marks, cherry angiomas, spider angiomas). Less often, red dots are tiny bleeds under the skin. The table compares the common causes and the warning sign.

Are red spots on my face acne?

If they are tender red bumps that come and go alongside blackheads or whiteheads, they are most likely acne papules and pustules. On brown and black skin the bumps can look darker or purple, and they often leave brown marks behind. Acne usually sits on the forehead, cheeks, chin and jawline, and on the chest and back.

Over-the-counter benzoyl peroxide, adapalene and salicylic acid treat mild acne. Deep, painful or scarring acne needs a dermatologist. Our guide to papules vs pustules explains the different types of breakouts.

Why do I have flat red marks where my pimples used to be?

Flat pink, red or purplish marks left after pimples heal are post-inflammatory erythema (PIE). They come from small blood vessels that stay widened after the inflammation, which is why they look red instead of brown. A 2013 paper in the Journal of Clinical and Aesthetic Dermatology proposed the term to separate these red marks from the brown marks of post-inflammatory hyperpigmentation.

PIE usually fades on its own over months. Sun protection, gentle care and azelaic acid can help, and vascular lasers are an option for marks that last. Pressing gently on a PIE mark usually makes it fade for a moment; brown marks stay the same. See our full guide to red acne marks (PIE) and, for brown marks, how to fade dark spots.

What is a small, bright red dot on my face?

A smooth, bright red dot or tiny dome that does not come and go is often a cherry angioma, a harmless growth of small blood vessels. DermNet describes it as a firm red, blue or purple papule, 0.1 to 1 cm in diameter, that causes no symptoms. Cherry angiomas increase in number from about age 40, though about 5% of adolescents have them, and DermNet notes they are more noticeable on white skin than on skin of color.

They do not need treatment. If one bothers you, a dermatologist can remove it with freezing, electrosurgery or a vascular laser. Occasionally a dark or changing spot that looks like an angioma is removed and checked to rule out melanoma, so show a doctor any spot that grows quickly, bleeds without injury or changes color.

What are spider veins and broken capillaries on my face?

A red dot with fine lines radiating from it like spider legs is a spider angioma, also called a spider telangiectasis. DermNet says it affects 10 to 15% of the population, usually on the face, neck and upper chest. Pressing on the center makes the legs disappear; they refill as soon as you let go. A single spider angioma is harmless.

Many spider angiomas at once are more common in pregnancy, with combined birth control pills, and with liver disease, so a sudden crop of them is worth mentioning to a doctor. Fine, thread-like red vessels across the nose and cheeks without a central dot are telangiectasias, often called broken capillaries. They are common with sun damage and with rosacea. Vascular lasers and light treatments can reduce them. Our guide to signs of sun damage on the face covers prevention.

Could red bumps on my cheeks and nose be rosacea?

If the red bumps sit on a background of flushing or lasting redness across the nose and cheeks, rosacea is likely. The AAD describes acne-like breakouts on the cheeks that just won't clear and visible blood vessels as signs of rosacea, with redness on lighter skin and a brown or violet color on darker skin. The bumps are visible on all skin tones. Unlike acne, rosacea has no blackheads.

Rosacea often burns or stings and flares with heat, sun, alcohol and spicy food. The NHS says a doctor may prescribe creams and gels or a course of antibiotic tablets, and dermatologists use lasers and light treatments for the redness and vessels. See rosacea vs acne and rosacea triggers to avoid.

When are red dots on the face a red flag?

Pinpoint red, purple or brown dots that do not fade when pressed may be petechiae: tiny spots of bleeding under the skin. Cleveland Clinic explains that petechiae stay purple, red or brown when you press on them, while a rash turns pale, and that they are not raised or itchy. MedlinePlus says bleeding into the skin, aside from a common bruise, should always be checked out by a health care provider.

On the face and around the eyes, petechiae often follow hard straining: vomiting, a coughing fit, heavy lifting or giving birth. Other causes are more serious, including infections, low platelet counts, blood thinners and other medicines, and blood cancers such as leukemia.

Cleveland Clinic advises seeking medical attention for pinpoint red dots together with fever, confusion, dizziness or fainting, trouble breathing, or spots that spread quickly. The NHS lists a rash that does not fade when a glass is pressed against it as a possible sign of meningitis, and notes it can be harder to see on brown or black skin, so also check paler areas such as the palms of the hands, soles of the feet, roof of the mouth and inside the eyelids. Call emergency services for a non-fading rash with fever, especially in a child.

How do I do the press test on red spots?

Press the side of a clear drinking glass or a clean glass slide firmly against the spot and look through it:

• The red fades or turns pale: the color comes from blood vessels that are widened but intact. This is typical of inflamed acne, PIE, rosacea and spider angiomas.
• The red stays the same: the color may come from blood outside the vessels, as in petechiae. If you also feel unwell or have a fever, get medical help right away.

The test is only a rough guide, and on darker skin the change can be hard to see. When in doubt, ask a doctor.

When should I see a dermatologist about red spots on my face?

Book a visit if:

• A red spot grows, bleeds without injury, crusts or does not heal within a few weeks.
• Many new spider angiomas or red dots appear in a short time.
• Acne is deep, painful, leaving scars or not improving after a couple of months of over-the-counter care.
• Redness and bumps on your cheeks and nose keep coming back, or your eyes feel gritty or irritated.
• Red marks from old pimples bother you and are not fading after several months.

For non-fading dots with fever or feeling unwell, go to urgent care or the emergency room instead. For everything else, find a dermatologist near you. To compare red spots with red rashes, see our visual guide to rashes on the face, hives on the face and why your face is red.