Unexplained Red Spots on Skin: Causes and Insights - Dermatology

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Unexplained red spots on the skin can be concerning, especially when they appear suddenly and without accompanying symptoms like pain or itching. Based on your description of the red spots being flat and located beneath the skin, there are several potential causes to consider.

1. Petechiae: These are small, pinpoint red or purple spots that can appear on the skin due to bleeding under the skin. They are often caused by minor trauma, certain medications, or conditions that affect blood clotting. While you mentioned that you do not believe this is purpura, it is still worth considering if there has been any recent physical activity or medication changes.

2. Cherry Angiomas: Although you indicated that these spots are not cherry angiomas, it’s important to note that these benign growths of small blood vessels can appear as small red spots on the skin. They are common and usually harmless, but they can be removed if desired for cosmetic reasons.

3. Seborrheic Keratosis: These are non-cancerous skin growths that can appear as red, brown, or black spots. They are often raised but can also be flat and may vary in size. They are generally harmless and do not require treatment unless they become bothersome.

4. Dermatological Conditions: Conditions such as eczema or psoriasis can sometimes present as red spots, although they typically come with other symptoms like itching or scaling. If the spots are not itchy or painful, this may be less likely.

5. Allergic Reactions: Sometimes, an allergic reaction to a product or environmental factor can cause localized redness or spots. If you have recently changed any skincare products or been exposed to new allergens, this could be a factor.

6. Vascular Lesions: Conditions such as vascular malformations or other benign vascular lesions can also present as red spots. These are usually harmless but may require further evaluation if they change in appearance or number.

7. Infections: Certain viral infections can cause red spots on the skin, although these are often accompanied by other symptoms. If you have had any recent illnesses, this could be a consideration.

Given that the spots are not painful or itchy, they may not be a cause for immediate concern. However, it is essential to monitor them for any changes in size, color, or number. If they persist, change, or if you develop any new symptoms, it would be advisable to consult a healthcare professional for a thorough evaluation.
In conclusion, while there are several benign explanations for unexplained red spots on the skin, a definitive diagnosis can only be made through a physical examination and possibly further testing. If you have any concerns or if the spots begin to change, seeking medical advice is the best course of action.