12 Causes of Red Spots on Legs

By Zina Semenovskaya, MD
Medically reviewed checkmarkMedically reviewed
January 24, 2022

Changes in your skin can be worrisome, especially if your symptoms include itchiness, discomfort, or pain.

And while red spots on your legs could be due to things like mild acne or a simple heat rash, other possible causes may warrant medical attention.

In this article, I’ll describe 12 possible causes of red spots on legs as well as treatment options and when to see a doctor. If you’ve developed a mild skin rash on your legs and you have no other symptoms, it’s OK to wait a few days to see if the rash will go away on its own.

However, if the spots persist for a few days, spread, become painful or infected, or if you develop any additional symptoms, contact your healthcare provider.

They can diagnose the rash and recommend the appropriate treatment plan.

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Potential Causes of Red Spots on Legs

Some causes of red spots on legs clear up in a few days on their own, while other causes require medical attention.

Identifying what’s going on can help determine the most effective course of treatment.

Below are some of the common causes of red spots on legs. 

Folliculitis

Folliculitis occurs when a fungal or bacterial infection (or even ingrown hairs) causes hair follicles to become inflamed or infected.

This can look like:

  • Small red, itchy, or sore bumps
  • White-headed pimples around hair follicles
  • Tiny blister clusters around hair follicles

Mild cases of folliculitis can clear up on their own with basic self-care, including cleaning the affected area with antibacterial soap, using a warm compress, and applying soothing lotions to relieve itchy skin.

In other cases, your doctor may recommend using antibiotic or antifungal cream or shampoo.

If your folliculitis persists after a few days, contact a healthcare provider to discuss treatment options.

Psoriasis

Thick pink or red spots on the legs covered with white or silvery scales (called plaques) typically indicate psoriasis.

This chronic autoimmune disease tends to run in families.

While psoriasis most often affects only a few areas of skin, it can cover a larger area of the body.

The places most commonly affected by psoriasis are the:

  • Elbows
  • Knees
  • Face, scalp, and inside of the mouth
  • Fingernails and toenails
  • Genitals
  • Lower back
  • Palms and feet

Steroid creams, moisturizers, and medicated lotions can treat psoriasis.

Eczema (atopic dermatitis)

Eczema (atopic dermatitis) causes dry, red, very itchy patches or spots that can appear on the hands, feet, neck, inside of elbows, legs, behind the knees, face, and elsewhere on the body.

Most times eczema is a chronic condition, with changes in severity from time to time. 

There is no cure for eczema.

However, over-the-counter (OTC) and prescription creams can help alleviate symptoms.

Hives (urticaria)

Allergies to foods, medications, or insect bites, and exposure to heat, cold, or the sun can cause hives (urticaria) in some people.

These uncomfortable, red, raised, itchy bumps come in a variety of shapes and sizes and can occur anywhere on the body.

They can also change size and location.

Hives tend to resolve after the allergic reaction ends and typically aren’t life-threatening.

Vasculitis

Vasculitis refers to the inflammation of the body’s blood vessels.

More than 20 different types of vasculitis can affect men and women of all ages. 

Hypersensitivity vasculitis (HV), also called leukocytoclastic vasculitis, is an extreme reaction to a drug, infection, or foreign substance that can cause red spots on the skin, often found on the lower legs.

In most cases, stopping use of the drug or substance causing the reaction will clear the rash.

Otherwise, prescription medications can help control symptoms. 

Keratosis pilaris

Keratin is a protein that makes up skin, hair, and nails.

If keratin builds up and plugs hair follicles, it causes keratosis pilaris.

This benign skin condition can look like small bumps or goosebumps on the skin and has a rough texture.

Keratosis pilaris more commonly affects people with very dry skin or eczema. 

Moisturizers are usually sufficient to manage symptoms, otherwise, your provider may recommend a steroid cream to reduce redness.

Insect bites

Most insect bites are harmless, but they can sometimes cause pain, itchiness, or discomfort.

Fire ant bites and certain other insect bites can also cause red spots on the skin. 

Using insect repellant and protective clothing can help prevent insect bites.

If bitten, topical or oral pain relievers, including ibuprofen (Advil) or lidocaine (Solarcaine), can help provide pain relief. Antihistamines and calamine lotion can help relieve itching.

Rosacea

Rosacea causes flushing and redness in the face.

Rarely, it causes red spots on the legs.

Most people can manage rosacea by identifying and avoiding triggers, wearing sunscreen, and, if necessary, taking prescription medication or using laser therapy.

Chicken pox

Though it’s less common since the chicken pox vaccine became available in 1995, children and adults still get this highly contagious viral infection.

Chicken pox causes raised, itchy red bumps that, over time, become blister-like and eventually break open and then crust over. Fever, headache, and fatigue often occur as well. 

These symptoms typically last 1-2 weeks and respond to home treatments such as calamine lotion, colloidal oatmeal baths, and OTC antihistamine and fever-reducing medication like acetaminophen (Tylenol) or ibuprofen (Advil).

Heat rash

Also called miliaria or prickly heat, heat rash occurs when blocked pores or sweat ducts trap sweat underneath the skin.

Adults, children, and babies can get heat rash.

Symptoms include red spots or bumps and itching or prickling.

Most heat rashes heal with cooling of the skin via methods such as spending time in air conditioning, taking a cool shower, and using cold compresses.

Acne

Acne is a common skin condition that occurs when excess oil, bacteria, and dead skin cells clog pores.

This leads to blemishes that can range in size from small whiteheads, blackheads, and red spots or bumps (pimples) to large, painful, cyst-like lumps under the skin.

While acne blemishes most commonly appear on the face, forehead, chest, upper back, and shoulders, they can also appear on the legs. 

Treatment options vary depending on the type of acne, so it’s best to contact a doctor for customized acne care.

Skin cancer

In rare cases, unexplained bumps or spots on the legs or skin can be a sign of skin cancer.

There are three major types of skin cancer: basal cell carcinoma (BCC), squamous cell carcinoma, and melanoma. Red spots on the legs could be a sign of BCC or an early form of skin cancer called Bowen’s disease.

Early detection is key to treating skin cancer, so if you notice abnormal growths or red spots on your legs that don’t go away within a week, follow up with a healthcare provider or dermatologist.

Treatment

Treatment for red spots on legs depends on the cause.

Some, such as psoriasis and eczema, may benefit from prescription lotions, ointments, and medications.

Others can be treated with over-the-counter (OTC) and home remedies.

OTC

OTC topical medications like hydrocortisone cream and calamine lotion may help alleviate itch and other symptoms caused by red spots on the skin.

And OTC pain relievers like ibuprofen (Advil) or acetaminophen (Tylenol) may help with any pain.

Home remedies

Home remedies may alleviate some symptoms of certain causes of red spots and skin rashes.

For itchy skin in particular, applying a cool compress or adding baking soda, uncooked oatmeal, or colloidal oatmeal to a lukewarm bath may bring some relief.

Before trying any home remedy, consult a healthcare professional to determine if the therapy will make your specific symptoms better or worse.

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When to See a Doctor

Many times, red spots on your legs isn’t cause for concern.

However, if they’re accompanied by severe symptoms or if they last for more than a week, contact a doctor.

They can help diagnose the cause of your symptoms and recommend a treatment plan.

How K Health Can Help

Did you know you can access online urgent care with K Health?

Check your symptoms, explore conditions and treatments, and if needed, text with a healthcare provider in minutes. 

K Health’s AI-powered app is HIPAA compliant and is based on 20 years of clinical data.

Frequently Asked Questions

What causes red spots on lower legs?
There are several possible causes of red spots on legs, including eczema (atopic dermatitis), hives (urticaria), insect bites, and heat rash. If you’re unsure what’s causing your symptoms, contact a medical provider.
What do leukemia spots look like?
Some people with acute promyelocytic leukemia develop small red dots under the skin (called petechiae) that are generally most noticeable on people with light skin tones. In people with darker skin tones, these spots may be darker or less noticeable.
Why am I getting spots on my legs?
Working with a healthcare professional is the best way to determine the exact cause of spots on your legs. Possible causes include eczema, hives, insect bites, heat rash, and more serious causes like skin cancer.
What causes little red spots on legs?
It can be difficult to discern what’s causing red spots on your legs. Possible causes include eczema, hives, insect bites, and heat rash. However, some causes can be more serious. If you’re unsure about what’s causing your symptoms, contact a medical provider.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Zina Semenovskaya, MD

Dr. Semenovskaya specializes in emergency medicine, and received her medical degree from Weill Cornell Medical College. She is currently the medical director at Remote Emergency Medicine Consulting, LLC and splits her time working clinically as an emergency medicine attending in California and Alaska. She is the first of our doctors to be fluent in Russian.

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