Diagnostics
In order to be able to make a correct diagnosis, the doctor will take a medical history with questions about the beginning and duration of the red spots, their appearance, a possible itching or burning sensation, their localization and spread, similar symptoms in the past and any self-therapy that has already been carried out. The red spots are then examined. Swabs or blood samples may also be taken.
Therapy
Depending on the cause of the red spots, there are also different therapies. As a matter of principle, every new skin rash should be examined and evaluated by a dermatologist to rule out serious infections or skin diseases. Infections can be treated with certain antibiotics (for bacterial and parasitic causes), antivirals (against viruses) or antimycotics (against fungi).
Skin diseases such as acne can be treated with retinoids, antibiotics and keratolytic drugs such as benzoyl peroxide. Rosacea is treated with antibiotics such as tetracycline and isoretinoin. For allergies, antihistamines such as clemastine or prednisolone can help. For psychologically caused red spots, relaxation exercises and autogenic training are recommended.
Prognosis
Regardless of the causes, the prognosis for red spots on the neck and body is usually good. Underlying infections or diseases can be treated with medication, allergic reactions can be avoided and treated. If a dilatation of the vessels due to alcohol, excitement or nervousness is the cause of the red spots, it cannot really be treated. In this case, alcohol withdrawal, temperature regulation or autogenic training would help. With enough self-confidence, however, this problem would also be easily solved.
Accompanying symptoms of red spots on the neck
Red patches, which manifest themselves mainly on the neck and face, are usually found in the context of a dermatological disease such as acne vulgaris, rosacea, contact dermatitis (allergic reaction to cosmetic products) or perioral dermatitis. This usually affects young women over 35 years of age and manifests itself through red spots, pimples and scaling in the mouth–nose area, which can often also cause a burning sensation.Studies assume that the cause lies in the use of changing care products or too frequent application of cream. Red spots on the neck and décolleté are often found in the context of erythrophobia, a psychologically caused blushing when nervous and excited.
These are usually extensive and confluent and are caused by an increased circulation of capillary skin vessels. Red patches that appear separately on the neck and nape of the neck can be an expression of allergic reactions, e.g. to perfumes or shampoos, or can also occur as part of a naevus flammeus (“flame mark”). This is usually congenital and harmless and has been present since childhood.
Red spots on the neck without itching are usually the result of increased blood circulation. Often the face and décolleté are also affected and the red spots are accompanied by a feeling of heat. These red spots can occur after a longer stay in the heat (for example, during a sauna visit) and usually subside by themselves after a short while.
Red spots on the neck can also appear briefly after exercise. In addition, the skin is also better supplied with blood if it has been exposed to extreme cold (for example in winter) and you get back into the warmth. Furthermore, red spots on the neck can be caused by various foods.
These include eating strongly spiced or spicy foods. Red spots on the neck or face can also appear after drinking alcohol, especially when drinking red wine or schnapps. If the skin is rubbed with blood circulation-promoting products such as a skin peeling, red spots can also appear.
A permanent dilation of the blood vessels (rosacea), which usually causes red spots on the face and especially on the cheeks, chin and forehead, can also cause red spots on the neck and décolleté in severe cases. Rosacea occurs in adults from the age of 30. Since the correct facial care should be observed, it is recommended that affected persons consult a dermatologist.
In babies and children, red spots can be an indication of harmless, congenital skin symptoms or systemic infections caused by the so-called childhood diseases. Typical harmless, congenital red skin symptoms can include hemangiomas and a nevus flammeus. The nevus flammeus (“port-wine stain“) is a congenital malformation of the capillary vessels below the epidermis, which shimmer under the skin and appear as a large red spot on the baby’s face or neck.
If the naevus flammeus is found in the neck area, it is usually harmless. If, on the other hand, it is found in the area of the face, this can be an indication of an underlying systemic disease, a so-called phacomatosis (e.g. von Hippel Lindau syndrome or Sturge Weber syndrome). Since a nevus flammeus usually disappears by itself during the first years of life, it is advisable to wait.
In persistent cases the “stork bite” can be removed with the help of a laser. Another cause of red spots in babies can be hemangiomas, a so-called blood sponge in babies. Hemangiomas are benign vascular tumors, which can occur mainly in premature babies, but whose prognosis is usually benign.
Infantile hemangiomas usually manifest themselves after the first 4 weeks of life as a small, red spot on the face and then grow into a raised haemangioma by the 6th month of life. Afterwards, the regression begins, which usually takes many years. With particularly large hemangiomas, small scars or swellings may remain.
Congenital hemangiomas, on the other hand, are already fully mature at birth and may or may not recede afterwards (depending on their shape). If there are more than 3 hemangiomas in the baby, an additional ultrasound scan of the baby’s skull and abdomen should be performed, as more than 3 hemangiomas are associated with an increased risk of hemangiomas in the liver and brain. For cosmetic reasons, the hemangioma should be removed with a laser or with the help of a drug (propranolol).
As in adults, red spots in babies or small children can also indicate systemic infections, e.g. the typical childhood diseases such as measles, rubella and three-day fever. In the case of three-day fever (or also called exanthema subitum), after an initial rise in temperature and a fever interval of 3-5 days, a sudden drop in temperature and a subsequent rash occurs.This presents itself in the form of bright red spots on the neck and torso of the child, which can spread to the face and even affect the palate (so-called “Nagayama spots”). The therapy is carried out symptomatically to relieve the fever, the illness ends by itself.
Measles has a typical 2-phase course, in which flu-like symptoms such as coughing, rhinitis and fever initially occur. This is followed by a severe feeling of illness and the typical measles exanthema breaks out. This is manifested by numerous large red spots, some of which confluidate.
These are typically found behind the ears and then spread over the entire body. Rubella is caused by the rubella virus and usually has an incubation period of 14-21 days. Typical symptoms of rubella are a slightly impaired general condition, a severe swelling of the lymph nodes behind the ears and on the neck and the subsequent exanthema.
This is characterized by small to medium-sized, light red spots that do not merge into one another. They start behind the ears and then spread to the entire body. After 3 days the rash is usually completely gone.
Scarlet fever, a fine red rash especially in the groin, strongly reddened cheeks with a brightening around the mouth and a strongly reddened tongue, which is also called raspberry or strawberry tongue because of its appearance, can be found in addition to severe sore throat and difficulty swallowing. After 1 week, the red spots fade away and there is a bran-like scaling of the skin, especially on the palms of the hands and the soles of the feet.
