Why Is My Face Purple After Vomiting? Understanding the 'Mask Phenomenon'

October 1, 2025 •

5 min read

According to dermatological case reports, it is a well-documented phenomenon that forceful and repetitive straining, such as from vomiting, can cause tiny, non-threatening broken blood vessels to appear on the face. If you’re asking, 'Why is my face purple after vomiting?', the answer is most often a benign condition called petechiae or purpura.

Quick Summary

Forceful vomiting can cause tiny blood vessels in the face to rupture due to increased pressure, resulting in small red or purple spots known as petechiae or purpura. This temporary condition, often called the 'mask phenomenon,' is typically harmless and fades on its own within days as the capillaries heal. While usually no cause for concern, persistent or spreading spots, especially when accompanied by other symptoms, warrant a medical evaluation.

Key Points

Cause: The primary cause is increased venous pressure during forceful vomiting, which ruptures tiny capillaries just under the skin.
Appearance: The resulting spots, known as petechiae (pinpoint dots) or purpura (larger patches), are harmless collections of blood that have leaked into the skin.
Commonality: This phenomenon, sometimes called a "mask phenomenon," is relatively common after severe straining from vomiting, coughing, or childbirth.
Prognosis: The discoloration is temporary and typically fades completely on its own within a few days to a couple of weeks, without needing specific treatment.
Warning Signs: While usually benign, medical advice should be sought if the rash persists beyond two weeks, spreads, or is accompanied by other symptoms like fever or easy bruising.
Other Factors: Frequent vomiting, as in bulimia nervosa, can also lead to facial swelling from enlarged salivary glands, a different but related condition.
Home Care: Treatment is not usually necessary, but resting, staying hydrated, and applying cool compresses can help soothe any minor discomfort.

Understanding the 'Mask Phenomenon'

When you experience a forceful bout of vomiting, the intense muscle contractions and involuntary straining significantly increase pressure throughout your body. This pressure, particularly concentrated in the head and neck, causes a surge in the delicate blood vessels known as capillaries. The facial tissues, especially the areas around the eyes (periorbital region) and neck, have relatively loose tissue and are rich in these tiny blood vessels. The sudden, high pressure can overwhelm the vessel walls, causing them to rupture and leak small amounts of blood into the skin.

This is known as the 'mask phenomenon' or emesis-induced facial purpura. The resulting discoloration appears as a rash of tiny red or purple pinpoint dots (petechiae) or slightly larger patches (purpura). The deep purple or reddish hue is simply the leaked blood becoming visible under the skin's surface, similar to a minor bruise. This reaction is not a sign of major internal bleeding but rather a superficial skin effect of the physical strain. The rash is not palpable (you cannot feel it with your fingers) and is typically harmless, fading spontaneously as the body reabsorbs the leaked blood.

What Happens to Your Capillaries?

Sudden Pressure Increase: The force of vomiting, coughing, or other straining maneuvers creates a sudden, strong rise in venous pressure in the upper body.
Capillary Rupture: The delicate, tiny capillaries are unable to withstand this abrupt pressure surge and break.
Blood Leakage: The broken vessels leak small amounts of blood into the surrounding skin tissue.
Discoloration: The trapped blood is what causes the characteristic red or purple spots. As the blood is reabsorbed by the body, the spots gradually fade, much like a bruise.

The Science Behind the Discoloration: From Petechiae to Bruising

The appearance of the discoloration depends on the extent of the capillary rupture. Medical professionals use specific terms to classify these skin lesions based on their size.

Types of Skin Bleeding Due to Pressure

Petechiae: These are the smallest type, appearing as tiny, pinpoint red, purple, or brown spots, typically less than 2mm in diameter. They are the most common result of vomiting-induced straining.
Purpura: These are slightly larger blood spots, ranging from 2mm to 10mm in diameter. The rash from vomiting is sometimes called emesis-induced purpura.
Ecchymosis: Commonly known as a bruise, this is a larger area of blood collection under the skin, over 10mm in diameter. While less common from a single episode, severe straining can lead to more widespread facial bruising.

Other Potential Factors and Underlying Causes

While isolated petechiae from vomiting are benign, other factors can sometimes contribute to or worsen the appearance. It is crucial to distinguish between simple strain-induced spots and those potentially caused by a different underlying issue.

For example, individuals with chronic conditions involving frequent vomiting, such as bulimia nervosa, can develop noticeable facial swelling in addition to or instead of petechiae. This swelling, sometimes called "chipmunk cheeks," is caused by the frequent irritation and enlargement of the salivary glands, particularly the parotid glands. This is a different mechanism from the capillary rupture that causes purple spots, although both can occur in tandem. Other, more serious causes of widespread petechiae include blood disorders (like thrombocytopenia), infections (like meningitis), or severe allergic reactions.

How to Care for Your Skin and When to Seek Medical Attention

For simple, strain-induced petechiae, specific treatment is not required. The spots typically resolve on their own as the body heals the tiny, broken vessels. However, you can take some steps to soothe the skin and aid recovery.

At-Home Remedies

Rest: The most important step is to allow your body to recover from the stress of vomiting. Avoid any further strenuous activity that could increase pressure.
Hydration: Vomiting can lead to dehydration. Drinking plenty of fluids, such as water or electrolyte drinks, can help rehydrate your body.
Cool Compresses: Applying a cool, damp cloth to your face can help soothe any discomfort and reduce inflammation.
Avoid Irritation: Do not rub or scrub the affected areas, as this can cause further irritation to the delicate skin and capillaries.

When to See a Doctor

While often harmless, there are specific instances where you should seek medical advice. If your facial discoloration is accompanied by any of the following, a doctor should evaluate you:

The rash persists for more than two weeks or spreads significantly.
You notice excessive or unexplained bruising elsewhere on your body.
You experience symptoms of a potential bleeding disorder, such as nosebleeds or bleeding from your gums.
You also have a fever, severe headache, confusion, or other signs of infection.
You are concerned about an underlying eating disorder like bulimia.


Sign	Typical Strain-Induced Discoloration	Potentially More Serious Concern
Appearance	Tiny, non-raised red/purple dots (petechiae) localized to the face, neck, and upper chest.	Widespread, spreading, or excessive bruising (ecchymosis).
Symptom Profile	The discoloration is the only noticeable symptom; no fever, pain, or illness beyond the cause of vomiting.	Accompanied by fever, severe headache, confusion, or unexplained bleeding from other sites.
Duration	Fades on its own within a few days to two weeks as the body reabsorbs the leaked blood.	Persists for more than two weeks, worsens, or returns without re-straining.
Underlying History	Occurs after a single, isolated episode of forceful vomiting or straining.	A pattern of frequent vomiting, potential eating disorder, or history of bleeding issues.

Conclusion

The sight of a purple face after vomiting can be alarming, but in the vast majority of cases, it is a benign and temporary condition caused by the rupture of tiny capillaries due to pressure. This "mask phenomenon" is simply a visible sign of physical strain and not a symptom of a serious health problem. The discoloration will naturally fade as your body recovers. By resting, hydrating, and avoiding further strain, you can aid the healing process. However, staying mindful of your symptoms is key. If the discoloration lingers, spreads, or is accompanied by other signs of illness, consulting a healthcare provider will ensure there isn't a more complex underlying issue at play. For most, the best course of action is simply to wait patiently for the spots to disappear on their own, a testament to the body's remarkable healing capabilities.

For more information on causes of petechiae, you can visit the Mayo Clinic's resource on the topic.

Frequently Asked Questions

These small spots are called petechiae, which are tiny, broken capillaries caused by the increased pressure from straining during vomiting. They are generally harmless and temporary.

Yes, it is fairly common, especially after a particularly forceful or intense bout of vomiting. The discoloration is a result of burst capillaries and is not typically a cause for concern.

In most cases, the petechiae will fade on their own within a few days to a week or two as the body naturally reabsorbs the leaked blood.

You should see a doctor if the spots do not fade within two weeks, if they spread, or if you also experience a fever, unexplained bruising, or bleeding from other areas.

It is difficult to prevent, as it is a physiological response to pressure. The best approach is to address the underlying cause of the vomiting and reduce the intensity of straining.

Yes, while petechiae are more common, severe straining can lead to larger patches of broken capillaries, known as purpura or ecchymosis (bruising).

Yes, facial swelling, particularly around the jaw, can be caused by enlarged salivary glands from repeated vomiting, as seen in conditions like bulimia. This is distinct from the broken blood vessels that cause petechiae.

While not a direct cause of the broken capillaries, severe dehydration can impact overall health and may affect the integrity of blood vessels. Staying hydrated is important for recovery.

The spots will resolve on their own, so no specific treatment is required. You can rest, stay hydrated, and apply a cool compress to soothe the area, but avoid rubbing the skin.