Small blood spots on the hands like pinpoints may be caused by trauma, allergic purpura, cherry angiomas and so on. 1. Trauma: the hand is stimulated by needlestick injuries, stab wounds and other stimuli, which may cause subcutaneous capillary rupture, appearing on the hand with small blood spots like a needle point. 2. allergic purpura: it is an inflammatory reaction of the blood vessels, which may cause subcutaneous capillary rupture, skin bleeding spots, skin bruises, which leads to small blood spots on the hands like pinpricks. 3. Cherry angioma: caused by abnormal proliferation of blood vessels in the skin, which may also lead to small blood spots on the hands like pinholes. There may be other reasons why there are small blood spots on the hands like pinholes, it is recommended to go to the hospital in time for examination and treatment as prescribed by the doctor.