Mottled Skin: Causes, Symptoms, Diagnosis, And Treatment

There are treatment options to help manage and reduce mottled skin.

Medically reviewed by Dr. Harryono Judodihardjo, PhD, DipGUM
Written by Reevan Vishwas Rego, MA (Mass Communication & Journalism), Certified Skin Care Coach
Edited by Anjali Sayee, BTech
Fact-checked by Swathi E, MA (English Literature), Certified Skin Care Coach  • 

Mottled skin or livedo reticularis is a common sign of poor circulation due to exposure to cold temperatures. It causes blood flow restriction in the small veins beneath the skin, causing the development of fine red or purple skin patches known as reticula. Mottled skin is a temporary skin condition that resolves on its own and usually does not require any medical intervention. However, if it does not go away after a few days, it may also indicate a reaction to medications or due to a serious medical condition that may require immediate medical attention. Keep reading to understand why the skin mottles, symptoms, diagnosis, and when it is a cause for concern.

What Is Mottling Of Skin?

Mottling is a condition characterized by red, gray, and purple patches in a net- or lace-like pattern that appear on your skin. You may begin to notice these patchy marks on your arms, legs, knees, and the back. A variety of conditions can lead to mottling of the skin – the most common of them being exposure to cold surroundings. In some cases, this leads to a disruption in blood flow due to the variations in temperature.

Young women commonly experience mottled skin on legs due to the exposure to extreme cold weather. Mottled skin may also be caused by the deposition of calcium within the blood vessel walls or endothelial dysfunction (where the blood vessels on the heart’s surface constrict) (1).

Mottled or blotchy skin can either be caused due to isolated factors or as a side effect of some medication. Medications prescribed for Parkinson’s disease are known to commonly cause this skin condition (2).

protip_icon Fun Fact
The term livedo reticularis referring to the mottled skin condition, is derived from Latin. “Livere” means bluish, and “reticular” means a net-like pattern.

Let us understand the common signs of mottled skin and how you can identify it.

What Are The Symptoms Of Mottled Skin?

The most common symptom of mottled skin is purple or red patch or dappled appearance on the skin. A closer inspection may reveal a network of lacy-looking patches leading to an uneven, discolored skin tone. Other signs include pain in the lymph nodes or development of ulcers related to mottled skin. However, these symptoms are only based on anecdotal evidence.

We will look into the causes of mottled skin in the next section.

What Are The Causes For Mottling Of Skin?

Mottled skin can be caused due to many factors. However, poor blood circulation and blood vessel spasms are the leading causes (1). Poor blood circulation can be a result of high cholesterol and high blood pressure levels. Smoking also may narrow blood vessels and restrict the normal flow (3).

Other causes of mottled skin include:

  • Lupus

Lupus (or systemic lupus erythematosus (LSE)) is an autoimmune disease that affects multiple body organs. You may begin to notice lesions on your skin, which eventually may turn into red and purple variegated patches (4).

  • Exposure To Extreme Cold

Exposure to extremely cold or freezing temperatures causes your body to restrict blood flow to your skin by constricting the blood vessels. This thermoregulatory function happens to preserve your core temperature – resulting in the formation of purple speckled skin. In this case, the mottled, spotted skin can be reversed by exposing yourself to warmer temperatures (5).

  • Bier Spots

Another cause of skin mottling is Bier spots. This is common among individuals aged 20 to 40 years and is more significant in women. Here, you notice white marble-like patterns instead of purple and red splotchy patches. Skin mottling due to Bier spots is harmless and requires no treatment. However, Bier spots may signify other underlying conditions that may warrant relevant treatment (6).

  • Shock And Trauma To The Body

Shock and trauma to the body in the form of electric burns, injuries, or blunt force can damage your blood vessels. Such trauma can disrupt blood flow to various parts of your body, including your skin. This may eventually lead to mottling of the skin (3).

  • Pancreatitis

People with acute pancreatitis may find their abdominal skin mottling. In a study, a 40-year-old woman experiencing acute pancreatitis developed a blue rash on her abdominal region. Further examination suggested it to be mottled skin. Her mottled abdominal skin was found to be consistent with her previous pancreatitis attacks (6).

  • Sepsis

Sepsis is your body’s extreme response to an infection during a life-threatening emergency. It occurs when a pre-existing infection causes a chain reaction within your body. Untimely treatment may even result in death. Sepsis may also cause skin mottling (7).

  • Rheumatoid Arthritis

Rheumatoid arthritis is characterized by inflammation of the joints. It also may cause tissue damage and chronic pain. An uncommon manifestation of rheumatoid arthritis is rheumatoid vasculitis. The condition causes inflammation, ulcers, and gangrenous formations on the skin. It is observed only in 1% of rheumatoid arthritis patients. Rheumatoid vasculitis also affects blood vessels and may cause mottled skin (8).

These are some of the causes of mottled skin. But how to diagnose it and when should you consult a doctor?

How To Diagnose Skin Mottling And When To See A Doctor?

Red and purple patches in a lace-like pattern on your skin can almost always denote mottled skin. Mottled skin usually does not require a doctor’s visit as it tends to subside in a day or two. However, symptoms that prolong or get you seriously worried warrant a doctor’s inspection.

protip_icon Quick Tip
Livedo reticularis is of four types: Physiological, primary, idiopathic, and amantadine-induced (1).

If you are suffering from mottled skin and are seeking treatment for it, let us understand how you can go about it.

Treatment Options For Mottling Of Skin

With regards to the treatment of mottled skin, there is no one specific method or medication. It solely depends on a case-to-case basis. A person suffering from Parkinson’s disease is likely to have mottled skin as a side effect from the medication they are taking as part of their treatment. Similarly, some medications that are critical to the treatment of certain conditions may cause the mottling of the skin, which doesn’t mean that you stop taking that medication.

Infographic: A Comprehensive Guide To Understand Mottled Skin

If your skin looks blotchy with a lacy network of purple or red patches, chances are you have mottled skin. Factors like sepsis, high blood pressure, and rheumatoid arthritis may result in the development of these patches. Check out the infographic below to get a better understanding of the condition and when to take action. Scroll down to know more!

a comprehensive guide to understanding mottled skin (infographic)

Illustration: StyleCraze Design Team

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Download Infographic in PDF version

Mottling of the skin is a disorder in which you may experience red and purple lace-like patches on your skin. This could be due to something as simple as being exposed to extremely cold temperatures or as severe as lupus or Parkinson’s disease. Mottled skin is not considered a serious issue; however, see your dermatologist to determine the exact causes behind the symptoms if the problem persists. Unfortunately, there is no one-size-fits-all treatment for mottled skin. Each case must be treated individually depending on the diagnosis that determines the underlying reason.

Frequently Asked Questions

Should I be worried about mottled skin?

While mottled skin is considered harmless, you should consult a doctor if it doesn’t heal with warming or you develop painful lumps or other accompanying symptoms.

Is it normal to have mottled skin?

Yes. Mottled skin is quite common in a cold climate, but you shouldn’t dismiss it if it persists.

Can heat cause mottled skin?

Yes. Erythema ab igne (EAI), or toasted skin syndrome [10], is a mottled rash on the torso that can be seen in people exposed to local or regional heat.

Key Takeaways

  • Livedo reticularis is characterized by the appearance of net- or lace-like purple patches on the skin.
  • The leading causes of mottled skin include blood vessel spasms, poor circulation, lupus, and cold surroundings.
  • It is usually a harmless condition, but consult a dermatologist if the condition does not subside.


Mottled skin, although a common and transient condition causing patches of discoloration, is usually harmless. To better understand this occurrence and explore possible treatment options, watch this informative video given below!

References

Articles on StyleCraze are backed by verified information from peer-reviewed and academic research papers, reputed organizations, research institutions, and medical associations to ensure accuracy and relevance. Read our editorial policy to learn more.

  1. Livedo Reticularis: A Review of the Literature
    https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC4594389/
  2. Skin Disorders in Parkinson’s Disease: Potential Biomarkers and Risk Factors
    https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC5352163/
  3. Platelets and Cardiovascular Disease
    https://www.ahajournals.org/doi/full/10.1161/01.CIR.0000086897.15588.4B
  4. Cutaneous Manifestations of Systemic Lupus Erythematosus
    https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC3410306/
  5. Raynaud Disease
    https://www.ncbi.nlm.nih.gov/books/NBK499833/
  6. Bier spots: An uncommon cause of mottled skin
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7464368/
  7. Livedo Reticularis: A Rare Skin Manifestation of Pancreatitis
    https://pancreas.imedpub.com/livedo-reticularis-a-rare-skin-manifestation-of-pancreatitis.php?aid=19842
  8. Alteration of Skin Perfusion in Mottling Area During Septic Shock
    https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC3848827/
  9. Arthropathy in Dermatology: A Comprehensive Review
    https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC5372453/
  10. Erythema Ab Igne: A Mottled Rash on the Torso
    https://www.cureus.com/articles/26132-erythema-ab-igne-a-mottled-rash-on-the-torso
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