Mottled Skin: Causes, Symptoms and Possible Treatments

Mottled Skin: Causes, Symptoms and Possible Treatments

Mottled skin is a term to describe skin that appears to have lacy patches of purple discoloration on it. The patchy-looking skin is often a chronic medical condition that looks worse when the skin is exposed to the cold. Mottled skin is also called livedo reticularis and it thought to be connected to vascular conditions and autoimmune diseases like rheumatoid arthritis and lupus.

The most common symptom of mottled skin is red or purple patches most commonly on the legs, but this condition can also affect the arms and upper body. Primary livedo reticularis often has no known cause. However, other cases of mottled skin are classed as secondary livedo reticularis, meaning that it is caused by another underlying medical condition.

According to Johns Hopkins Medicine, livedo reticularis can also be seen in babies and young women, and is more prominent on the extremities, and is often accentuated by cold exposure. So for most people with mottled skin, avoiding the cold is the only way to prevent it from getting worse. Usually, the only way to cure mottled skin is to address the underlying cause, if that is known.

Symptoms of Mottled Skin (Livedo Reticularis)

The term livedo reticularis comes from Latin meaning “bluish net-like appearance.” According to, skin that is mottled develops a visible network of blotchy patches that can be anywhere from a red to dark purple color with pale skin in the middle.1

The Indian Dermatology Online Journal reported that mottled skin without any underlying cause mainly affects middle-aged women. However, both men and women can have the appearance of mottled skin if it is the result of another disease.2

Mottled skin more commonly affects the extremities like the hands, arms, feet, and legs. This is why many doctors ascribe it to a vascular condition.

Mottled Skin (Livedo Reticularis) Causes

There are many common and rare medical conditions that can cause lacy patches of discolored skin. Here are some of the more common reasons for having mottled skin.

Impaired circulation

Mottled skin can be caused by a number of medical syndromes that result in impaired blood circulation.

The Indian Dermatology Online Journal commented that livedo reticularis has been reported in people with blood circulation disturbances. The purplish patchy skin is caused by a lack of oxygenated hemoglobin-rich blood cells which causes the skin discoloration.2

Good blood circulation is important for a healthy heart and to maintain healthy blood pressure levels. For some practical tips on how to improve your blood circulation, please read my article on how to improve blood circulation naturally.


Lupus is an autoimmune disorder that can cause mottled skin with net-like purple patches. According to Johns Hopkins Medicine, lupus causes various skin diseases and livedo reticularis is just one of them. The doctors at Johns Hopkins say that lupus can cause mottled skin in babies and young women and is more noticeable in cold weather.3

Lupus can also cause tiny red spots in the skin which are called petechiae. This is due to lupus interfering with clotting mechanisms in the blood.

Rheumatoid arthritis

Although rheumatoid arthritis often causes joint inflammation and pain, it can also cause mottled skin. Like lupus, rheumatoid arthritis is an autoimmune disorder but it usually affects joints in the body and causes deformity in these. However, people suffering from rheumatoid arthritis often have dark, patchy skin.

Staff from DermNet New Zealand say that rheumatoid arthritis can cause skin changes resulting in dark purplish areas on the skin.4 Dr. David Zelman on WebMD says that rheumatoid arthritis can also affect blood vessels which can cause a painful rash on the legs.5

Antiphospholipid syndrome

Antiphospholipid syndrome (or sometimes called Hughes Syndrome) is an immune disorder that can cause blood clots. Antiphospholipid is also associated with lupus and it affects young to middle-aged adults more than others.

According to dermatologists, one of the main symptoms of antiphospholipid syndrome is mottled skin. Because of the increased risk of blood clots and circulation problems, it can also cause leg ulcers and put you at greater risk of developing deep vein thrombosis.6


Mottled skin with an appearance of a lacy network of purple patches can occur in people who have acute pancreatitis. Acute pancreatitis happens when the pancreas suddenly becomes inflamed and causes severe abdominal pain, nausea, and vomiting. According to the New England Journal of Medicine, livedo reticularis can show up 2 to 3 days after the abdominal pain.7

Side effect of medications

Some medication cause lace-like dark patches on the skin. For example, it has been reported that some medication for Parkinson’s disease can cause livedo reticularis.8 Doctors from the Mayo Clinic also report that medication used to treat multiple sclerosis can also cause mottled skin.9

Hormonal factors

In some people, diet and some unknown hormonal factors can produce symptoms of mottled skin. For example, the Indian Dermatology Online Journal reported that hypothyroidism is associated with livedo reticularis. The symptoms of lace-like patchy purple skin were resolved when the appropriate medication was given to resolve the low thyroid levels.2

Therefore, having areas of mottled skin that appear as blotchy patches could be one of the signs of a thyroid disorder. Please read my article on natural remedies to boost your thyroid function to find out how to manage this condition naturally.

Too many red blood cells

A condition called polycythemia is when you have too many red blood cells. This can cause your skin to have a purple lace-like network of patches. Dermatologist Dr. Sara de Menezes says that too many red blood cells can cause mottled skin.10


Fibromyalgia is a chronic and complex medical condition that causes muscle pain, fatigue, and sleep problems. Although fibromyalgia is usually associated with chronic pain, the symptoms of fibromyalgia can also manifest themselves as discolored patches on your skin.

The journal Rheumatology reported that a common symptom of fibromyalgia syndrome is livedo reticularis.

Other Causes of Mottled Skin (Livedo Reticularis)

According to dermatologist Dr. Sara de Menezes, there are other causes of mottled skin.11 Some of these are:

  • Sneddon syndrome
  • Protein C and S deficiency
  • Multiple sclerosis
  • Parkinson disease
  • Tuberculosis
  • Hepatitis C
  • Inflammatory breast cancer

Mottled Skin in Babies

Very often babies develop mottled skin and according to Dr. Sara de Menezes, about 50% of normal infants have this. This condition should improve with age.

However, you should be aware that pale blotchy skin along with a fever, unusual crying, and irritability are just some of the warning signs of meningitis.12

What to Do About Mottled Skin (Livedo Reticularis)

According to the journal Actas Dermo-Sifiliograficas, there is not an effective treatment for livedo reticularis. Some doctors treat the symptoms with blood-thinning medication and anticoagulants. If you have secondary livedo reticularis (i.e. when the lace-like purple discolored skin is caused by another condition), doctors will treat the underlying cause to help improve the appearance of your skin.13

It can be difficult to know what to do about mottled skin, especially if it is difficult to identify the underlying cause. However, most doctors agree that keeping out of the cold is one of the best ways to stop mottled skin and reduce the appearance of patchy purple blotches on your skin.

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Article Sources

  1. Medscape. Livedo reticularis.
  2. Indian Dermatol Online J. 2015 Sep-Oct; 6(5): 315–321.
  3. HopkinsLupus. Lupus-specific skin disease and skin problems.
  4. DermNetNZ. Rheumatoid arthritis.
  5. WebMD. When rheumatoid arthritis causes skin problems.
  6. DermNetNZ. Antiphospholipid syndrome.
  7. N Engl J Med. 1954; 251:851-85.
  8. JAMA. 1970;212(9):1522-1523.
  9. MayoClinic. What causes livedo reticularis?
  10. DermNetNZ. Skin manifestations of hematological
  11. DermNetNZ. Livedo reticularis.
  12. NHS. Skin rashes in babies.
  13. Actas Dermosifiliogr. 2008;99:598-607

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