What Is Mottled Skin (Livedo Reticularis): Symptoms, Causes, and Treatments

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Livedo ReticularisMottled skin, also known as livedo reticularis, is alone a harmless condition that is commonly seen with vascular issues and autoimmune diseases. The condition can also arise as a side effect of medications used to treat Parkinson’s disease and certain other conditions. It’s believed to appear as a result of blood vessel spasms or problems with circulation near the skin. It’s marked by mottled purplish hues, usually appearing net-like on the lower extremities.

What Does Mottled Skin Look Like?

Mottled skin, or livedo reticularis, refers to the Latin description of a bluish, net-like appearance. The discoloration of the skin with lines and patches of purple and blue is actually the constricting of the blood vessels close to the skin’s surface. This can occur as internal changes directly affect the blood vessels, including your body temperature, the aging process, health conditions, sun exposure, and medication use. It is a painless condition that is more visible when in cold temperature environments.

This can show as patterns across the arms, legs, and face, ranging from red to deep brown or purple in color. Mottled skin is seen in both males and females, with the patches appearing more pronounced in those with light skin.

Mottled Skin (Livedo Reticularis) Symptoms

The most obvious symptom of mottled skin is the pattern of purplish-blue lines imitating lace with defined borders. The discoloration is affected by the blood vessels closest to the top layer of skin, so individuals with translucent skin pigmentation will notice changes right away.

What may not be so easy is determining exactly what is causing the blood vessels to constrict in most cases. Mottled skin may be accompanied by severe symptoms of breathing difficulty, painful nodules, ulcers on skin, or the sudden onset of the patch-like skin. In such instances, there is likely a serious health condition behind it and immediate medical attention may be required.

What Causes Mottled Skin (Livedo Reticularis)?

The underlying health conditions that cause the mottled skin to appear can range in severity from mild, treatable conditions to those of a serious nature with only manageable symptoms.

1. Shock

Entering a state of shock from a traumatic event can lead to mottled skin. This can be serious, and potentially life-threatening, if shock is induced by exposure to an acute traumatic event. Such events would include exposure to poison, burns, infections, or another accident. Other symptoms of shock, in addition to mottled skin, include:

  • Breathing issues (rapid or struggling for air)
  • Dilated pupils
  • Rapid pulse
  • Nausea or vomiting
  • Weakness
  • Dizziness
  • Fainting

2. Impaired Circulation (Vascular Disease)

The health and proper functioning of our body parts and systems depend on normal blood circulation. Blood disorders and syndromes that hinder or interfere with circulation can cause a lack of essential oxygenated, hemoglobin-rich blood cells. This can affect the appearance of the skin, resulting in purplish-blue patches.

Impaired circulation can also result from vascular disease. Some conditions affecting blood flow include:

  • Atherosclerosis
  • Blood clots
  • Aortic aneurysms
  • Peripheral vascular disease

3. Lupus

The autoimmune disease lupus directly affects the skin with various symptoms and conditions, and could also cause mottled skin. This is prevalent in young lupus patients, as well as females of all ages. Other symptoms of lupus include:

  • Facial rash
  • Fatigue
  • Pain, swelling, or stiffness
  • Dry eyes
  • Fever
  • Sensitivity to sunlight
  • Poor circulation marked by bluing of the fingers and toes
  • Trouble breathing
  • Headaches

4. Rheumatoid Arthritis (RA)

In some cases of rheumatoid arthritis (RA), another autoimmune disorder, patients may experience a change in the color and texture of their skin, including mottled skin. The lesser-known symptom of a darkened skin pattern can accompany the pain and inflammation of the joints. This is due to the affect this disorder has on the blood vessels near the surface of the skin. Other symptoms of RA include:

  • Fatigue
  • Low fever
  • Pain and stiffness that lasts longer than 30 minutes
  • Anemia
  • Weight loss
  • Firm lumps or nodules beneath the skin in ankles, elbows, and hands

5. Fibromyalgia

This chronic condition may produce mottled skin as a mild symptom compared to the traditional severe muscle pain, insomnia, and general fatigue.

6. Antiphospholipid Syndrome

Better known as Hughes syndrome, this blood disorder is often observed in lupus cases, and may cause blood clots to form. These blood clots affect blood circulation, so mottled skin is considered to be a possible key symptom. Other symptoms of antiphospholipid syndrome to watch for include:

  • Seizures
  • Headaches
  • Blood clots
  • Strokes
  • Dementia

7. Pancreatitis

The debilitating pain associated with an inflamed pancreas can be followed by mottled skin on the legs and arms. Acute cases of pancreatitis can also cause nausea and vomiting. Additional symptoms indicating pancreatitis can include:

  • Pain in the upper abdomen
  • Fever
  • Fast pulse

8. Medication

As a side effect of medication for some health conditions, the purplish-blue patches of skin can appear. This is often seen with drugs prescribed for Parkinson’s disease and multiple sclerosis. Some medications that can lead to mottled skin include:

  • Amantadine
  • Catecholamines
  • Minocycline (“Minocin”)
  • Gemcitabine (“Gemzar”)

9. Hypothyroidism and other Hormone Imbalances

Hormonal changes linked to diseases and special diets may also cause mottled skin. Hypothyroidism, or a lack of thyroid hormone, is just one example. This condition leads to a slower metabolism and related symptoms, which may include:

  • Unexplained weight gain
  • Depression
  • Fatigue

10. End-of-Life Mottling

It’s not uncommon to see mottled skin in the elderly or a person who is close to dying, whether from terminal illness or natural causes. Accompanying symptoms may include:

  • Trouble swallowing
  • Refusing food and water
  • Delirium
  • Unconsciousness
  • Difficulty breathing
  • Extreme fatigue
  • Extremely slow heart rate

Mottled Skin (Livedo Reticularis): Other Possible Causes

In addition to the mentioned underlying health conditions, we should also note there are other conditions that may cause mottled skin. Any of the following situations can attribute to the visibility of the patchy discoloration of the skin because they can directly, or indirectly, affect the blood vessels.

  • Changes in internal core body temperature that affect blood circulation (extremely cold outdoor temperatures may produce similar effects)
  • Thinner, less elastic skin against the blood vessels as a result of the aging process
  • Any treatment or preventive measure for blood clots
  • An underdeveloped circulatory or vascular system in newborns and infants (mottled skin usually dissipates with age)
  • Prolonged exposure to the sun, such as a day spent in the park or on a beach, even with SPF protection

Mottled Skin in Babies

Sometimes newborn babies will have mottled skin when cold. The condition typically resolves itself, and keeping the baby warm by wrapping him or her in a blanket may help. It’s also important to check the infant’s temperature, as mottled skin may indicate an illness as well.

How to Treat Mottled Skin

The mottled skin treatment focuses on the underlying cause of the condition, as most times, it will disappear if the health cause is treated or cured. For cases not associated with a health condition, it can be treated and possibly prevented by keeping the skin covered in extreme cold temperatures and in sunlight.

A person suffering from shock or acute pancreatitis will require emergency care, which may include oxygen, intravenous fluids, testing, and anti-inflammatory medication. For autoimmune diseases, drugs to manage the immune response and inflammation levels may be necessary. Mottled skin resulting from impaired circulation and vascular diseases may be prevented by making changes to medications and implementing lifestyle measures like a healthier diet or increasing activity.

Natural Remedies for Mottled Skin

There are home remedies for patients who seem to have a more permanent case of mottled skin.

1. Aloe Vera

In addition to the touted healing powers of aloe vera plant gel, it can also be used to protect the skin from the sun and to alleviate any redness of the skin from the mottled skin patches. Leave on the affected area for at least 30 minutes, if not until your next shower or bath.

2. Baking Soda

The patches may require the removal of any dead skin cells, and baking soda is a natural exfoliant. Combine three tablespoons of baking soda with water to create a paste. Apply directly to mottled skin for a 30-minute massage treatment. Rinse and repeat once a day, or three times a week.

3. Oatmeal

The anti-inflammatory and antioxidant components of oatmeal could eliminate redness of the mottled skin while moisturizing any rough patches. You can apply a paste of the oatmeal mixed with water and honey directly onto the patches. Add oatmeal to a warm bath for an overall body treatment.

4. Green Tea

Just as with oatmeal, you can also target the redness and inflammation with the powerful properties of green tea. You can apply it to the mottled skin by steeping one tea bag in hot water and soaking a cloth in it to put on affected area. You can also add rice flour or oatmeal powder to create a healing paste. Repeat three times each week.

5. Coconut Oil

Use the anti-septic and anti-microbial properties of coconut oil to help rehydrate the dry patches of molted skin. You can apply it directly to the affected area for the skin to absorb or create a paste mixed with one teaspoon of honey and sugar. Repeat twice each week.

6. Yogurt

Target any rough mottled skin patches with the soothing treatment of yogurt. Apply and leave on the affected area for a 30-minute treatment before rinsing. Repeat three times a week.

When to See a Doctor

If your mottled skin doesn’t clear up on its own in a timely fashion, you may want to visit a doctor. If you find yourself in one of the following situations, schedule an appointment:

  • Your skin discoloration doesn’t disappear with warming
  • Your mottled skin appears alongside other noticeable, concerning symptoms
  • Painful nodules or ulcers develop on the affected area
  • You have existing peripheral vascular disease
  • You have lupus or other connective tissue conditions

Final Thoughts on Mottled Skin

Mottled skin is not a dangerous condition to have as it is an indicator of the physical properties of the blood vessels near the skin’s surface. Yet, the sight of purplish-blue lines creating a pattern on the arms, legs, or face can be troublesome for some patients. It can be brought on by an underlying health condition that may require treatment, and it is possible that the mottled skin signs will disappear once the condition causing them is treated or managed. For those patients with a more permanent form of patchy or purple, mottled skin, there are several natural home remedies that may lessen the appearance and any accompanying symptoms.

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Gibson, L., “Livedo Reticularis” Mayo Clinic, June 3, 2017; https://www.mayoclinic.org/livedo-reticularis/expert-answers/faq-20057864, last accessed June 19, 2018.
Kurtz, D., “What Your Baby’s Skin Is Telling You” Intermountain Healthcare, February 17, 2016; https://intermountainhealthcare.org/blogs/topics/intermountain-moms/2016/02/what-your-babys-skin-is-telling-you/, last accessed June 19, 2018.