Mottled skin is also known as livedo reticularis. It can be a standalone condition or a symptom of another disorder. It may also be a side effect of certain medications, such as drugs prescribed for Parkinson's.
Mottled skin is characterized by purple or reddish patches that cover the legs, arms, or upper body. The exact appearance of these patches can vary. They may appear as follows:
- a net-like pattern
- a violet web under the skin
- reddish stains
When livedo reticularis occurs as a standalone condition, there is no known cause.
Potential causes of mottled skin
Livedo reticularis as a standalone condition most often affects middle-aged women, according to a 2015 study. It may also affect young women and newborn babies.
Mottled skin also occurs as a symptom of other conditions, including:
Livedo reticularis commonly affects the skin of the legs.
Lupus is a rare autoimmune and inflammatory condition that may cause livedo reticularis.
Lupus is linked to sensitivity to sunlight, which may cause skin rashes. The most recognizable of these is a butterfly-shaped rash on the face. Lupus may also cause mottled skin.
Other symptoms of lupus include:
Research into lupus is ongoing. The National Institute of Allergy and Infectious Disease support many studies into the condition.
The Indian Dermatology Online Journal notes a link between mottled skin and poor circulation. A lack of oxygenated blood rich in hemoglobin may cause skin discoloration.
Rheumatoid arthritis (RA) is another potential cause of mottled skin.
RA could also cause dark, patchy, or mottled skin, which may be due to the way the inflammatory condition affects the blood vessels.
Other symptoms of RA include:
- low fever
- pain and stiffness that lasts for more than 30 minutes
- weight loss
- firm lumps or nodules beneath the skin in the hands, elbows, or ankles
The primary symptom is mottled skin. As well as red or purple skin patches, the condition causes:
- blood circulation problems
- blood clots
- leg ulcers
People who have antiphospholipid syndrome are at an increased risk of developing deep vein thrombosis.
This condition affects the thyroid. The thyroid is a gland that produces hormones that affect metabolic rate. Hypothyroidism is when the thyroid is underactive. This condition may lead to:
- weight gain
Acute pancreatitis may cause mottled skin or livedo reticularis on the abdomen.
Acute pancreatitis may cause mottled skin. This condition happens when the pancreas becomes inflamed.
- severe abdominal pain
Mottled skin is a secondary symptom of pancreatitis that may occur up to 3 days after the onset of primary symptoms.
Mottled skin may be a sign that a person's body is in shock. Shock is a medical term and does not refer to any feeling of surprise or experiencing something unexpected.
Shock is a medical emergency and may be caused by:
- accident or trauma
- blood loss
As well as cold, pale, or mottled skin, the symptoms of shock include:
- breathing difficulties
- enlarged pupils
- rapid heart rate
- rapid breathing
If someone seems like they are in shock, contact emergency services immediately. Shock may be life-threatening without treatment.
Mottled skin in babies
Newborn babies sometimes have mottled skin, but this is not harmful and usually goes away by itself.
Exposure to the cold may cause babies to develop mottled skin. Keeping a baby wrapped up and warm helps avoid this.
Mottled skin near death
The skin may appear mottled when an elderly or terminally ill person is close to dying. Other signs that someone is approaching death include:
- trouble swallowing
- refusing food and water
- being delirious or unconscious
- breathing difficulties
- extreme fatigue or weakness
- reduced heart rate
People should speak to their doctor if they have mottled skin and are not sure why.
Discussing this and any related symptoms with a doctor will help them reach a diagnosis. Sometimes, doctors will require further tests to diagnose certain conditions.
The treatment plan for mottled skin will depend on the underlying cause.
There is no one treatment for mottled skin. The best treatment will depend on the underlying cause:
If shock is the cause of mottled skin, a person should seek immediate medical care. Treatment may include oxygen, intravenous fluids, and further tests.
Several different autoimmune diseases may cause mottled skin. Treatment may include medication that controls the immune response and reduces inflammation.
Treatments for acute pancreatitis include intravenous fluids and anti-inflammatory medication. Lifestyle changes may also help in the long-term.
If poor circulation causes mottled skin, exercise and other lifestyle changes may help.
End of life
When mottled skin develops as an end-of-life symptom, doctors will help make the person as pain-free and comfortable as possible.
Cold temperatures can make mottled skin worse. People with mottled skin should wrap up warm.
Eating well and taking regular exercise may reduce the risk of developing vascular problems. Avoiding smoking also reduces the risk of poor circulation.
Mottled skin is not harmful in and of itself. However, it may indicate an underlying condition.
The outlook for each condition that may cause mottled skin is different. As a general rule, the sooner a doctor diagnoses the condition, the better it can be treated or managed.