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Mottled Skin (Livedo Reticularis): What to Do About Blotchy Skin

Have you ever glanced down at your arms and legs and noticed your skin playing a game of Connect the Dots, forming blotchy or even web-like patterns? You may be experiencing mottled skin. 

While it might sound a bit scary, most of the time mottled skin usually isn’t something to panic about. With the help of Lurlyn Pero, MD, an internal medicine specialist with Banner Health, we delve into what mottled skin is, what causes it and what you can do if you notice it on your skin.

What is mottled skin?

Mottled skin, or livedo reticularis, is a skin condition with irregular patches of discoloration forming a net-like or marble-like pattern across the skin, usually on the arms and legs. The skin may have red and purple marks, streaks or spots.

“Mottled skin may appear differently, depending on an individual’s skin tone,” Dr. Pero said. “On light skin, it may vary in shades of red, blue or purple. In dark skin tones, the pattern may be a dark brown.”

What causes mottled skin?

Mottled skin is more common in newborns and infants, children and people assigned female at birth. The cause is most often reduced blood flow to areas of the skin, but there may be other factors. 

“The cause of mottled skin could be due to benign causes like temperature changes and stress or acute causes due to a medical condition symptom or a medication’s side effect,” Dr. Pero said. 

Benign causes

In most cases where the cause is benign, you may notice mottling on the arms, legs and feet. Causes may include:

Cold temperatures: When exposed to cold temperatures, your blood vessels constrict, reducing blood flow to the skin’s surface and causing it to appear mottled or blotchy. 

Emotional stress: When stressed, your body releases hormones that can affect blood flow, leading to changes in skin color.

Acute causes

When the cause is acute, you may notice mottling throughout the body (including the stomach and chest). These causes may include: 

Medical conditions: Certain conditions, such as lupus and rheumatoid arthritis, can lead to skin changes like mottling. Mottled skin might indicate serious medical conditions like sepsis. However, conditions this serious usually show signs and symptoms long before mottled skin shows up.

“Mottled skin may also be an early symptom of COVID-19,” Dr. Pero said. 

Medication side effects: Certain medications might also trigger mottled skin as a side effect. These may include medications that treat:

What do to about mottled skin

If your skin looks mottled because of cold weather or stress, try warming up if you are cold or relaxation techniques if you are stressed. Warm up your skin with a warm bath, jacket or blanket. Try gentle exercises to improve circulation or deep breathing exercises.

If you smoke, consider quitting. Quitting can improve blood flow and make your skin healthier.

If mottled skin isn’t linked to cold, stress, or smoking, it’s time to talk and make an appointment and see your health care provider in person. 

“This is a reason to see your provider face-to-face and not via telehealth, to perform a complete exam of you and your skin,” Dr. Pero said. “They can check if there’s a deeper issue and decide if you need extra tests or treatment.”

Some medications may cause mottled skin as a side effect. Your provider can review your meds and adjust them if needed to help ease the skin trouble. Dr. Pero recommended speaking with your treatment team to discuss any medication side effects you may be having, especially with cancer treatments, and weigh those against the long-term benefit you are looking to gain with your treatment.

If mottled skin is connected to illnesses like lupus, your provider can guide you on the best treatment.

Can I do anything to prevent mottled skin?

While mottled skin can’t always be prevented, simple lifestyle changes may help. Here are some tips:

  1. Stay warm: Cover your hands and feet and dress in layers in cold weather.
  2. Manage stress: Try activities like deep breathing, meditation or yoga to keep stress levels in check.
  3. Quit smoking: This can improve your overall health and your skin’s appearance.
  4. Stay active: Get regular physical exercise, at least 30 minutes most days of the week.
  5. Hydrate: Drinking plenty of water keeps your skin hydrated and supports healthy circulation. 
  6. Protect your skin: Use sunscreen outdoors to protect your skin from harmful UV rays.
  7. Eat a balanced diet: A diet rich in fruits, vegetables, lean proteins and whole grains provides essential nutrients that support skin health and circulation.


If you notice patches of blotchy, discolored skin that concern you, discuss it with your health care provider or a Banner Health specialist who can pinpoint the cause and guide you on the best ways to manage it. Mottled skin can be alarming to see but is usually harmless and temporary.

For more related blogs, check out:

Dermatology Allergy and Immunology Wellness