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Blotchy or Mottled Skin - Causes, Symptoms, Diagnosis, and Treatment

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Blotchy or Mottled Skin - Causes, Symptoms, Diagnosis, and Treatment

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Purple or reddish patches on the skin give an appearance of mottled skin, and these patches appear as patterns of net or web on the skin. Please read the article to know more.

Medically reviewed by

Dr. Barve Vaibhav Saidas

Published At September 28, 2021
Reviewed AtNovember 6, 2023


The entire outer surface of the body is covered by the largest organ in the body, the skin. The skin may serve as a window into the hidden mechanisms and internal alterations of the human body. Skin involvements often coexist with systemic illnesses in many disorders; for example, psoriasis and lichen planus are chronic inflammatory skin conditions that can raise the risk of metabolic syndrome and atherosclerosis. As markers for underlying cancers, medications, and collagen vascular disorders, certain skin manifestations, like neutrophilic dermatoses and autoimmune bullous diseases, can signal internal organ involvement as well as systemic diseases. This article discusses the blotchy or mottled skin manifestations which often have various causes.

What Is Blotchy or Mottled Skin?

Blotchy or mottled skin is a condition where the skin has a patchy and irregular color. This condition is also called livedo reticularis. This condition differs from one person to another in the aspect of appearance. The skin can have red or purple colored marks, streaks, or spots. There are also some cases where the skin has a marbled appearance with different colors.

What Are the Various Causes of Mottled Skin?

There are various causative factors responsible for mottled skin. Two of the most common causes are blood circulation problems and blood vessel spasms. A few causes include:

1. Shock:

Shock is a very serious and life-threatening condition. Negative experiences such as accidents, trauma, excessive blood loss, burns, poisons, and infections can induce shock in a person. When mottled skin is accompanied by other symptoms, it can be due to shock, and this requires immediate medical attention. The list of symptoms that might indicate shock are:

  • Mottled, cold, or pale skin.

  • Rapid pulse.

  • Nausea and vomiting.

  • Rapid breathing.

  • Weakness.

  • Larger than normal pupils.

  • Breathing difficulty.

  • Dizziness.

  • Fainting.

  • Anxiety.

  • Thirst or a dry mouth.

  • Low urine output or dark urine.

As mentioned before, shock is a serious medical condition and should be brought to the doctors’ attention immediately to avoid any serious complications.

2. Vascular Diseases:

If the person has any underlying vascular disease, the blood vessels in the body get affected and cause mottled skin. Some of the vascular diseases that might lead to the formation of mottled skin include:

  • Atherosclerosis.

  • Blood clots.

  • Aortic aneurysms.

The symptoms of vascular diseases might include pain, breathing problems, and fatigue along with mottled skin.

3. Reaction to Medications:

There are some cases where mottled skin is caused as a side effect or a reaction to certain medications. Mottled skin might be accompanied by other additional symptoms based on the medications, such as allergies, nausea, fatigue, etc. Drugs that are known to cause mottled skin are:

  • Amantadine.

  • Catecholamines.

  • Minocycline.

  • Gemcitabine.

4. Lupus:

When the organs and tissues of the body are attacked by the immune system, lupus develops. Skin that is mottled is also one of the signs of lupus. Additionally, lupus is an inflammatory chronic autoimmune disorder. Some of the other symptoms of lupus include

  • Dry eyes.

  • Headaches.

  • Breathing problems.

  • Butterfly rash on the face.

  • Fatigue.

  • Pain, stiffness, or swelling.

  • Fever.

  • Sensitivity to sunlight.

  • Fingers and toes turning blue to cold.

5. Antiphospholipid Syndrome:

This is also an autoimmune disease that affects the blood vessels. When the person has antiphospholipid syndrome, mottled skin can be found around the knees and wrists. Mottled skin is one of the symptoms of antiphospholipid syndrome, and some of the other symptoms include:

  • Seizures.

  • Dementia.

  • Blood clots.

  • Strokes.

  • Headaches.

6. Pancreatitis:

Mottled skin is also caused by pancreatitis or inflammation of the pancreas. Some of the other symptoms of pancreatitis are:

  • Pain in the upper abdomen.

  • Vomiting.

  • Nausea.

  • Fever.

  • Rapid pulse.

7. End of Life-Stage:

When a person is old and is nearing death, mottled skin may appear at the end-of-life stage. Other symptoms of end of life-stage include:

  • Being unconscious.

  • Decreased cardiac activity.

  • Refusing water and food.

  • Having trouble.

  • Swallowing.

  • Breathing difficulty.

  • Extreme fatigue and weakness.

  • Loss of memory.

8. Cold Environment:

When a person is exposed to a severely cold environment for a prolonged period, it can cause mottled skin. This is because exposure to a severely cold environment affects the flow of blood throughout the body and disrupts circulation. Other symptoms that indicate that the mottled skin is due to a cold environment include shivering, numbness, and cold.

9. Mottled Skin in Newborn Babies:

There are cases where a newborn baby has mottled skin. Usually, this condition is harmless and benign. Hence, it does not require any medical attention, and it goes away on its own. The main reason behind mottled skin in babies is exposure to cold temperatures. So generally, the treatment will include keeping the baby warm and avoiding the cold. It will go away on its own, and no medication is required in most of the cases.

What Are the Symptoms of Mottled Skin?

The appearance of the skin as blotchy with red or purple spots is the most noticeable characteristic of mottled skin. These uneven or discolored colored spots can appear anywhere and on any part of the body. In many cases, we can find a lacy network of patches on the skin.

The symptoms that are accompanied by this blotchy appearance include

  • Painful nodules.

  • Ulcers on the skin.

Generally, mottled skin does not require any treatment, and it often resolves on its own. But in some cases, if it does not go away, then a proper diagnosis and treatment are required.

How to Treat Mottled Disease?

There is no single treatment for all cases of mottled skin. Hence the treatment method is based on the cause and the other symptoms that appear along with mottled skin.

1. Shock:As the shock is very serious, it requires immediate medical attention. In the hospital, the patient will be given intravenous fluid and oxygen before performing other tests. The results of these tests will assist in identifying the etiology of shock.

2. Vascular Disease:For vascular disease, lifestyle changes and medications that help in maintaining blood pressure and cholesterol are required. Drugs help in preventing the narrowing of arteries. Also, if the patient has an aneurysm, surgery is required in some cases.

3. Autoimmune Disease:For autoimmune diseases such as lupus or antiphospholipid syndrome, medications will be prescribed by the doctor to help reduce the immune response and control the inflammation.

4. Medications: If skin mottling is caused as a side effect of any medications, then one should talk to the doctor for available alternative options. The doctor might suggest a different treatment instead of medications, or in some cases, he will change the dosage and frequency of the medicines.

5. Cold Environment: Mottled skin that appears due to a cold environment can be treated with home remedies. Layering warm clothes, using heated blankets, and producing body warmth by rubbing the affected area can reduce the blotch caused due to cold temperatures.

6. End of Life-Stage: For patients who experience mottling of skin in the last stage of life, treatment will focus on keeping the person comfortable.

Can Mottled Skin Be Prevented?

It is possible to prevent mottled skin in some cases. Some of the precautions that are to be followed to prevent skin mottling are avoiding cold temperatures, having a healthy diet plan to avoid vascular diseases, avoiding smoking, doing physical exercises to keep the circulation proper, and keeping the body warm.


In many cases, mottled skin is benign and does not require any medical care. But if the skin mottling is accompanied by other symptoms, then consult a doctor to find if there are any causes for mottled skin and plan the treatment accordingly. Also, make sure to keep the body active and warm to avoid any vascular disease or cold-induced skin mottling.

Frequently Asked Questions


Is Mottled Skin a Terrible Condition?

Although mottled skin is not a serious condition by itself, the underlying causes like pancreatitis, shock, vascular diseases, lupus, etc., determine the rate of the seriousness of blotchy skin.


What Does Mottled Skin Symbolize?

Mottling of the skin occurs when the heart cannot effectively pump blood to different parts of the body. As a result, the blood pressure drops down, and blood flow to the body is slowed, leading to cold extremities.


How Do Mottled Legs Appear?

A circulation abnormality near the surface of skin or blood vessel spasms results in Livedo reticularis, which gives the skin on the legs a purplish, net-like pattern with discrete borders. This appearance leads to the formation of mottled legs.


What Causes Mottled Hands?

Mottling of the skin in the hands can be due to cold temperature, which decreases the circulation of blood, adverse effects of medications like Minocycline, Gemcitabine, Catecholamines, etc., shock, lupus, vascular diseases, end-of-life stage, etc.


How Is Blotchy Skin Presented?

The patchy appearance of skin with discolorations that can be red, purple, or blue is called blotchy skin. It is usually irregular in appearance and can be due to temporary or permanent causes.


What Are the Causes of Blotchy Skin?

- Eczema.
- Hives.
- Contact dermatitis.
- Psoriasis.
- Heat rash.
- Vitiligo.
- Spider veins.
- Melasma.
- Rosacea.
- Tinea versicolor.
- Shingles.
- Alcohol flush syndrome.
- Scarlet fever.


Does Stress Cause Blotchy Skin?

Blotchy skin can occur due to stress, which is manifested by the presence of reddish, itchy skin. In a few cases, burning sensations and pain may also be present. People with urticaria are more predisposed to blotchy skin caused by stress. It usually lasts for about a few weeks and is managed by stress-relieving techniques.


When Is Mottled Skin on a Baby a Problem of Concern?

Blotchy skin on babies presents with a bluish marbled or weblike pattern, and the skin is blue or pale in color. Along with mottling, if there is an increase or decrease in the average temperature of the baby, it needs immediate medical intervention.


Can Mottled Skin in Babies Go Away on Their Own?

Mottled skin in newborn babies due to cold exposure is a benign condition that can be managed by keeping the baby's body warm and avoiding exposure to cold. It usually goes away without any treatment.


Is Blotchy Skin on Babies Normal?

Mottled skin, which presents as a lacy pattern on the baby's skin with reddish and pale areas, is a normal phenomenon due to the unstable blood circulation of the surface of the baby's skin.


Does Mottled Skin Appear With Cold Exposure?

Exposure to cold temperature decreases blood circulation, which results in the appearance of mottled skin. It is also accompanied by other symptoms like cold feeling, numbness, and shivering.


Does a Heating Pad Produce Mottled Skin?

Discoloration of the skin due to prolonged exposure to heat like heating pads results in toasted skin syndrome, which presents with itching and burning sensation. It is also known as erythema ab igne.
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Dr. Barve Vaibhav Saidas
Dr. Barve Vaibhav Saidas



blotchy or mottled skin
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