Mottled Skin: Causes, Warning Signs and What You Can Do

Seeing blotchy, net-like or patchy skin can be scary. Mottled skin (also called skin mottling or livedo) means the blood flow under the skin is uneven, which makes red, purple or pale patches. Sometimes it’s harmless — like when you’re cold — and other times it signals a medical problem. Here’s how to tell the difference and what to do right away.

Common causes you’ll see at home

Cold exposure: Your body narrows small blood vessels to preserve heat. That can make a patchy pattern on arms, legs or hands. It usually clears after you warm up.

Low circulation or shock: If someone is pale, cold to the touch, and has mottled skin on the limbs or torso, that can mean poor blood flow. This can happen with severe dehydration, fainting, heart issues, or sepsis.

Medications and allergic reactions: Some drugs can change skin color or trigger swelling and mottling. If the mottling appears with hives, swelling, trouble breathing or after a new medicine, treat it seriously.

Chronic patterns like livedo reticularis: This is a persistent, lace-like pattern often linked to autoimmune conditions, blood clotting problems, or vascular issues. It may not hurt but should be checked by a doctor.

How to check it and when to seek help

Do a quick home check: is the person warm or cold? Is there pain, fever, dizziness, fast heartbeat, or breathing trouble? Press the skin briefly — if it doesn’t return to normal color in a couple of seconds, circulation may be poor.

Call emergency services or go to the ER if mottling comes with confusion, fainting, rapid breathing, chest pain, very low blood pressure, or high fever. These can be signs of sepsis, shock, or a serious heart or lung problem.

Make an urgent GP or clinic appointment if the pattern is new, slowly spreading, or tied to other symptoms like joint pain, unexplained bruises, or ongoing cold sensitivity. For long-standing, non-urgent mottling, see a primary care doctor or dermatologist.

What doctors will check: they’ll review your medicines, look for signs of infection, check blood pressure and pulses, and might order blood tests (complete blood count, inflammation markers, clotting tests), an ECG, or vascular studies. If they suspect autoimmune disease, expect additional tests or a referral to a rheumatologist.

Simple first-aid tips: keep warm if cold is the cause, remove tight clothing, take photos to track changes, note any new medicines, and write down other symptoms and when they started. That record helps your clinician.

Need more reading? Our post on "Medications and Angioedema" covers drug reactions that can affect skin, and articles about safe online pharmacies can help if you’re replacing meds. If you’re unsure whether your case is an emergency, it’s safer to get checked — quick action can make a big difference.