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What is Mottled Skin? Understanding the Causes and Treatments

Editorial Team
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Updated: Jun 04, 2024
Views: 461,527
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What Is Mottled Skin?

Mottled skin, or dyschromia, manifests as uneven, blotchy patches on the skin, often indicative of underlying vascular changes. According to a study published in the Journal of the American Academy of Dermatology, dyschromia is a common dermatological complaint among patients, though its prevalence varies widely based on the specific type and cause. While mottled skin itself is typically painless, it can signal more serious health issues, such as circulatory problems or, in rare cases, life-threatening conditions like sepsis. Understanding what mottled skin is crucial not only for cosmetic reasons but also for one's overall health, as early detection and treatment of the underlying cause can be vital.

Blood vessels are a series of narrow tubes that help transport blood from the heart throughout the rest of the body and back again to the heart. Some blood vessels are located just beneath the skin’s surface, which can make them visible in certain individuals with light colored skin. If any condition results in changes to the blood vessels, they can end up causing mottled skin. Common causes of changes to the blood vessels include increases or decreases in body temperature, aging, blood disorders, or even heart disease.

The main symptom of mottled skin is red or purple patches that occur on any area of the skin. These changes generally occur once the blood vessels are constricted. The blood vessels cannot properly distribute blood throughout the body and blood may build up in certain areas close to the skin’s surface.

Mottled skin is typically treated by having a doctor determine the underlying cause. He or she may recommend that patients who constantly get skin mottling should be especially careful to wear protective gloves and other clothing when their skin is going to be exposed to heat or cold. If the mottling is due to a specific disorder, it will generally subside once the underlying disorder is treated.

People with less skin pigmentation are generally at a higher risk for skin mottling than those with darker complexions. This is simply due to the fact that the blood vessels are typically much more visible in people with more translucent skin. The red or purple discoloration may not be as noticeable in dark skin; however, those with darker complexions may still experience blood vessel changes, just without the visible evidence.

In rare cases, skin mottling can be a sign of a serious immediate health concern. If the mottling comes on suddenly and appears with other symptoms, such as difficulty breathing or pain in the area, it could be a sign of physical shock. In these cases, a doctor will need to find out immediately if the person has any other serious preexisting conditions or injuries or it could be fatal if not treated. Mottling can predict survival in septic shock patients.

Autoimmune Diseases

Often, autoimmune diseases can also be a cause of mottled skin. These include:

Systemic Lupus Erythematosus (SLE)

Known as Lupus, SLE is an autoimmune condition affecting the soft tissues, kidneys, and skin. Mottling on the skin is seen in several lupus patients. A butterfly rash on the face is a typical feature of the disease. Different types of cutaneous (skin) mottling are observed in lupus patients. This mottling is present on the hands, face, and other regions.

Antiphospholipid Syndrome

Antiphospholipid syndrome affects the blood vessels, leading to mottling of skin on the wrists and knees. Symptoms like headaches and seizures can accompany mottling.

Side Effects of Medicines

Though rare, skin mottling can be a side effect or reaction to certain medications. Drugs associated with skin mottling include catecholamines, minocycline, and gemcitabine.

Pancreatitis

Another medical condition that can make the skin mottled is inflammation of the pancreas. Also known as pancreatitis. Pain in the abdomen with fever is a common symptom of pancreatitis.

End-Stage Disease

Mottled skin may appear in patients in the end-of-life stage (close to dying). Mostly, mottling occurs with other end-of-life symptoms. These are symptoms such as breathing, swallowing problems, and reduced heart health.

What is Mottled Skin in Infants and Babies?

Mottled skin is common in newborn babies, and the condition is known as Cutis Marmorata. In most cases, the changes in skin appearance are due to the body’s response to cold temperature. As such, they do not need treatment.

Risk Factors for Skin Mottling

People with less skin pigmentation are generally at a higher risk for skin mottling than those with darker complexions. This is simply due to the fact that the blood vessels are typically much more visible in people with more translucent skin. The red or purple discoloration may not be as noticeable in dark skin; however, those with darker complexions may still experience blood vessel changes, just without the visible evidence.

How To Prevent the Formation of Mottled Skin?

Mottling is often associated with cold and poor circulation. You can prevent the condition with some simple yet effective steps. Walk, stay warm, massage your body, and reduce compression on the extremities.

Carrying out regular exercise can be beneficial in maintaining an excellent cutaneous blood supply. Even walking can do the job and prevent mottling.

Prone individuals must reduce pressure from the arms and legs. Changing sitting positions after some time can take off the pressure from your legs. Avoiding tight clothing can also reduce the pressure on the extremities. Which helps improves blood circulation.

Massaging the limbs is also a good practice to improve the blood flow of the region. Studies show that massage therapy efficiently enhances peripheral blood flow, especially in young women. This therapy can help prevent skin mottling.

Patients who suffer from skin mottling should wear protective clothing when their skin is going to be exposed to heat or cold. Such patients are also advised to wear multiple layers of clothing. Or one thick layer of clothing to stay warm and away from mottling.

How Is Mottled Skin Treated?

Mottled skin is typically treated by having a doctor determine the underlying cause. He or she may recommend that patients who constantly get skin mottling should be especially careful to wear protective gloves and other clothing when their skin is going to be exposed to heat or cold. If the mottling is due to a specific disorder, it will generally subside once the underlying disorder is treated.

Mottling due to cold subsides when the external cold stimulus is taken away. However, in cases of mottling due to shock, the patients are managed by the administration of intravenous fluids and oxygen.

Vascular disease patients are given medications to widen the arteries (and prevent future narrowing). Drugs may include blood pressure and cholesterol-lowering medicines. Aneurysms are also managed either via surgical or non-surgical interventions.

Autoimmune diseases are managed using disease-modifying anti-rheumatic drugs (DMARDs) and anti-inflammatory medications. There is no definitive cure for the autoimmune disease. But mottling on the skin subsides when the disease progression is controlled.

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By Editorial Team
Our Editorial Team, made up of seasoned professionals, prioritizes accuracy and quality in every piece of content. With years of experience in journalism and publishing, we work diligently to deliver reliable and well-researched content to our readers.
Discussion Comments
By anon994791 — On Mar 07, 2016

When I was born, doctors said I had port-wine stain birthmarks- half my forehead is red, I have a red splotch between my eyes, I have like a red mark (looks like a red rash) on my neck/chest, lower abdomen (starts near my belly button and curves around and up my back), and both my legs down to my feet and half of the bottom of my left foot are all red. They have faded a lot during the years (I'm now 19) and you can only really see the red on my forehead when I'm upset/angry/not wearing foundation and I often have to point out my birthmarks. You can also see a lot of my veins on my stomach and legs, I bruise easily on my legs and I've had varicose veins covering my legs since I was a teenager. In recent years, I've been looking into birthmarks more and I've realized what I have, doesn't really describe any sort of birthmark. (Well, perhaps the one of my forehead.)

My mum is a midwife and the other day a baby was born who looked similar to me when I came out (all blotchy) and the midwives said that it was probably mottled skin.

I haven't really had any health issues other than the varicose veins, but do any of you think it's likely I have mottled skin, not port-wine stain birthmarks? Also, do you think I should go to a dermatologist to get checked for underlying symptoms? I've never had any real health issues, hence why it hasn't really been an issue. (I don't really care about them because I've had them my whole life and for years I thought it was just the way skin was; I thought I even had a magic foot!)

By anon359375 — On Dec 17, 2013

Okay. Most of you will dismiss me as a clueless little kid, but here I go. I'm currently 12 and I've had mottling of the skin ever since I was 9. Whenever it comes, my legs and arms stiffen up and I can't walk.

In 2011 I was diagnosed with systemic scleroderma but all of my rheumatologists dismissed it as a false diagnosis. I've been going through this for almost seven years and I'm sick and tired of it. I recently found a doctor that did a test on me and found a whole bunch of stuff in me, but I believe that he only did the test for the common, big-name diseases. I have an elevated ANA all the time, which should be a big indicator of something wrong.

I do also frequently have big white splotches on my toes. Does anybody maybe suggest something? All of my symptoms match up with the systemic scleroderma. Please help.

By Neecy — On Jul 06, 2013

I don't want to sound morbid, but mottled skin is also a part of the dying process. I'm not saying that if you have mottled skin that you are dying! My sister recently died of lung cancer, and her hands and arms became mottled. It's because there wasn't any oxygen getting to them. If you have a loved one who is dying, this is a sign of imminent death. Just saying...

By anon337117 — On Jun 03, 2013

Mottled skin can also be caused if you have Fibromyalgia in some cases.

By anon335798 — On May 23, 2013

I have had purple mottled skin on my arms for as long as i can remember. It is accompanied by bright red blotches also. I have high blood pressure that I take medications for. My family doctor shrugged it off as nothing. I don't have insurance and it is discouraging to read all these comments that dermatologists as well don't know what it is. It's obviously not fatal, at least yet. I'm 53 and wish somebody could diagnose me without it costing all the money I have.

By anon334972 — On May 17, 2013

While I sleep, my hand and arm fall asleep. I wake up in pain and shake my hand and arm awake. I'm pretty sure I'm causing this by lying on my arm and cutting off circulation. But after doing this by accident, for maybe a year on and off, more on lately I have discoloration on my right hand. Could this be mottled skin? I have yet to go to a doctor.

Will the blood vessels eventually release and will my hand go back to the way it looked before? Anyone dealt with something similar? Also, is it dangerous?

By anon333985 — On May 09, 2013

My daughter, age 6, has mottled skin. It looks like she's cold, but she is not. Sometimes complains in the day/night of leg pain, her foot or hand fall asleep and become painful and tingling. She bruises easily and they take a while to go away. She sleeps with fan on and says it helps her to breathe. She has no known respiratory problems. She was healthy at birth and on time at delivery.

We have seen a hematologist and she has not had this all her life! The doctor said she was not anemic, and her clotting time was only off by a second or so. He dismissed her and diagnose her with Raynaunds! This is not a correct diagnosis! She is always hungry and wants snacks, too. I don't give many sugary snacks.

She's active, jumping/running/playing, but gets really red and hot fast! Does anyone have a clue? I really need some feedback. I'm at a dead end. Thanks!

By anon331986 — On Apr 26, 2013

I have complex regional pain syndrome and get mottled skin all the time, no matter the temperature, since I was diagnosed in 2003. It has spread from the affected limb now throughout my body as the CRPS has.

By anon311977 — On Jan 04, 2013

Raynaud's Disease is when you are exposed to cold your skin mottles, and you have pain in your fingers or toes from cold. Toes or fingers may turn white or purple They turn purple, white, then a bright red when heat is restored to body parts. I have this, and have found the best thing is to move the body around, do exercises to warm the body or an easier solution: take a nice warm, shower or bath. It gets the blood flowing again. Please look it up if you think you may have this.

By anon310929 — On Dec 28, 2012

I've had mottled skin my whole life and coming from Scotland this is an extremely common condition of having a chilly climate and lots of pale skinned people.

We had a newly qualified doctor in the 1990s from New Delhi and when he started seeing all these patients with mottled skin he thought it was an iron deficiency epidemic. We joked that whatever you went to see him for, the prescription was iron pills.

My mottled skin goes away when I'm in bed or in a warm country on holiday, which is fine for me. The rest of the time I just wear tights so no one sees.

By anon286870 — On Aug 22, 2012

I have mottled skin and high blood pressure. It's fine when I am out in the sun, but terrible when I get cold. I also suffer from white and severely painful fingers and toes in the winter.

By anon283539 — On Aug 05, 2012

My legs showed mottled skin in 2004 after a rigorous walk in the cold winter air of Connecticut. A blood test in 2010 showed I was terribly anemic. Result: CAD, cold agglutinin disease. Treatment: Rituxan

Sjogren's test relates to CAD. But the underlying condition for CAD to occur in you must be detected. Only 5 percent of lucky ones have no underlying reason for CAD to occur.

Take mottling seriously if it happens due to exposure to cold, and see your doctor right away.

By anon283536 — On Aug 05, 2012

If you notice that mottling happens when exposed to the cold, please have a Coombs test done of your blood immediately for cold agglutinin disease or "CAD". This rare disease destroys red blood cells, due to exposure to cold, and you will become dangerously anemic. You must act now. Once blood hemoglobin levels drop to 7, you are in danger. It affects your heart, and all other organs. if HGB drops to 4, you are in danger of your life.

If you notice blue cheeks, ears, fingers and toes,even after you play a game of tennis on a balmy evening, you have CAD. Please proceed now. Even if it is a rare disease (one person in 1 million), it happened to me, and it could be your case too.

By anon271277 — On May 25, 2012

I know a person with brain cancer. He has mottled skin tones, purple like in the stomach. What could it be?

By anon267308 — On May 09, 2012

I've had mottled skin all of my life and I've never had a problem.

By anon263663 — On Apr 25, 2012

@anon117841: I read your post and I'm having the same problem. I too have been to the dermatologist and rheumatologist. My blood work has come back with always a slightly high wbc count and they also did a blood test for sjogrens and lupus, which came back positive but they're still not satisfied that these are still the root problem.

My regular doctor now wants to do an MRI and check my pituitary gland. I'm in hopes that they find what is wrong with me. I have been going through this for almost five months.

I can't do anything without constant pain and I also look like a freak my skin is so bad..Everything has changed so much, I have lost all muscle mass and my skin just looks horrible.

I'm 48 and just don't understand whats happening to me. I already have heart problems. I wish you the best. Just keep telling your regular doctor you need that MRI. And if he or she doesn't do it find you another one who will.

Good luck to you and God bless you. I hope we both and everyone else with the same health issues can get the help we deserve and need to have some quality of life again.

By anon259561 — On Apr 06, 2012

I have mottled skin. It's kind of strange, if you ask me.

By anon254976 — On Mar 15, 2012

I have had mottled skin all of my life. I inherited it from my father's side of the family. He had it all of his life, and my daughter also has it. My family doctor told me when I was young, it was my body's way of trying to keep warm when I get chilly. We have seen no health issues. I am 48.

By anon180225 — On May 26, 2011

Look up sepsis. It is very dangerous. The body has an infection. It can put toxins in the bloodstream and cause the immune system to attack your organs.

By anon159343 — On Mar 11, 2011

I was born with mottled skin and have had it all my life! It appears when I get cold and you can't see it at all when I'm warm! I've never had any serious health problems that could be attributed to this!

By anon145876 — On Jan 25, 2011

I think anon may need to be checked for multiple sclerosis.

By anon126933 — On Nov 14, 2010

How about your blood pressure? If it's high consider Sneddon's Syndrome. Characteristics include headaches, high blood pressure and mottling of the skin in the absence of an underlying disease/condition.

By anon121339 — On Oct 24, 2010

sounds like rynad syndrome.

By anon117841 — On Oct 11, 2010

I have mottling skin and no doctors seem to know why. I get cluster headaches and my skin only gets like that when I'm standing and worsen when I'm cold.

Much pain comes along where I can't even sit or stand for too long due to pain. I have seen a dermatologist, a rheumatologist, an internal medicine doctor and they all keep telling me nothing is wrong because my blood tests are all good.

Every day I do research on the Internet and I came across the pituitary gland, which could be a reason why. I asked my doc to check my hormones and she never wants to. Is there anybody out there who can help me?

By mitchell14 — On Jul 13, 2010

It is interesting how even harmless-seeming changes in the skin or other appearances can be a sign of a dangerous condition, but that seems to be common. After all, even a tan can be as dangerous as sunburn when talking about skin cancer, so it makes sense that the skin is such an indicator of overall health.

By sapphire12 — On Jul 13, 2010

I had no idea mottled skin could be a sign of something more serious, though i don't know if I've ever known anyone who had it.

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