Between the itchiness, photosensitivity (light sensitivity), and butterfly-shaped rash, systemic lupus erythematosus (SLE) can cause a variety of skin symptoms. “Today I noticed the mottled, weblike pattern on my thighs after a shower, and hours later it’s still there. I’ve seen it a few times before but figured it’s from using a hot water bottle for the aches (my best friend),” one MyLupusTeam member shared.

This pattern is called livedo reticularis — a skin symptom that looks like a mottled (patchy or blotchy), netlike discoloration. Livedo reticularis is often triggered by cold temperatures, which is why it might show up after stepping out of a warm shower.

Keep reading to learn about the underlying causes of livedo reticularis, along with how it’s managed and when to call a doctor about this symptom.

What Is Livedo Reticularis?

Livedo reticularis appears in a pattern resembling lace or a fishnet across the skin. It’s most often noticeable on the legs, but it can affect other parts of the body as well. This blotchy discoloration may be red, blue, purplish, or dark brown, depending on your natural skin tone.

Causes

Livedo reticularis can be caused by various factors, including:

• Changes in blood circulation
• Temperature
• Blood vessel abnormalities

The symptom may be associated with lupus, rheumatoid arthritis, and other autoimmune diseases. It may also be linked to Raynaud’s phenomenon, occur as a medication side effect, or result from infections or vascular disorders that affect blood flow. Women ages 20 to 50 are most commonly affected, according to MedlinePlus, and the condition also often occurs in babies.

Severity

The severity of livedo reticularis can vary from person to person. Usually, this symptom is harmless and temporary. However, it may sometimes indicate an underlying medical condition that requires further evaluation and treatment. It’s important to ask a healthcare professional if you have concerns about the severity or persistence of livedo reticularis, especially if it’s accompanied by other symptoms or affects your daily activities.

Why Is Your Skin Mottled After You Shower?

Livedo reticularis is commonly associated with cold temperatures, so cold water could be a trigger. It’s also possible that exposure to cold air after ending a warm shower could cause this symptom to appear. Individual experiences may vary, and not all cases of livedo reticularis are related to temperature changes.

If you’re experiencing this symptom, take note of what exposures trigger it. For example:

• Do you have blue, red, dark brown, or purply blotchy legs after a shower?
• Does this symptom occur after you go swimming?
• Do you notice it more often in winter or in cold environments?

Keeping a symptom journal can help you predict and avoid potential triggers for this skin condition with simple lifestyle changes.

Should You Be Worried About Mottled Skin?

One MyLupusTeam member experiencing red, blotchy skin after a shower asked, “Should I be concerned? Immediately report to the rheumatologist? Next appointment’s in four months!”

If you notice skin mottling after a shower, take note of its appearance and any changes over time. If it goes away within a reasonable amount of time after you warm up, it’s probably not a cause for alarm or a reason to seek immediate care.

However, if mottled skin lingers after warming up or comes with symptoms such as pain, lumps and nodules, numbness, or ulcers (sores), tell your rheumatologist or dermatologist. It could indicate lupus livedo reticularis, an unrelated skin rash, or another medical condition. Seeking an accurate diagnosis is the only way to know for sure.

There are no specific treatment options for livedo reticularis, but management strategies include:

• Avoiding cold temperatures
• Warming up the affected area
• Treating the underlying condition (such as lupus)

Your healthcare provider can evaluate how this symptom fits into your overall health and provide appropriate medical advice on managing your condition.

Talk With Others Who Understand

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, more than 235,000 members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

Have you ever experienced mottled skin or other skin problems while living with SLE? What did you do? What tips can you offer to others living with this and other symptoms of lupus? Share your experience in the comments below, or start a conversation by posting on your Activities page.