Between itchiness, photosensitivity, and the butterfly-shaped malar rash, systemic lupus erythematosus (SLE) can cause skin symptoms across the body. “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.

Livedo reticularis is a skin symptom that appears as a mottled, netlike, reddish-blue pattern on the skin of people with lupus and many other health conditions. It is often triggered by cold temperatures, including the drop in temperature after you get out of a warm shower.

Here, we explore the causes and treatments for livedo reticularis, as well as when someone living with lupus should be concerned.

What Is Livedo Reticularis?

Livedo reticularis appears in a pattern that resembles lace or a fishnet across the skin. It’s most often noticeable on the legs, although it can occur on other parts of the body as well. This blotchy discoloration is usually a red, blue, or violet hue, but it can vary greatly based on your skin color.

Causes

This symptom can be caused by various factors, including changes in blood circulation, temperature, or blood vessel abnormalities. It can be associated with lupus and other autoimmune diseases, with Raynaud’s phenomenon, and as a side effect of certain medications. It can also occur as a result of infections or vascular disorders that affect blood flow. Babies and women ages 20 to 50 years old, according to MedlinePlus, are the most commonly affected demographic groups.

Severity

The severity of livedo reticularis can vary from person to person. In most cases, it may be a harmless and temporary occurrence, but in others, it may be a sign of an underlying medical condition that requires further evaluation and treatment. It’s important to ask a health care professional if you have concerns about the severity or persistence of livedo reticularis, especially if it is accompanied by other symptoms or affects your daily activities.

Showers and Livedo Reticularis

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

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

• Does it occur after you go swimming?
• Does it happen more commonly during the winter months?
• What about when you are in a cold environment?

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

When To Worry

One MyLupusTeam member experiencing mottled 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 how it changes over time. If it goes away within a reasonable amount of time after you warm up, it’s usually not a cause for alarm and it is not necessary to seek immediate care.

If your mottled skin remains for a long time after warming up or is accompanied by other concerning symptoms such as pain, lumps and nodules, numbness, or ulcers, tell your rheumatologist or dermatologist.

There is no specific treatment for livedo reticularis. Treatment options include:

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

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

Talk With Others Who Understand

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, more than 223,000 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.