Table of ContentsView AllTable of ContentsTemperatureStressSkin ConditionsTinea VersicolorInfectionsPregnancyAlcoholPIHTreatment
Table of ContentsView All
View All
Table of Contents
Temperature
Stress
Skin Conditions
Tinea Versicolor
Infections
Pregnancy
Alcohol
PIH
Treatment
Blotchy skin is a fairly common condition that most people experience at some point in their lives. The patches of discolored skin can be red, purple, or blue.
This article outlines some of the many potential causes of blotchy skin. They include skin conditions likeeczemaandrosacea, infections like scarlet fever and shingles, temperature exposure, stress, pregnancy, and more.
Verywell / Danie Drankwalter
Temperature changes can lead to changes in blood circulation in the body. When this occurs, skin color may be altered in response to either more or less blood flow.
Exposure to Cold
When you first walk out into cold weather, the blood vessels in your skin narrow. This happens to minimize heat loss from the body. It can lead to changes in the skin’s appearance, including paleness and blue mottling. The discoloration resolves on its own once your body warms up.
Some people experience blotchy skin in the cold weather due to hives.Also known asurticaria, hives are welts on the skin that can occur from an allergic reaction or, in this case, exposure to cold temperature. Hives appear as blotchy, discolored (a change in skin tone that can appear purple, red, gray, or brown) skin and can lead to itching and pain.
Heat Rash
Heat rashfirst appears as a pink rash consisting of tiny bumps. It tends to occur along the neck, chest, and upper back. Heat rash is more common in children and can occur after spending time outdoors in the heat, humidity, or sun, or after engaging in a strenuous activity.
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More than 85 million Americans contend with some type of skin disorder. Many of these cause skin blotchiness.
Eczema
Eczemais an umbrella term for seven different conditions that can cause inflammation and itchiness. People with dark skin may notice patches of purple or gray, while those with lighter skin may experience red blotchiness.
A dermatologist is best equipped to diagnose eczema and which type someone may have. It can be tricky since they all include common symptoms like discoloration, scaly skin, and itching.
More than 30 million Americans, including many children, have some type of eczema.
How to Treat Toddler Eczema
Folliculitis
Folliculitisoccurs when a hair follicle becomes inflamed or infected. It starts out as small, discolored bumps resembling acne. It can be itchy and uncomfortable.
Folliculitis can break out on the face, arms, legs, and back after engaging in everyday activities like wearing tight clothing, shaving, or sitting in a very hot tub. (So many people get folliculitis from hot tubs that there is a condition called “hot tub folliculitis.”)
Hives
About 20% of adults experience hives at some point in their lives.The hives appear as discolored welts, which are large, raised bumps on the skin. They are usually very itchy and can beblanched, which means that the center turns white when you press on it.
In addition to cold exposure, you can get hives when your body reacts to an allergen found in food, plants, medications, or infections. Some people even experience them as a result of exercise.
Most cases of urticaria are temporary, but they can become chronic.
If you ever experience hives along with difficulty breathing or a feeling that your throat is closing up, seek emergency medical help. Rarely, life-threatening reactions such asanaphylaxis(an allergic reaction) can occur.
Causes and Risk Factors of Urticaria (Hives)
Psoriasis
Psoriasisis a chronic skin disease that speeds up the growth of skin cells. It is an autoimmune disorder, meaning that the immune system attacks the body’s own skin cells.
While normal skin cells grow and then fall off every month, the skin cells of people with psoriasis die in three or four days. But instead of falling off, they pile up on the skin and cause itching, burning, and stinging.
Depending on the severity of the condition, psoriasis can be treated with creams or ointments, medications, or ultraviolet light therapy.
Rosacea
Rosaceais a common skin condition that affects about 14 million Americans.It usually starts as a tendency to blush easily. Other symptoms include discoloration, acne-like breakouts, irritated skin, visible blood vessels, sensitivity to the sun, and inflammation.
The exact cause of rosacea is unknown, but it seems to be related to the immune system. Individuals with fair skin and light-colored eyes and hair are more at risk for rosacea, but rosacea can also impact darker skinned people. People between the ages of 30 and 50 are at higher risk as well.
A family history of rosacea and a history of acne can also put people at greater risk for developing rosacea.
Could Your Acne Really Be Rosacea?
Sunburn
The inflammation and discoloration from sunburn can lead to blotchy skin. This change in color is due to sun damage. Excessive sun exposure without ultraviolet (UV) protection damages the skin cells and leads to accelerated skin aging.
How to Treat a Sunburn
Yeast on the skin causestinea versicolor, which is a common fungal skin infection. It results in discolored patches on the skin, often found on the chest or back. Discolored skin patches can range in color from dark brown, white to light brown, gray-black, or pinkish red.
Oily skin can set off tinea versicolor. It tends to be most common among adolescents and young adults.
Tinea versicolor can be stubborn, often requiring multiple applications of an antifungal or dandruff shampoo to the skin. An oral antifungal medicine or topical cream may also help.
Explore Hereditary Factors
Your skin’s No. 1 job is to protect your body from disease and infection. But some infections can seemingly outmatch the skin, at least in the short term, and cause blotchiness.
Scarlet Fever
In addition to fever and chills, scarlet fever can cause a discolored, bumpy rash about one to two days after the infection starts.
The rash usually begins as flat blotches on the skin that eventually become raised. The rash usually appears on the neck and in the underarms and groin area and eventually spreads over the body.
Shingles
Symptoms of shingles include:
Shingles can also cause fever, headache, muscle pain, and vomiting.
Until the virus clears up on its own, you can manage the pain and symptoms with pain relievers. Shingles can recur once it has resolved, so the CDC recommends that people above age 50 talk with their healthcare provider about getting the shingles vaccine.
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It’s common for pregnancy to change skin tone. Changing hormones may trigger a common condition known asmelasma. Sometimes called “the mask of pregnancy,” melasma causes brown patches to appear on the face, including the bridge of the nose, forehead, and chin, as well as the neck.
It can intensify after sun exposure. Melasma usually fades on its own after childbirth.
Alcohol Flush Syndrome
If you’ve ever felt your cheeks and neck flush after a few sips of a cocktail, you may have experienced alcohol flush syndrome.
Alcohol intolerance can cause skin discoloration, flushing, itching, and swelling. Other symptoms can include nausea and vomiting, rapid pulse, low blood pressure, headache, and diarrhea.
This signals an intolerance to alcohol, which is an inherited metabolic condition. More specifically, it means someone lacks certain enzymes that the body uses to metabolize alcohol.
Avoiding alcohol can prevent symptoms and resolve blotchiness.
Alcohol Allergies and Intolerance
Post-Inflammatory Hyperpigmentation
After a skin rash has healed, post-inflammatory hyperpigmentation (PIH) can take its place. Acne can also result in PIH, especially in people with darker skin tones.
PIH can be difficult to treat, even with such things as a prescription-strength medication, chemical peel, and laser treatment.
Since sunlight can cause hyperpigmentation to get worse, limiting time in the sun and applying sunscreen are often a part of a treatment plan.
Contact your healthcare provider right away if you develop a rash suddenly (with or without pain or itchiness), or if an existing rash spreads rapidly across your body. This could be a sign of an allergic reaction or an infection.
Summary
Blotchy skin is a change in skin color due to a reaction or condition. Some of the causes, like cold weather exposure, can be avoided. Others, like psoriasis and rosacea, can’t.
Whatever is causing your skin to break out in blotches, the good news is that the condition is often short-lived.
See a dermatologist if blotchiness recurs without an obvious cause, worsens, or doesn’t go away.
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21 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Academy of Dermatology Association.Welts on skin due to cold temperature could be hives.Seattle Children’s Hospital.Heat rash.American Academy of Dermatology Association.Stress: Is it a common eczema trigger?American Academy of Dermatology.New study shows significant economic burden of skin disease in the United States.National Eczema Association.An overview of the different types of eczema.National Eczema Association.What is eczema?American Academy of Dermatology Association.Acne-like breakouts could be folliculitis.American Academy of Allergy, Asthma and Immunology.Hives defined.American Academy of Family Physicians. American Family Physician.Exercise-induced urticaria.National Psoriasis Foundation.About psoriasis.National Psoriasis Foundation.Phototherapy for psoriasis.American Academy of Dermatology Association.Is rosacea causing your red, irritated skin?Skin Cancer Foundation.Sunburn & your skin.Karray M, McKinney WP. Tinea Versicolor. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024. Available from:https://www.ncbi.nlm.nih.gov/books/NBK482500/Johns Hopkins Medicine.Tinea versicolor.Medline Plus.Skin pigmentation disorders.U.S. Centers for Disease Control and Prevention.Symptoms of scarlet fever.American Academy of Dermatology Association.Shingles: Diagnosis and treatment.National Institutes of Health. National Institute on Alcohol Abuse and Alcoholism.Alcohol flush reaction.Callender VD, Baldwin H, Cook-Bolden FE, Alexis AF, Stein Gold L, Guenin E.Effects of topical retinoids on acne and post-inflammatory hyperpigmentation in patients with skin of color: A clinical review and implications for practice.American Journal of Clinical Dermatology.2022;23(1);69–81. doi:10.1007/s40257-021-00643-2.American Academy of Dermatology Association.Rash 101 in Adults: When to seek medical treatment.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Academy of Dermatology Association.Welts on skin due to cold temperature could be hives.Seattle Children’s Hospital.Heat rash.American Academy of Dermatology Association.Stress: Is it a common eczema trigger?American Academy of Dermatology.New study shows significant economic burden of skin disease in the United States.National Eczema Association.An overview of the different types of eczema.National Eczema Association.What is eczema?American Academy of Dermatology Association.Acne-like breakouts could be folliculitis.American Academy of Allergy, Asthma and Immunology.Hives defined.American Academy of Family Physicians. American Family Physician.Exercise-induced urticaria.National Psoriasis Foundation.About psoriasis.National Psoriasis Foundation.Phototherapy for psoriasis.American Academy of Dermatology Association.Is rosacea causing your red, irritated skin?Skin Cancer Foundation.Sunburn & your skin.Karray M, McKinney WP. Tinea Versicolor. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024. Available from:https://www.ncbi.nlm.nih.gov/books/NBK482500/Johns Hopkins Medicine.Tinea versicolor.Medline Plus.Skin pigmentation disorders.U.S. Centers for Disease Control and Prevention.Symptoms of scarlet fever.American Academy of Dermatology Association.Shingles: Diagnosis and treatment.National Institutes of Health. National Institute on Alcohol Abuse and Alcoholism.Alcohol flush reaction.Callender VD, Baldwin H, Cook-Bolden FE, Alexis AF, Stein Gold L, Guenin E.Effects of topical retinoids on acne and post-inflammatory hyperpigmentation in patients with skin of color: A clinical review and implications for practice.American Journal of Clinical Dermatology.2022;23(1);69–81. doi:10.1007/s40257-021-00643-2.American Academy of Dermatology Association.Rash 101 in Adults: When to seek medical treatment.
American Academy of Dermatology Association.Welts on skin due to cold temperature could be hives.
Seattle Children’s Hospital.Heat rash.
American Academy of Dermatology Association.Stress: Is it a common eczema trigger?
American Academy of Dermatology.New study shows significant economic burden of skin disease in the United States.
National Eczema Association.An overview of the different types of eczema.
National Eczema Association.What is eczema?
American Academy of Dermatology Association.Acne-like breakouts could be folliculitis.
American Academy of Allergy, Asthma and Immunology.Hives defined.
American Academy of Family Physicians. American Family Physician.Exercise-induced urticaria.
National Psoriasis Foundation.About psoriasis.
National Psoriasis Foundation.Phototherapy for psoriasis.
American Academy of Dermatology Association.Is rosacea causing your red, irritated skin?
Skin Cancer Foundation.Sunburn & your skin.
Karray M, McKinney WP. Tinea Versicolor. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024. Available from:https://www.ncbi.nlm.nih.gov/books/NBK482500/
Johns Hopkins Medicine.Tinea versicolor.
Medline Plus.Skin pigmentation disorders.
U.S. Centers for Disease Control and Prevention.Symptoms of scarlet fever.
American Academy of Dermatology Association.Shingles: Diagnosis and treatment.
National Institutes of Health. National Institute on Alcohol Abuse and Alcoholism.Alcohol flush reaction.
Callender VD, Baldwin H, Cook-Bolden FE, Alexis AF, Stein Gold L, Guenin E.Effects of topical retinoids on acne and post-inflammatory hyperpigmentation in patients with skin of color: A clinical review and implications for practice.American Journal of Clinical Dermatology.2022;23(1);69–81. doi:10.1007/s40257-021-00643-2.
American Academy of Dermatology Association.Rash 101 in Adults: When to seek medical treatment.
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