Can I fix my uneven skin tone on legs with laser? (Photos)

Hello, my name is Ranen and I am an aesthetic nurse at Aesthetic Skin in Chicago.It makes sense that you’re trying to figure this out — what you’re describing is very common, often long-standing, and frustrating because it’s so visible even when it’s not dangerous.
I can’t diagnose you, but here are the most likely benign patterns that match your description and some things that truly can help, depending on the cause. Skin barrier support helps especially if some of the redness is from KP or irritation. AHA or urea lotions (AmLactin, Urea 10–20%), Ceramide moisturizers. Gentle exfoliation 1–2× per week.Laser treatments (if you want a cosmetic fix)
Aesthetic dermatology can significantly reduce visible mottling:
Pico laser – targets pigment,Vascular lasers (like Excel V or IPL) – target redness/purple tones, IPL – great for diffuse redness or blotchy discoloration.

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.
Best,
Dr. Karamanoukian
Realself100 Surgeon

Thank you for your detailed message and photos. What you’re describing sounds like a condition called livedo reticularis, which is a common vascular pattern that presents as mottled, reddish-purple discoloration on the skin — especially of the legs and arms. It often becomes more noticeable when you’re cold or standing for a long time.

A few important points:
It’s usually benign, especially if your primary care provider has ruled out underlying vascular or autoimmune causes.

It's not necessarily related to poor circulation, especially since your extremities don’t get cold and you don’t have other systemic symptoms.

Treatment Options:
1. Vascular Lasers
Yes, laser treatments — particularly Pulsed Dye Laser (PDL) or Nd:YAG laser — may help reduce the appearance of discoloration by targeting superficial blood vessels.

Results can vary depending on skin tone, depth of vessels, and how reactive your vascular system is.

Multiple sessions are typically needed for optimal results.

2. Lifestyle Tips
Keep warm, as cold exposure often triggers or worsens the mottling.

Avoid prolonged standing when possible.

Compression stockings can sometimes help improve blood flow and reduce pooling in the lower extremities.

3. Topical Treatments
Unfortunately, there are no effective topical creams to significantly improve livedo or vascular-related discoloration.

Self-tanners or spray tans, as you mentioned, are often used cosmetically.

When to Investigate Further
Even though it appears benign in your case, if you ever develop:

Pain, ulcers, numbness, or worsening discoloration,

Or systemic symptoms (like fatigue, joint pain, or skin breakdown),

…you should follow up again with a specialist, as rarely livedo can be a sign of a more serious vascular or autoimmune issue.

Summary:
Laser treatments can help reduce the visible discoloration, especially if it’s persistent and bothersome.

It’s likely a benign vascular condition, and not due to poor circulation in the classic sense.

Keeping warm and avoiding long periods of standing may also help minimize flare-ups.

You’re not alone in this — many people experience this, and there are safe, effective ways to improve the cosmetic appearance if it continues to bother you.