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

Question

Hi, I’ve had this problem on my legs (and arms) since I was in middle or high school. Super red and purple and splotchy. the only way to cover it up is with spray tan. The spots you see could be called mottled skin I guess? It gets really bad when I’m standing in one place for a little while. My hands and feet don’t get cold easily so it’s not bad circulation, right? My primary care physician hasn’t said its anything concerning. Is there anything I can do to improve it?

Anna Chacon, MD, FAAD · Answer

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.

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

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

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