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If I want to say, "you look tired", 疲れそう doesn't work, as that is "looks like
I/you will get tired", but is 疲れたそう a thing? feels wrong...

Is it possible to use ~そう past tense? past negative? Is there a better way to
say this?
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question
grammar usage tense auxiliaries
how to use ~そう past tense
Yes, 疲れそう means "It looks tiresome" rather than "You look tired".

To say "You look tired", you can say 疲れていそう or 疲れてそう using the subsidiary verb
いる. Other ways to say similar things are 「お疲れですか」, 「疲れているようですね」,
「疲れて(い)るみたいですね」, and 「疲れてる?」

疲れたそう(だ) means something like "They say he/she got tired," because this そう
follows the dictionary form of the auxiliary た. For the conjugation rules, see
[Problems with そうです in this
sentence](https://japanese.stackexchange.com/q/44797/5010)

* * *

**EDIT:** So, the past tense is not at all necessary to say "You look tired."
To be clear, this "(look) tired" is the passive form, not the past form, of
the transitive verb "tire." If you need to say "You look **ed** tired
yesterday", then you can simply turn them into the past tense. The past form
of ～そう(だ/です) is ～そうだった/～そうでした.
「昨日は疲れて(い)そうだったね」「昨日はお疲れでしたか」「昨日は疲れて(い)るみたいでしたね」「昨日、疲れてた?」
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answer