Bluish discoloration of the skin may be a sign of lack of oxygen in the blood.
Blue fingernails may represent a type of cyanosis caused by a lower level of lack of circulating oxygen in the red blood cells. It may also represent a high level of an abnormal form of hemoglobin in the circulation. If normal color returns upon warming and/or massage, the cause is due to the body part not getting enough blood supply due to cold, constriction (of the tissues or the blood vessels that supply the tissues) or some other reason. If the fingernails remain blue, then there may be an underlying disease or structural abnormality interfering with the body’s ability to deliver oxygenated red blood to the body.
- Adult respiratory distress syndrome
- Aspiration pneumonia
- Carbon monoxide poisoning
- Cardiac tamponade
- Pulmonary embolism
- Raynaud’s phenomenon
- Chronic obstructive pulmonary disease (COPD)
- Polycythemia vera
- Pulmonary edema
Diagnosis and Treatment
A non-invasive pulse oximeter is the simplest way to measure the oxygenation of the blood. Arterial blood gases (ABG’s) are drawn to measure oxygenation and determine other factors that may be contributing to blue fingernails. Treatment involves identifying and correcting the underlying cause and restoring the oxygenated blood flow to the fingers.
Call 911 if:
Blue fingernails are accompanied by:
- Air hunger or gasping for breath
- Shortness of breath or breathing difficulties
- Chest pain
- Sweating profusely
- Pain or numbness in the arm, hands or fingers
- Pallor or blanching of the arm, hands or fingers
- Dizziness or fainting