Blue lips may represent a type of cyanosis caused by lower levels of oxygen in the red blood cells. It may also represent high levels of an abnormal form of hemoglobin in the bloodstream. If normal color returns upon warming or massage, the cause is due to the body part not getting enough blood supply. This can be due to cold, constriction, or some other reason. If the lips remain blue, then there may be an underlying disease or structural abnormality. Either of these can interfere with the body’s ability to deliver oxygenated red blood to the body.
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 lips. Treatment involves identifying and correcting the underlying cause and restoring the oxygenated blood flow to the lips.