Pallor or grayish or blue skin is a result of a lack of oxygenated blood. Your blood carries oxygen around the body, and when this is disrupted, you see a discoloration. The disruption may be to the flow of blood itself, which produces paleness and/or a gray tint to skin tone. When you experience a lack of oxygen, your blood may still be flowing, but it changes color. This causes your skin to become blue or gray in color.
A gray, pale, or bluish tint to the skin can be an indicator of one or more health problems. In general, pallor results from insufficient oxygen, which can be caused by many different things. Some situations in which your skin turns pale are medical emergencies—for instance, if you are choking or cannot breathe. The symptom could also be a result of something that does not constitute an emergency. In other instances, a grayish tint is a characteristic of a chronic or late-stage disease, such as cancer. The appropriate course of treatment and the outlook depends on the situation and what is causing skin discoloration.
When someone is in the late stages of a disease or organ failure, blood flow slows and produces a gray pallor:
- late stage chronic kidney disease, or renal failure
- late stage, terminal cancer
- congestive heart failure
- hemochromatosis, or iron storage disease
Some conditions or chronic diseases can produce pallor or a bluish skin color because of inadequate blood flow or lack of oxygen in the body. Some of these situations are emergencies and may require immediate medical treatment, while others can be treated, but are not immediately life threatening:
- choking on a foreign object, which requires emergency care
- aspiration pneumonia
- chronic infections, such as pulmonary tuberculosis
- heart disease
- chronic obstructive pulmonary disease (COPD)
If you see someone with pale, bluish, or gray skin, who seems to be distressed, it could be an medical emergency. Other signs of an emergency include difficulty breathing, an inability to talk, lips and nails turning blue, and loss of consciousness. If you think someone is choking or cannot breathe, call 911 and get medical help right away.
Hemochromatosis is an unusual and rare genetic disorder that causes a person to retain too much iron in the blood. Grayish skin is a sign of the late stages of the disease, but it can still be treated. Treatment involves removing blood on a regular basis to reduce the amount of iron.
For an emergency choking situation, treatment means removing the blockage. This can be done with the Heimlich maneuver. Other conditions that produce pallor and gray skin have varied treatment options. Infections can be treated with medications, such as antibiotics for bacterial infections. Heart disease, emphysema, and COPD cannot be cured, but can be controlled and treated with medications and lifestyle changes.
The outlook for many people who have the symptom of gray or blue skin varies depending on the condition causing it. For patients in the late stages of a terminal disease, the outlook is not good. Hemochromatosis can be controlled, although if it is not caught until the late stages, some organ damage may be irreversible.
For chronic conditions such as COPD, emphysema, infections that cannot be cured, and heart disease, the prognosis can be good if treatment is followed diligently. Although there are no cures for these conditions, lifestyle modifications and medications can control symptoms and allow for a comfortable and long life.
In emergency choking situations, the outlook is good if the obstruction can be removed quickly. If it is not removed in time, the blockage may be fatal or may cause brain damage due to restricted flow of oxygenated blood to the brain for a period of time.