What causes blue fingernails? 28 possible conditions
Bluish discoloration of the skin may be a sign of lack of oxygen in the blood.
Blue fingernails may represent a type of cyanosis of the nail bed caused by a lower level orlack 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 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 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.
Similar diagnoses include:
- 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
A non-invasive pulse oximeter is the simplest way to measure the oxygenation of the blood. Arterial blood gases (ABGs) are drawn to measure oxygenation of the blood to determine what factors might be contributing to blue fingernails. Treatment involves identifying and correcting the underlying cause and restoring adequate oxygenated of the blood.
You should call 911 if your 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
- Cyanosis. (2014, August). Retrieved from http://www.texasheart.org/HIC/Topics/Cond/cyanosis.cfm
- Cyanosis in children. (2013, January). Retrieved from http://www.cincinnatichildrens.org/health/c/cyanosis/
- Slide show: 7 fingernail problems not to ignore. (n.d.). Retrieved from http://www.mayoclinic.org/healthy-living/adult-health/multimedia/nails/sls-20076131
See a list of possible causes in order from the most common to the least.
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