What causes blue fingernails? 28 possible conditions

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Bluish Discoloration Overview

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.

Associated Diagnoses

Similar diagnoses include:

  • asthma
  • adult respiratory distress syndrome
  • aspiration pneumonia
  • carbon monoxide poisoning
  • cardiac tamponade
  • emphysema
  • 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 (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.

When to Call 911

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

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See a list of possible causes in order from the most common to the least.

1

Emphysema

Emphysema is a lung disease that, along with chronic bronchitis, represents a type of chronic obstructive pulmonary disease (COPD). Lack of oxygen may give skin and lips a bluish hue.

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2

Peripheral Vascular Disease

Peripheral vascular disease is a circulation disorder caused by plaque build-up in peripheral arteries. It typically affects the arteries that supply blood to the arms, legs, and organs located below the stomach.

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3

Pulmonary Embolism

This condition is considered a medical emergency. Urgent care may be required.

A pulmonary embolism is a blood clot that affects blood flow to the lungs. It can damage part of the lung due to restricted blood flow, decrease blood oxygen. The most common symptom is shortness of breath.

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4

Carbon Monoxide Poisoning

This condition is considered a medical emergency. Urgent care may be required.

Carbon monoxide poisoning occurs when we inhale too much carbon monoxide. It can lead to tissue damage and possibly death. Signs include a dull headache, nausea, confusion, and blue lips or skin.

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5

Arterial Embolism

This condition is considered a medical emergency. Urgent care may be required.

An arterial embolism is a blood clot that has become stuck in the arteries. This can block or restrict blood flow, causing tissue damage or death in the affected area. Clots generally affect the arms, legs, or feet.

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6

Asthma Overview

Learn about asthma. Explore the types of asthma and read information about their symptoms, causes and treatments. Continue reading!

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7

Adult Respiratory Distress Syndrome

This condition is considered a medical emergency. Urgent care may be required.

Adult respiratory distress syndrome (ARDS) is a severe lung condition that occurs when fluid fills up the air sacs in your lungs. Common symptoms include labored breathing, fever, fast pulse, and blue skin or nails.

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8

Raynaud's Phenomenon

Raynaud's phenomenon is a condition where blood flow to your fingers, toes, ears or nose is restricted or interrupted. This occurs when the blood vessels in your hands or feet constrict. Episodes of constriction ar...

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9

Pneumothorax (Collapsed Lung)

Pneumothorax is a collapsed lung. This occurs when air becomes trapped in the space around the lungs. Along with a steady ache in the chest and shortness of breath, your skin or lips may turn blue.

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10

Pulmonary Fibrosis

Pulmonary fibrosis is a condition that causes lung scarring and stiffness. This keeps the body from getting enough oxygen.

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11

Bronchiectasis

Bronchiectasis is a condition in which the bronchial tubes of the lungs are permanently damaged and enlarged, which causes infections and blockages in the airways, and gives the skin a blue appearance.

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12

The Catastrophy of Cardiac Tamponade

This condition is considered a medical emergency. Urgent care may be required.

Cardiac tamponade is a serious medical condition in which fluids fill the space between the sac around the heart and the heart muscle, creating pressure. Symptoms include anxiety, short breath, fainting, and more.

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13

Choking Adult Or Child Over 1 Year

This condition is considered a medical emergency. Urgent care may be required.

Choking occurs when an object, food, or liquid becomes lodged in the throat. Emergency signs of choking include the inability to speak, cough, or breathe. Lips may start to turn blue from lack of oxygen.

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14

Cor Pulmonare

Cor pulmonale causes the right ventricle to enlarge and pump blood less effectively than it should. Shortness of breath, chronic cough, and a blue tint to the mouth and fingernails are all symptoms.

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15

RSV (Respiratory Syncytial Virus) Infection

Respiratory syncytial virus, or RSV, is a common virus that causes infections of the lungs and airways. Common symptoms include fever, wheezing, and bluish skin from oxygen deprivation.

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16

Getting a Handle on Aspiration Pneumonia

This condition is considered a medical emergency. Urgent care may be required.

Aspiration pneumonia is an inflammation of your lungs and bronchial tubes that happens after foreign matter is inhaled. Symptoms include chest pain, wheezing, and blue discoloration of the skin.

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17

Tetralogy of Fallot (TOF)

Tetralogy of Fallot is a congenital heart defect that can be fatal if left untreated. Symptoms are present at birth and include bluish-colored skin, clubbed fingers, and developmental delays.

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18

Polycythemia Vera

Polycythemia vera is a disorder in which the body produces an excessive amount of red blood cells. This can lead to clots, which block blood from reaching the heart or brain, causing serious damage.

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19

Epiglottitis

This condition is considered a medical emergency. Urgent care may be required.

Epiglottitis is a life-threatening condition characterized by inflamed epiglottis tissue. Once the airway becomes blocked, an adult or child may exhibit bluish discoloration of their skin or lips from lack of oxygen.

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20

Pulmonary Edema

This condition is considered a medical emergency. Urgent care may be required.

Pulmonary edema is a condition in which the lungs fill with fluid. When this occurs, the body struggles to get enough oxygen, often resulting in breathlessness, coughing, excessive sweating, and bluish skin or lips.

Read more »

This feature is for informational purposes only and should not be used to diagnose.
Please consult a healthcare professional if you have health concerns.
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