You may have had bruises that temporarily turned part of your skin a shade of black, blue, or purple. Those injuries usually heal on their own without treatment. But if your foot starts to take on a purple color without any bumps or bruises, you should see your doctor. Purple feet are a sign of a circulation problem that can be potentially serious.

When circulation in your feet is healthy, cuts heal quickly and your skin retains its natural color. Blood reaches your feet through a network of arteries, which are the blood vessels that carry blood from your heart. Your blood travels through veins back to your heart and lungs for more oxygen and the start of another round trip.

Many conditions can interrupt the healthy flow of blood between your heart and feet. In many cases, though, treatment can help improve circulation and get your feet closer to their natural, healthy color.

The following is a list of health concerns that can affect the circulation and color of your feet:

Ischemic foot

Ischemia refers to a reduction in healthy blood flow in one or more arteries. If you have ischemic foot, it means your foot isn’t getting an adequate supply of oxygen-rich blood.

Ischemic foot can result from a buildup of cholesterol plaque in one of the main arteries supplying blood to your foot. You could also have a blood clot that’s blocking blood flow in an artery. Sometimes an artery can become injured, whether from a puncture wound or from blunt trauma. Risk factors for ischemic foot include:

  • high cholesterol
  • high blood pressure
  • diabetes
  • having a history of vascular problems
  • obesity

In addition to toes and feet turning purple, you may have pain in your feet and lower legs when walking. In serious cases, you may also feel pain when you’re at rest.

The key to preventing ischemic foot is to manage your cholesterol, blood pressure, and blood sugar levels. This may require medications, as well regular exercise and a diet that will help keep your weight in a healthy range. You should also stop smoking, as it can seriously harm your blood vessels.

Acrocyanosis

Acrocyanosis also reduces healthy blood flow in the arteries of your feet. The meaning of the term acrocyanosis is bluish discoloration of the skin due to decreased oxygenation to the extremity.

It’s usually caused by spasms of tiny blood vessels near the surface of your skin. When an artery spasms, it constricts suddenly. This brief tightening can drastically reduce or even stop blood flow in your artery.

Acrocyanosis can also affect your hands, causing the skin to turn blue or purple. It’s a painless condition that usually causes no other noticeable symptoms. The condition also usually affects women more often than men.

Emotional stress and cold weather can cause acrocyanosis. Avoiding hand or feet exposure to extremely cold temperatures may help prevent future episodes.

Raynaud’s disease

Raynaud’s disease is similar to acrocyanosis in some ways. Both conditions are often triggered by cold weather and both cause skin to turn blue or light purple. But, episodes of Raynaud’s can come and go, and may last for a few minutes at a time. Acrocyanosis episodes tend to persist. Also, Raynaud’s affects the smaller blood vessels in your fingers and toes, while acrocyanosis affects the larger arteries of your feet and hands.

There are two types of Raynaud’s: primary and secondary. Primary isn’t linked to an underlying condition and may be so mild you could have it and not realize it. Secondary Raynaud’s is usually a complication of a more serious condition, such as:

  • scleroderma
  • other connective tissue diseases
  • carpal tunnel syndrome
  • diseases of the arteries

Women are more likely than men to have Raynaud’s. Anyone can develop it, but the condition usually begins in your teens or 20s.

Diabetes

Diabetes can affect your feet in two important ways: loss of healthy nerve function and a reduction in healthy circulation. If your circulation is affected by diabetes, you could notice discoloration of your toes and feet. The skin on your feet could turn blue, purple, or gray. You may also develop a rash or patches of red or purple skin.

Diabetes leads to circulation problems because high levels of blood sugar can damage the walls of your arteries. Over time, this can reduce normal circulation, especially to your lower legs and feet. You might notice swelling in your lower legs and ankles and have cuts or bruises that don’t heal properly.

Maintaining a healthy blood sugar level will help prevent complications of diabetes. For most people that means a target fasting blood sugar measurement of less than 100 milligrams per deciliter.

Frostbite

Cold temperatures can reduce circulation in your hands and feet because your body prioritizes healthy circulation to your internal organs over normal blood flow to the extremities. Moving from the cold to the warm indoors or donning a pair of gloves or socks may be enough to resume normal circulation in your fingers and toes.

In extreme cold weather, the stakes are much higher. Frostbite occurs when your skin is exposed to severe cold. Usually, your feet, hands, ears, and face are most at risk. Superficial frostbite turns exposed skin red and hard. But deep frostbite can turn skin purple. Even after the skin warms, it may stay purple. This is considered a medical emergency.

The best way to prevent frostbite is to avoid exposure to extreme cold temperatures. Be sure you wear clothing that protects all parts of your body from cold exposure.

The treatments for these conditions usually involve medications or procedures to maintain healthy circulation. Sometimes a healthy lifestyle and simple preventive measures are enough.

If the damage to your foot’s circulation is so severe that there’s a risk of foot tissue dying, amputation may be necessary. But doctors should only turn to that in the most extreme situations after other treatments have failed.

Before such a drastic step is taken, the following treatments may be appropriate:

Treating ischemic foot

In addition to proper control of blood pressure, cholesterol, blood sugar, and smoking cessation, you may need to take antiplatelet medications, such as aspirin. In serious cases, surgery may be appropriate to attach a blood vessel from another part of your body to the affected artery, creating a route for blood to bypass the narrowed section of the artery.

Treating acrocyanosis

Your doctor may prescribe calcium channel blockers. These medications help keep your arteries open to maintain healthy blood flow and reduce blood pressure inside your arteries. The topical application of nicotinic acid derivatives and minoxidil also may relieve symptoms.

Treating Raynaud’s disease

Wearing gloves and thick socks in cold temperatures may help reduce episodes. Medications such as calcium channel blockers or vasodilators, which help keep smaller arteries open, may also be necessary. More invasive treatments usually aren’t necessary. In serious cases, nerve surgery that removes tiny nerves from around blood vessels in your affected feet or hands may help lessen the response to cold temperatures.

Treating diabetes

Your doctor may prescribe medications, such as metformin, to help keep your blood sugar levels in a healthy range. If you have type 1 diabetes, you may also need regular injections of insulin.

Treating frostbite

Initial frostbite and other cold-weather injuries can be treated by warming, soaking the affected skin in a warm bath for half an hour or so, and letting it air dry. Don’t rub frostbitten skin. Treat it carefully and have it evaluated by a doctor. If any tissue is permanently damaged, it may have to be surgically removed. This could include toes.

Your feet carry you through life, so take their health very seriously. Keep them warm in cold temperatures and make sure you take the steps to ensure healthy circulation throughout your body. Have regular blood work and physical examinations. This way you and your doctor can spot early signs of high cholesterol, high blood sugar, or other conditions that can affect the color and future of your feet.