Many conditions can cause your skin to have a bluish tint. For example, bruises and varicose veins can appear blue in color. Poor circulation or inadequate oxygen levels in your blood stream can also cause your skin to turn bluish. This skin discoloration is also known as cyanosis.
Cyanosis can affect your:
- fingers, toes, and nails
- earlobes
- mucous membranes
- lips
- skin
This bluish coloring is more common in newborns as their skin learns to adjust to the environment. It’s also more noticeable on light colored skin. Cyanosis can also suggest there’s something wrong with areas of the body, such as the:
- lungs
- heart
- circulatory system
Most often, cyanosis is a symptom of a serious health condition. Read on to learn about the types of cyanosis, what causes this condition, and when you should see a doctor.
There are four types of cyanosis:
- Peripheral cyanosis: Your limbs are not getting enough oxygen or blood flow due to low flow or injury.
- Central cyanosis: There’s low overall oxygen available to the body, often due to abnormal blood proteins or a low oxygen state.
- Mixed cyanosis: A combination of peripheral and central cyanosis occurs at the same time.
- Acrocyanosis: This happens around your hands and feet when you’re cold, and should resolve after you warm back up.
Cyanosis occurs when there’s too little oxygen in the blood. Oxygen-rich blood is deep red and causes your skin’s normal color. Under-oxygenated blood is bluer and causes your skin to look bluish purple.
Cyanosis can develop quickly due to an acute health problem or external factor. Life-threatening causes of cyanosis include:
- suffocation
- obstruction of the airway
- problems with lung expansion or chest wall injuries
- heart abnormalities (present during birth) that cause blood to bypass the lungs and never collect oxygen
- heart attack or heart failure
- pulmonary hypertension, or high blood pressure in the lungs
- pulmonary embolism, or blood clot in the lungs
- shock
- methemoglobinemia, most often caused by drugs or toxins where blood proteins become abnormal and cannot carry oxygen
Cyanosis can also be the result of a worsening health condition, or develop gradually due to a chronic or long-term health condition. Many health disorders that involve the heart, lungs, blood or circulation will also cause cyanosis. These include:
- chronic respiratory disease, such as asthma or COPD
- sudden infection in your airways, such as pneumonia
- severe anemia, or low red blood cell count
- overdoses of certain medications
- exposure to certain poisons, such as cyanide
- Raynaud’s syndrome, a condition that can restrict blood flow to your fingers or toes
- hypothermia, or exposure to extreme cold causing your body temperature to drop
Most causes of cyanosis are serious and a symptom of your body not getting enough oxygen. Over time, this condition will become life-threatening. It can lead to respiratory failure, heart failure, and even death, if left untreated.
Contact your doctor if you develop a bluish tint to your skin, lips, fingertips, or fingernails that can’t be explained by bruising and doesn’t go away.
Seek emergency medical attention if you develop cyanosis along with any of the following symptoms:
- difficulty breathing
- shortness of breath
- rapid breathing
- chest pain
- coughing up dark mucus
- fever
- confusion
Your doctor can diagnose cyanosis just by looking at your skin. To diagnose the cause of cyanosis, your doctor will perform a complete physical exam. They’ll ask you about your medical history and when your symptoms developed.
They may also order one or more tests, such as:
- complete blood count (CBC)
- pulse oximetry to measure the level of oxygen in your blood
- electrocardiogram (ECG) to measure the electrical activity of your heart
- echocardiogram or ultrasound of the heart
- X-ray or CT scan of your chest
In blood tests, extremely low concentrations of hemoglobin can cause cyanosis. Central cyanosis occurs when your hemoglobin count reaches below 5 grams per deciliter. Normal hemoglobin for an adult is between 12 and 17 g/dL.
The treatment plan your doctor recommends will depend on the underlying cause of your cyanosis.
For example, your doctor may prescribe supplemental oxygen therapy if you have a condition that affects your airways or breathing. In this therapy, you will receive oxygen through a mask or a tube placed in your nose.
For conditions that affect your heart or blood vessels, your doctor may prescribe medications, surgery, or other treatments.
If you’ve been diagnosed with Raynaud’s syndrome, your doctor may advise you to dress warmly and limit your time in cold environments.
Some causes of cyanosis are difficult to prevent. But you can take steps to lower your risk of developing cyanosis and some conditions that cause it.
These steps include:
- Protect your heart, blood vessels, and respiratory system by avoiding smoking and second-hand smoke and exercising regularly.
- Schedule regular check-ups with your doctor to monitor your health, and let them know if you notice any changes in your health.
- Follow your doctor’s recommended treatment plan for any health conditions that you have, such as diabetes, heart disease, Reynaud’s syndrome, asthma, or COPD.
- Wear more layers and warmer clothes during wintertime.
- Get vaccinated to prevent respiratory infections and serious illnesses.