Cyanosis

What is cyanosis?

Cyanosis is the medical term for when your skin, lips or nails turn blue due to a lack of oxygen in your blood. If you have darker skin, cyanosis may be easier to see in your lips, gums, nails and around your eyes. The word cyanosis comes from the word cyan. Cyan is a blue-green color.

Normally, red blood cells carry oxygen to the tissues in your body. Your blood is red when it’s filled with oxygen because your blood cells are bright red. As a result, when oxygen-filled blood circulates throughout your body, your skin has a pink or red tone.

When there’s not enough oxygen circulating in your blood, it’s darker and more of a blue or purple tone. The area of your body that’s most affected by cyanosis can help determine the cause.

What does cyanosis signify?

Cyanosis can mean your organs, muscles and tissues aren’t getting the amount of blood they need to function properly. Many different conditions can cause cyanosis. While blue skin and lips aren’t always a cause for concern, some conditions do need immediate medical treatment. Conditions causing cyanosis may be related to your lungs, heart or central nervous system.

What are the different types of cyanosis?

The three types of cyanosis are circumoral (perioral), peripheral and central.

Circumoral (perioral) cyanosis

Circumoral cyanosis is when only your mouth or lips turn blue. It often occurs when your blood vessels shrink in response to cold temperatures. Circumoral cyanosis is common — and can be normal— in newborns. In older children, it may appear when they go outside in cold weather.

Peripheral cyanosis

Peripheral cyanosis is when only your hands, fingers, feet and/or toes turn blue. This can happen in very cold weather if your hands and feet aren’t well protected. It’s rarely life-threatening, but it’s important to find out the cause because it may need quick treatment to prevent permanent injury.

Central cyanosis

Central cyanosis is when other parts of your body are affected in addition to your hands and feet. This may include your chest, cheeks, tongue, gums and lips. Serious heart, lung or blood conditions may be the cause of central cyanosis. It’s very important to seek treatment immediately.

What are the symptoms of cyanosis?

The main symptom of cyanosis is a bluish discoloration of your skin. The bluish tone may also affect your lips, tongue, gums, ears and nails.

If you have darker skin, cyanosis may look more gray or white. It may also show up more around your lips, tongue, gums, nails and eyes.

Cyanosis is typically caused by another condition. Depending on what’s causing the cyanosis, other symptoms you may experience include:

• Low body temperature (hypothermia).
• Numbness or tingling in your arms and legs.
• Coughing.
• Wheezing.
• Difficulty breathing.
• Dizziness.
• Extreme tiredness (fatigue).
• Weakness.

What does cyanosis look like?

Depending on what type of cyanosis you have, your skin, lips, tongue, gums, eyes or nails may look different shades of blue or purple. If you have darker skin, cyanosis may look white or gray.

What causes cyanosis?

Cyanosis is usually caused by a lack of oxygen in your blood. This may be because your blood doesn’t have enough oxygen in it, or because blood vessels are exposed to cold temperatures. Circulating blood keeps your organs and body parts warm. But if it’s very cold out, the blood vessels in your hands, feet and ears clamp down to keep your body temperature normal.

Many conditions can cause your blood to lack the oxygen it needs.

Airway problems

• Choking (suffocation).
• Swelling around your vocal cords (croup).
• Inflammation of the flap in your throat that covers your windpipe (epiglottitis).

Lung problems

• High altitudes.
• Asthma.
• Infection in your respiratory tract.
• Blood clot in an artery of your lung (pulmonary embolism).
• Chronic obstructive pulmonary disease (COPD).
• Pulmonary hypertension.
• Pneumonia.

Heart problems

• Heart defects that were present at birth (congenital heart defects), such as double outlet right ventricle and tetralogy of Fallot.
• Congestive heart failure.
• Cardiac arrest.

Other causes of cyanosis

• Wearing clothes that are too tight and limit your circulation.
• Exposure to extreme cold.
• Raynaud’s phenomenon, a disorder that causes your blood vessels to narrow.
• Medications that are used to treat high blood pressure.
• Seizures.
• Drug overdose.
• Toxic exposures.

How is cyanosis diagnosed?

Cyanosis is a symptom, and your healthcare provider will want to determine the cause of it. They’ll begin by performing a physical examination. They’ll ask you about your symptoms. Questions they may ask include:

• When did you first notice the cyanosis?
• Did the cyanosis appear suddenly or has it come on slowly?
• What part(s) of your body are blue?
• Have you recently traveled anywhere?
• Are you having trouble breathing?
• Are your arms or legs swelling?
• What other symptoms do you have?

What tests will be done to diagnose cyanosis?

Your healthcare provider may order tests to determine the cause of the cyanosis. These tests can include various blood, lung and heart tests:

• Pulse oximetry: A pulse oximeter measures the amount of oxygen in your blood by attaching a sensor to your finger.
• Arterial blood gas analysis: An arterial blood gas analysis measures the amount of oxygen and other substances in your arteries. This is the blood that has the most oxygen in it.
• Chest X-ray.
• Chest computed tomography (CT) scan.
• Complete blood count (CBC).
• Electrocardiogram (EKG): An EKG measures your heart’s electrical activity.
• Echocardiogram: An echocardiogram is an ultrasound of the heart that shows its function and structure.
• Pulmonary function tests: Pulmonary function tests can further help diagnose lung conditions.
• Cardiac catheterization: Cardiac catheterization can further help diagnose heart conditions.

How is cyanosis treated?

Cyanosis can be a symptom of many different conditions. The cause of your cyanosis will determine the treatment.

One of the first treatments your healthcare provider may use is oxygen therapy. Oxygen therapy provides you with extra oxygen to help boost your levels quickly. You may need a breathing machine or ventilator depending on the severity of your condition.

Other possible treatments include:

• Warmth and massage: Exposure to cold temperatures and conditions such as Raynaud’s phenomenon may be treated with warming and massaging the affected areas.
• Antibiotics: Antibiotics can treat infections such as pneumonia.
• Other medications: Your healthcare provider may prescribe medications to treat heart and lung conditions.
• Discontinuing medication: Your healthcare provider may recommend you stop taking certain medications.
• Inhalers: If a lung condition such as asthma or COPD caused your cyanosis, your healthcare provider may recommend an inhaler to help your lungs work better.
• Surgery: Congenital heart defects such as tetralogy of Fallot may need surgery soon after birth.

How can I take care of myself?

If cold temperatures or a condition such as Raynaud’s phenomenon caused your cyanosis, you may have to make lifestyle changes. You should dress in warm clothes when you plan to be outside. When you’re inside, make sure you’re in a heated room. It’s important that you keep your body warm.

You should quit smoking and cut back on your caffeine intake. Caffeine and nicotine can cause your blood vessels to narrow, which can lead to cyanosis.

How can I prevent cyanosis?

There are many different reasons for cyanosis and they can’t all be prevented. But there are some things you can do to prevent the condition.

Your healthcare provider may recommend you stop taking any medications that restrict your blood flow. You should also quit smoking and limit your caffeine intake. Make sure you dress warmly if you go into cold temperatures, especially taking care of your ears, fingers, toes and nose.

What can I expect if I have cyanosis?

The outlook for cyanosis depends on the reason for the condition and how quickly you receive treatment. It’s generally not life-threatening, but see your provider if you have any other associated symptoms or if the cyanosis happens when you’re warm and at rest.

When should I seek care?

Many conditions and disorders can cause cyanosis. Some are more serious than others. If you have any of the following symptoms along with bluish skin, go to your nearest emergency room or call 911:

• Difficulty breathing.
• Chest pain.
• Frequent headaches.
• Extreme tiredness (fatigue).
• Confusion.
• Fever.
• Excessive sweating (hyperhidrosis).
• Coughing up blood or dark mucus.
• Pain or numbness in hands, fingers or arms.

If your baby or child has cyanosis along with any of the following symptoms, take them to the nearest emergency room or call 911:

• Difficulty breathing.
• Difficulty feeding.
• Nostrils flaring when breathing.
• Chest caving in when breathing.
• Breathing fast.
• Grunting.
• Extreme tiredness (fatigue).
• Trouble sleeping.
• Limp body.
• Irritability.

A note from Cleveland Clinic

Cyanosis is when you have bluish skin, nails or lips due to a lack of oxygen in your blood. Cyanosis occurs for many reasons. While not always serious, cyanosis can be caused by a severe medical condition. It’s important to seek medical attention right away if you or your child have cyanosis along with symptoms such as difficulty breathing to ensure that you have the best outcome.