peripheral cyanosis is a condition in which the extremities develop a distinct bluish discoloration because they are not receiving enough oxygen-rich blood. This condition most often occurs on the hands, feet, fingers and/or toes.
Reduced blood circulation in the affected extremities is almost always the culprit. It starves oxygen-rich blood tissue. Oxygen-poor blood is dark red, reflecting blue-green through the skin.
Peripheral cyanosis is rarely severe. However, if your hands and feet do not return to their usual color and blood flow does not normalize after heating and massaging, you may have an underlying condition. In this case, you should seek medical attention.
This article provides an overview of the symptoms and causes of peripheral cyanosis. It also explains how it is diagnosed and treated.
Symptoms of peripheral cyanosis
Peripheral cyanosis can affect anyone, regardless of age.
Adults and children with peripheral cyanosis may experience the following symptoms:
- blue area that feels cold to the touch
- blue-green color on the fingertips, toes, palms, and/or feet
- Visible return to normal color after body parts are heated
Peripheral cyanosis is usually associated with cold, but it is also possible to have peripheral cyanosis and be warm.
Peripheral cyanosis in newborns is sometimes difficult to diagnose because of other skin discoloration problems, including jaundice.
Peripheral cyanosis escalation
Peripheral cyanosis can be a life-threatening emergency. Call 911 or go to the nearest emergency room immediately for medical attention if you have a blue discoloration and the following symptoms:
- chest pain
- dizziness or fainting
- excessive sweating
- Pain or numbness in arms, legs, hands, feet, fingers, or toes
- shortness of breath and/or other breathing problems
- White or pale appearance (signs of blocked blood flow) in arms, legs, hands, feet, fingers, or toes
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Mostly, this condition is caused by low levels of oxygen in the blood, clinically known as hypoxia. This happens when there isn’t enough oxygen from the lungs to get into the bloodstream.
Blood oxygen levels typically must fall below 80 to 85 percent for the skin to take on the blue tint characteristic of cyanosis.
Other common causes of peripheral cyanosis may include:
- Arterial insufficiency: sluggish/stopped blood flow to the arteries
- Deep vein thrombosis (DVT): a blood clot in a vein deep in the body
- heart failure, which affects the heart’s ability to pump enough blood to the body
- Hypovolemia: decrease in systemic blood volume
- Lymphedema, which causes dysfunction of the lymphatic system, causing swelling in the arms or legs and fluid retention in the fingers or toes
- Raynaud’s phenomenon, which causes restricted blood flow to the fingers, toes, ears, and/or nose in response to cold or stress
- severe hypotension: low blood pressure
- Septic shock, a life-threatening condition in which a systemic infection causes extremely low blood pressure
- Venous insufficiency: When the valves in the blood vessels in the legs do not work properly, causing blood to pool
Tight clothing or jewelry can also cause peripheral cyanosis.
Cyanosis in newborns may be related to problems with the heart, nerves, lungs, or cells.
Low levels of oxygen in the blood can cause peripheral cyanosis. The reasons behind this can vary widely, from severe low blood pressure to blood clots to heart failure.
Bluish skin is usually not a serious condition. However, any time skin color doesn’t return to normal after heat and massage, it’s important to understand why.
Doctors should be able to determine the root cause after a physical examination, listening to the heart and lungs, and doing blood tests.
Computed tomography (CT) scans and X-rays can identify abnormalities in the lungs and heart.
A pulse oximeter, which measures the concentration of oxygen in the blood, is a useful tool. Unfortunately, it cannot help determine oxygen metabolism or the amount of oxygen a person is using.
Peripheral cyanosis can also be diagnosed using arterial blood gas tests. This test measures acidity, carbon dioxide and oxygen levels in the blood.
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Treatment begins with identifying and correcting the underlying cause of the restricted blood flow. Prompt and appropriate treatment can help reduce any potential complications.
Medications for peripheral cyanosis relax blood vessels and may include antidepressants, antihypertensives, or medications commonly prescribed for erectile dysfunction.
Medications that restrict blood flow—including beta-blockers, birth control pills, and medications containing pseudoephedrine (Cold and Allergy Medications) – People with bluish skin should avoid it.
It’s also a good idea to limit your caffeine intake and quit smoking. Both are known to constrict blood vessels and slow blood flow.
Cyanosis in babies tends to go away when the underlying disease is under control. Cases of cyanosis with no known source can be treated with supplemental oxygen. As many as 4.3% of newborns require oxygen therapy.
The medical term for blue hands, feet, fingers and/or toes is peripheral cyanosis.
This temporary condition can occur in people of any age and usually goes away when the affected area is heated or massaged. If not, there may be an underlying problem that requires diagnosis and treatment.
Certain symptoms that suggest peripheral cyanosis can be life-threatening include chest pain, dizziness, and shortness of breath. If this happens, call 911 or seek medical attention immediately.
Frequently Asked Questions
What is the difference between peripheral cyanosis and central cyanosis?
Both of these conditions are signs of hypoxia — low levels of oxygen in the blood. Peripheral cyanosis affects the extremities, especially the fingers and toes. Central cyanosis appears as a bluish tinge throughout the body, especially in mucous membranes such as the lips.
Can massage make surrounding cyanosis go away?
Yes. If the condition is caused by extreme cold or Raynaud’s phenomenon, massaging and heating the affected body parts can stimulate the flow of oxygenated blood and help them return to their normal color.