A bluish coloring of the skin or nails, a condition whose medical name is cyanosis, is caused by a deficiency of oxygen in the blood. The skin discoloration is usually localized in the hands, lips, and feet, but in some cases, it may be more generalized.
Sometimes, bluish skin is a minor problem associated with cold weather. More often, however, bluish skin is a symptom of a heart or lung disorder.
Causes of bluish skin
Apnea is a condition in which normal breathing mechanisms fail, causing a pause in respiration. In adults, it occurs primarily in overweight, middle-aged, or elderly men during sleep. In infants (especially premature ones), however, a particular kind of apnea may occur. Sometimes this apnea disappears as the infant matures, but in other cases it is a sign of an underlying disorder that may require monitoring to prevent sudden death.
This is a cardiovascular disease that occurs primarily in men between the ages of 20 and 40 who smoke. It is also called thromboangiitis obliterans. Small and medium-size arteries become inflamed, eventually impairing the blood supply to the hands and feet. As circulation decreases, the extremities turn blue. The hands and feet may also feel cold or numb, or the person may experience tingling or burning sensations. There may also be persistent pain. If not treated, it may lead to gangrene in the affected limbs, requiring amputation.
This is an inherited disease in which the pancreas fails to produce enzymes needed to digest food normally. In addition, glands lining the bronchial tubes in the lung produce a thick, sticky mucus that interferes with breathing and tends to precipitate frequent respiratory infections. When normal breathing is hampered, cyanosis may develop.
Heart failure occurs when the heart's pumping mechanism is insufficient to maintain the proper oxygen balance in the body. It can be caused by congenital abnormalities, or it may result from a heart attack or another form of heart disease.
Many normal infants are born with transient cyanosis that disappears within a few minutes after birth, as the baby's heart and lungs begin to function on their own. However, the cyanosis may persist in children born with congenital lung or heart disorders. In the past, these infants were referred to as blue babies.
Infant cardiac problems may include a variety of congenital heart defects, such as a deformed aorta, heart-valve defects, transposition of the great arteries, or poorly functioning pumping chambers. A number of lung problems can also cause blue babies.
If the lungs are unable to oxygenate blood, severe respiratory distress may occur. In the newborn, this may be due to congenital problems or prematurity. For example, hyaline membrane disease, or infant respiratory distress syndrome, is primarily a disorder seen in premature babies. It is the result of a deficiency in certain substances (surfactants) that line the lungs, caused by insufficient lung maturation. In adults, respiratory distress syndrome is usually associated with a pulmonary embolism or an acute pulmonary injury,
such as a collapsed lung. Both of these conditions may be life threatening. A worsening of chronic lung problems also can cause cyanosis. Examples include severe asthma, chronic bronchitis, advanced emphysema, and severe bronchiectasis.
This is a disorder of the circulatory system that primarily affects the fingers, although the toes are sometimes involved. The arteries bringing blood to these extremities become highly temperature sensitive and contract rapidly in the presence of cold, reducing the flow of blood to the fingers. Lack of adequate oxygenated blood causes the fingers to become pale or bluish. When the disorder occurs independently, it is known as Raynaud's disease; when it occurs secondary to another problem (such as rheumatoid arthritis, scleroderma, systemic lupus erythematosus, obstructive arterial diseases, or pulmonary hypertension), it is called Raynaud's phenomenon.
Advice about bluish skin
The combination of cyanosis and difficulty breathing may signal a life-threatening problem, requiring emergency treatment
- Never ignore a significant change in skin color.
- Report any incident of cyanosis to your physician promptly.
- If the cyanosis is related to smoking, make every effort to stop.