Blue skin and lips (cyanosis)

Blue skin and lips is usually caused by low blood oxygen levels or poor circulation. It can be a sign of a serious problem. Call 999 or go to your nearest emergency department immediately if you notice an adult or child suddenly turning blue.

When to seek emergency help

Call 999 or go to your nearest emergency department immediately if you notice an adult or child suddenly turning blue.

This is particularly important if they have other symptoms, such as:

• difficulty breathing
• chest pain

This could be a sign of a life-threatening problem.

When to see your GP

See your GP if you have cyanosis that:

• comes on very gradually
• affects just the fingers, hands, toes or feet

This is usually the result of a less serious problem with blood circulation, but it should still be checked by a doctor.

Common causes of cyanosis

When blood has less oxygen than normal, it changes from bright red to darker in colour, making the skin and lips look blue.   Some of the main causes of cyanosis are described below. You shouldn’t use this to diagnose yourself. You should always leave that to your GP.

Cyanosis that just affects the hands, feet or limbs

If just the fingers, toes or limbs have turned blue and feel cold, it’s known as peripheral cyanosis.

It can be caused by being exposed to cold air or water. Other causes include poor circulation resulting from:

• Raynaud’s phenomenon
• peripheral arterial disease (PAD) 
• beta-blockers – medication commonly used to treat high blood pressure
• a blood clot blocking the blood supply to or from a limb

Cyanosis that affects the skin generally and/or lips

When all the skin and/or lips have a blue tinge, it’s known as central cyanosis. It is usually a sign of low levels of oxygen in the blood. Common causes for central cyanosis are listed below.

A problem with the lungs:

• worsening of a long-term lung condition, such as asthma or chronic obstructive pulmonary disease (COPD)
• lung infections, such as pneumonia, bronchiolitis or whooping cough
• bronchiectasis
• a pulmonary embolism 
• neonatal respiratory distress syndrome (NRDS) or acute respiratory distress syndrome (ARDS)
• drowning or nearly drowning

A problem with the airways:

• choking
• croup
• epiglottitis
• anaphylaxis (severe allergic reaction)

A problem with the heart:

• heart failure
• congenital heart disease
• cardiac arrest

Other causes:

• exposure to cold air or water
• being at high altitude
• fits (seizures) that last a long time
• a problem with the blood, such as abnormal haemoglobin (the blood can’t take up enough oxygen) or a high concentration of red blood cells (polycythaemia)

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Blue Lips: Causes, Photos, and Treatments

Bluish discoloration of the skin may signal a lack of oxygen in the blood. It could also indicate an abnormal form of hemoglobin (a protein in red blood cells) like it does with sickle cell anemia.

Cyanosis is the name for poor oxygen circulation in the blood that causes bluish discoloration of the skin. Central cyanosis affects the lips, but it can also affect the tongue and chest.

Blue lips may indicate a type of cyanosis caused by lower oxygen levels in the red blood cells. Blue lips may also represent high levels of an abnormal form of hemoglobin in the bloodstream (similar to bluish discoloration of the skin).

If normal color returns with warming or massage, your lips aren’t getting enough blood supply. Blue lips might not be due to cold or constriction.

If the lips remain blue, then there may be an underlying disease or structural abnormality. Either of these can interfere with the body’s ability to deliver oxygenated red blood to all areas.

The most common causes of blue lips are events that limit the amount of oxygen that the lungs take in, including:

• air passage blockage
• choking
• excessive coughing
• smoke inhalation

Congenital (present at birth) heart abnormalities can also cause cyanosis and the appearance of blue lips.

Less-common causes of blue lips include polycythemia vera (a bone marrow disorder that causes the production of excess red blood cells) and cor pulmonale (a decrease in the function of the right side of the heart caused by long-term high blood pressure). Septicemia, or blood poisoning caused by bacteria, may also lead to blue lips.

Cold weather conditions, vigorous exercise, and becoming “winded” from physical exertion can sometimes cause a temporary blue appearance in the lips.

Cyanosis that’s only found in the areas around the lips, hands, and feet is called acrocyanosis. It isn’t a cause for concern in children under the age of 2. But if the tongue, head, torso, or lips themselves appear bluish, the child needs to be examined by a doctor.

Blue lips in children under 2 years old can be a symptom of a respiratory syncytial virus (RSV) infection. Though an RSV infection is common and most kids have the virus at some point before their 2nd birthday, don’t assume that this is what’s causing the lip discoloration.

If your child’s lips are discolored, make sure that a pediatrician examines your child.

In some cases, blue lips can signal a serious blood and respiratory condition. In other cases, blue lips indicate chemical poisoning as a result of ingesting antifreeze or ammonia. It’s essential that your child receive the correct diagnosis before they begin any sort of treatment.

Many different conditions can cause blue lips. Here are 15 possible causes.

Warning: Graphic images ahead.

Cyanosis

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This condition is considered a medical emergency. Seek care immediately.

• This bluish discoloration of the skin and mucous membranes is caused by decreased oxygenation or poor circulation.
• It may occur rapidly due to an acute health problem, or slowly over time as a chronic condition gets worse.
• Many health disorders that involve the heart, lungs, blood, or circulation will cause cyanosis.
• Most causes of cyanosis are serious and a sign that your body isn’t getting enough oxygen.

Learn more about cyanosis.

Acute mountain sickness

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• This illness is caused by the low levels of oxygen and decreased air pressure found at high elevations.
• Typically, it occurs at about 8,000 feet (2,400 meters) or higher above sea level.
• Mild symptoms include:
  • dizziness
  • headache
  • muscle aches
  • insomnia
  • nausea
  • vomiting
  • irritability
  • loss of appetite
  • shortness of breath with exertion
  • increased heart rate
  • swelling of the hands, feet, and face
• Severe symptoms are due to fluid accumulation in the lungs and brain and include:
  • coughing
  • chest congestion
  • pale complexion and skin discoloration
  • inability to walk or lack of balance
  • confusion and social withdrawal

Learn more about acute mountain sickness.

Aspiration pneumonia

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• Aspiration pneumonia is a lung infection caused by accidentally inhaling food, stomach acid, or saliva into the lungs.
• It’s more common in people with impaired coughing or swallowing ability.
• Symptoms include:
  • fever
  • cough
  • chest pain
  • shortness of breath
  • wheezing
  • fatigue
  • difficulty swallowing
  • bad breath
  • excessive sweating

Learn more about aspiration pneumonia.

Chronic obstructive pulmonary disease (COPD)

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• Chronic obstructive pulmonary disease (COPD) is a chronic, progressive lung disease caused by alveolar (air sac) and airway damage.
• Early symptoms of COPD are mild, but get gradually worse over time.
• Early symptoms include:
  • occasional shortness of breath, especially after exercise
  • mild but recurrent cough
  • needing to clear your throat often, especially first thing in the morning
• Other symptoms include:
  • shortness of breath after even mild exercise, like walking up a flight of stairs
  • wheezing or noisy breathing
  • chest tightness
  • chronic cough with or without mucus
  • frequent colds, flu, or other respiratory infections

Learn more about chronic obstructive pulmonary disease (COPD).

Emphysema

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• Emphysema is one of the two most common conditions that fall under the COPD umbrella.
• It’s caused by the destruction of alveoli (air sacs) in the lungs.
• Symptoms include shortness of breath and coughing, especially during exercise or physical exertion.
• Severe symptoms include bluish-gray lips or fingernails from lack of oxygen.

Learn more about emphysema.

Pulmonary edema

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• Pulmonary edema is a condition in which the lungs fill with fluid.
• Increasing fluid in the lungs prevents oxygen from moving into the bloodstream and makes it more difficult to breathe.
• It may be caused by a variety of health conditions, but people with heart conditions have a higher risk of developing pulmonary edema.
• Symptoms include:
  • shortness of breath when being physically active
  • difficulty breathing when lying down
  • wheezing
  • rapid weight gain (especially in the legs)
  • swelling in the lower part of the body
  • fatigue

Learn more about pulmonary edema.

Respiratory syncytial virus (RSV)

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• Respiratory syncytial virus (RSV) is a common virus that most appears in children and infants.
• 58,000 children under 5 are hospitalized each year with RSV.
• Adults over 65 are also at risk. Each year an estimated 177,000 are hospitalized with RSV.
• Since RSV is a virus, it cannot be treated with antibiotics. Most cases resolve without treatment.
• Common symptoms include fever, congestion, and cough. A less common symptom is bluish skin.

Learn more about respiratory syncytial virus (RSV).

Acute respiratory distress

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This condition is considered a medical emergency. Seek care immediately.

• Acute respiratory distress is a severe, inflammatory form of lung injury that results in rapid accumulation of fluid in the lungs.
• Too much fluid in the lungs lowers the amount of oxygen and increases the amount of carbon dioxide in the bloodstream, leading to the damage of other organs.
• Many different conditions can cause ARDS, including serious infections, drug overdose, inhaling toxic substances, or trauma to the chest or head.
• The symptoms of ARDS typically appear between 6 hours and 3 days after an inciting illness or injury.
• Symptoms include:
• labored and rapid breathing
• muscle fatigue and general weakness
• low blood pressure
• discolored skin or nails
• fever
• headaches
• rapid heart rate
• confusion

Learn more about acute respiratory distress.

Carbon monoxide poisoning

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This condition is considered a medical emergency. Seek care immediately.

• Carbon monoxide (CO) is a gas that’s both odorless and colorless, and reduces how efficiently your red blood cells carry oxygen.
• Inhaling too much CO may lead to organ damage from reduced oxygen.
• The most common symptoms of CO poisoning are:
  • headache
  • weakness
  • excessive sleepiness
  • nausea
  • vomiting
  • confusion
  • loss of consciousness
• You should go to the hospital right away if you’ve been exposed to a source of CO, even if you don’t show symptoms of CO poisoning.

Learn more about carbon monoxide poisoning.

Pneumothorax

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This condition is considered a medical emergency. Seek care immediately.

• Pneumothorax occurs when air enters the space around your lungs (the pleural space).
• The change in pressure caused by an opening in your chest or lung wall can cause the lung to collapse and put pressure on the heart.
• The two basic types of pneumothorax are traumatic pneumothorax and nontraumatic pneumothorax.
• Symptoms include:
  • sudden chest pain
  • a steady ache in the chest
  • chest tightness
  • shortness of breath
  • breaking out in a cold sweat
  • cyanosis
  • severe tachycardia

Learn more about pneumothorax.

Pulmonary embolism

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This condition is considered a medical emergency. Seek care immediately.

• This type of embolism occurs when a blood clot in a vein travels to the lungs and gets stuck.
• The blood clot restricts blood flow to parts of the lung, causing pain and preventing oxygen from getting into the body.
• The blood clots that most often cause pulmonary embolisms begin as a deep vein thrombosis (DVT) in the legs or pelvis.
• Common symptoms of a pulmonary embolism include:
  • shortness of breath
  • stabbing chest pain when taking a deep breath
  • coughing up blood
  • rapid heart rate
  • dizziness or fainting

Learn more about pulmonary embolisms.

Sickle cell anemia

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• Sickle cell anemia is a genetic disease of the red blood cells that causes them to take on a crescent moon or sickle shape.
• Sickle-shaped red blood cells are prone to getting trapped in small vessels, which blocks blood from reaching different parts of the body.
• Sickle-shaped cells get destroyed faster than normal-shaped red blood cells, leading to anemia.
• Symptoms include:
  • excessive fatigue
  • pale skin and gums
  • yellowing of the skin and eyes
  • swelling and pain in hands and feet
  • frequent infections
  • episodes of extreme pain in the chest, back, arms, or legs

Learn more about sickle cell anemia.

Asthma

Share on PinterestUnited States-National Institute of Health: National Heart, Lung, Blood Institute, Public domain, via Wikimedia Commons

• This chronic, inflammatory lung disease causes the airways to narrow in response to triggering events.
• Airway narrowing may occur due to a variety of stimuli like:
  • viral illness
  • exercise
  • weather changes
  • allergens
  • smoke
  • strong scents
• Symptoms include:
  • dry coughing
  • high-pitched wheezing
  • tight chest
  • shortness of breath
  • difficulty breathing
• Symptoms of asthma may be reduced or resolved by using asthma medications.

Learn more about asthma.

Cardiac tamponade

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This condition is considered a medical emergency. Seek care immediately.

• In this serious medical condition, blood or other fluids fill the space between the sac that encases the heart and the heart muscle.
• Pressure from the fluid around the heart prevents the heart’s ventricles from expanding fully and keeps the heart from pumping effectively.
• It’s usually the result of penetrating injury to the pericardium.
• Symptoms include chest pain radiating to the neck, shoulders, or back, and discomfort that’s relieved by sitting or leaning forward
• Other symptoms include:
  • swollen veins in the forehead
  • low blood pressure
  • fainting
  • dizziness
  • cold
  • blue extremities
  • loss of consciousness
• A person with this condition may also experience trouble breathing or taking deep breaths and rapid breathing.

Learn more about cardiac tamponade.

Raynaud’s phenomenon

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• This is a condition in which blood flow to your fingers, toes, ears, or nose is restricted or interrupted by vasospasms.
• It may occur on its own or can accompany underlying medical conditions like arthritis, frostbite, or autoimmune disease.
• Blue or white discoloration of fingers, toes, ears, or nose can occur.
• Other symptoms include numbness, cold sensation, pain, and tingling in affected body parts.
• Episodes may last a few minutes or up to several hours.

Learn more about Raynaud’s phenomenon.

Speak to your doctor if you are noticing bluish lips so that they can help determine the cause. Performing a simple pulse oximeter check at home is not an accurate way of getting a diagnosis.

A pulse oximeter is used to determine the concentration of oxygen in your blood by comparing how much “red light” and “infrared light” are being absorbed by your blood. Arterial blood gases are drawn to measure oxygenation and detect other factors that may be contributing to blue lips.

There are times when a pulse oximeter won’t be necessary to find out what’s causing your blue lips. If you’ve already been diagnosed with asthma, emphysema, or another breathing condition, your doctor will probably conclude right away that this is the cause of your blue lips.

If you need help finding a primary care doctor, then check out our FindCare tool here.

Treatment of blue lips involves identifying and correcting the underlying cause and restoring the flow of oxygenated blood to the lips. Once your doctor has reached a diagnosis, one of several things may happen:

• If you’re taking blood pressure medication, beta-blockers, or blood thinners, the dosage may need to be adjusted. This is to ensure that your white blood cell count and red blood cell count remain balanced.
• If you have a respiratory condition like emphysema or COPD, it’s possible that blue lips are an indication that your condition has worsened. In that case, your doctor may recommend lifestyle changes like quitting smoking and starting an exercise regimen that will improve your respiratory and vascular health. Pulmonary rehabilitation may be recommended.

Call an emergency hotline immediately if blue lips are accompanied by any of the following symptoms:

• gasping for breath
• shortness of breath or breathing difficulties
• chest pain
• sweating profusely
• pain or numbness in the arm, hands, or fingers
• pale or white arms, hands, or fingers
• dizziness or fainting

If your blue lips occur suddenly and aren’t the result of strenuous exercise or time spent outdoors, call for emergency assistance. If cyanosis comes on gradually, keep an eye on it and schedule an appointment with your general practitioner if it doesn’t subside after a day or two.

If there’s an underlying condition causing your lips to appear blue, the discoloration will go away once the cause is identified and addressed. The amount of time it will take for the blue lips to subside varies widely, depending on what’s causing this symptom.

Lip discoloration doesn’t always indicate an emergency situation, but it’s not a symptom that should be ignored.

Blue lips as a sign of pathology

• Blue lips as a sign of pathology
• Secondary causes of cyanosis
• What measures should be taken

Blue lips as a sign of pathology

An indicator such as lip color tells a lot about the state of the body. Normally, the skin of the organ should be slightly pinkish or rich crimson. If a healthy shade disappears and is replaced by a frightening blue, this is a serious cause for concern. The pallor of the lips indicates a deterioration in local blood circulation and a violation of local metabolism.

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In a larger context, such a symptom indicates systemic lesions of the body that disrupt the normal functioning of internal organs. In particular, it is observed in the following pathological conditions.

1. Iron deficiency anemia. It is characterized by a low content of hemoglobin in the blood. Deficiency is formed as a result of insufficiently balanced nutrition, disorders in the gastrointestinal tract and injuries that caused severe blood loss. Women with heavy menstruation are also at risk.
2. Disorders of the functioning of the cardiovascular system (vascular thrombosis, heart attack, etc.). In these cases, blue lips are usually accompanied by a sharp increase in heart rate and heavy intermittent breathing. Such manifestations require urgent medical attention, as they are fraught with irreversible consequences.
3. Gross. The disease manifests itself mainly in children in infancy and poses a serious danger to health and life. The baby needs urgent hospitalization, as the likelihood of death is very high. In addition to cyanosis, the child has a strong dry cough and signs of suffocation. The main mistake of parents in such cases is to try to eliminate the symptoms on their own. Without qualified medical care, the disease progresses rapidly and leads to complications.
4. Diseases of the respiratory system (pneumonia, asthma, bronchitis). The inflammatory process in the airways leads to difficulty in the assimilation of air, as a result of which the patient develops an acute lack of oxygen. As in the previous case, the correct solution to the problem will be to call an ambulance. Treatment with folk methods for pneumonia and asthma attacks is ineffective.

If you do not know which doctor to contact if you have signs of cyanosis, make an appointment with a general practitioner. After a conversation and examination, the doctor will prescribe treatment or send you to a highly specialized specialist (cardiologist, pulmonologist, infectious disease specialist).

Secondary causes of cyanosis

Blue, bloodless lips are frightening. The person’s face begins to look sickly and emaciated. However, this manifestation is not always associated with acute diseases. Often the reason is the influence of external factors, which is easy to eliminate. Blue discoloration of the skin often occurs under the following conditions.

1. Hypothermia. Under the influence of low temperatures in the body, all functional processes slow down. The heart begins to beat less frequently, blood pressure decreases, brain activity slows down. Against this background, the flow of blood to the cells is disturbed, which leads to a significant blanching of the skin. The victim has symptoms such as blue lips and limbs, trembling in the body and a slow pulse. If a person is not hospitalized in a timely manner, there is a high probability of death or the onset of necrotic processes in the tissues.
2. Nicotine poisoning. Yellow teeth, a hoarse voice, and bad breath are not all signs of a heavy smoker. Many experienced cigarette lovers suffer from constant oxygen starvation against the background of tobacco smoke poisoning. This leads to a deterioration in complexion, the disappearance of the blush and staining of the lips in blue. The eyes become sunken, with dark circles around them.
3. Avitaminosis. With an acute shortage of useful trace elements, metabolism is disturbed, and cells begin to suffer from hypoxia. Cyanosis is considered one of the main signs of vitamin deficiency. Often it is combined with other pronounced symptoms: fragility and dryness of nails and hair, pale skin, irritability. A lack of vitamins leads to malfunctions in the digestive and cardiovascular systems, causes endocrine pathologies, so you should not start this condition.

What measures to take

If the blue lips are not caused by hypothermia or beriberi, you need to visit a doctor to determine its causes. To get started, just make an appointment with a general practitioner or family medicine doctor. The doctor will clarify the nature of the symptoms that accompany cyanosis. Then he will prescribe a number of diagnostic procedures, if necessary, recommend an examination by a cardiologist, endocrinologist, hematologist or pulmonologist. Usually, with this problem, the following instrumental studies are carried out:

• biochemical and clinical blood tests;
• urinalysis;
• Chest and abdominal ultrasound;
• MRI;
• CT with contrast;
• ECG;
• Echocardiography.

After receiving the diagnostic results, the doctor will be able to determine the factor that provoked external changes and draw up a treatment plan. Methods of treatment are selected taking into account the individual characteristics of the patient and the nature of the disease.

At the same time, there are several ways to return the lips to their normal color without medical help. In particular, hot, plentiful drinking helps, which increases blood circulation. Also, the skin begins to look healthier after performing physical activity that stimulates metabolism. As for heavy smokers, they just need to get rid of the bad habit.

What blue lips indicate

Hematology / 5 December 2013 15:41

Sometimes we notice that some of the surrounding lips have a blue or purple hue. The blue tint of the lips can indicate serious problems in the functioning of the body and the alarm signal cannot be ignored. If you notice that the color of your lips is turning blue, then you should undergo a medical examination . Blue lips can be accompanied by other symptoms, such as fever, blue legs, irregular heartbeat, sweating, severe coughing, and difficulty breathing.

Doctors call blue lips cyanotic. The main cause of blue lips is considered to be lack of oxygen in the body or oxygen starvation, which occurs due to cyanosis of the skin. Symptoms of oxygen starvation are the characteristic purple color of the skin and all mucous membranes, which is caused by an increase in the content of reduced hemoglobin in the blood.

Patients with cyanosis are the first to be suspected of having a cardiovascular problem and referred for evaluation by a cardiologist. Another common cause of blue lips is a bad habit – smoking . The body is adversely affected by toxic substances inhaled with tobacco smoke, of which there are about 4000.

In addition to blue lips, a person may have pallor of the skin. In this case, it is likely that a person suffers from iron deficiency anemia. Anemia is the most common cause of blue lips in a pregnant woman. Iron is the most important trace element that takes part in many processes in our body. Iron is found in hemoglobin, which turns blood red. A low hemoglobin level can be observed not only with insufficient intake of iron from food, but with heavy blood loss, for example, during menstruation in women or severe injuries and peptic ulcers.

Quite often the cause of blue lips in children is a serious disease called croup , which is necessarily accompanied by a strong cough, disturbances in normal breathing.

If red lips change their natural color over time, and the patient has a breath holding, rapid pulse, then we can talk about obvious symptoms of problems with the lungs or heart. The patient may have a heart attack, develop bronchitis, or develop asthma. All this indicates oxygen starvation. Sometimes the lips turn blue also due to the formation of a blood clot in the lungs. In this case, you must immediately seek help from a doctor.

Also, blue lips can often be observed with hypothermia. At low temperatures, the blood vessels located in the lips narrow, which does not allow blood to fill them completely. As a result, most of the blood begins to flow from these vessels to the internal organs: the brain, heart and kidneys, which helps maintain a constant temperature throughout the body. The natural pink color of the lips and skin occurs only if the blood moves through the vessels constantly at the same speed and in the usual volume. It will be possible to return their pink color to pale lips after warming the body, as well as a number of measures that will help small blue blood vessels no longer appear through the thin skin of the lips.

Sometimes blue lips occur in people with Raynaud’s disease, when the vessels in the extremities burst under the influence of low temperatures or from severe stress.