Peripheral cyanosis: Causes of blue hands and feet

Children's Health
Peripheral cyanosis is when the hands, fingertips, or feet turn blue because they are not getting enough oxygen-rich blood.

Cold temperatures, circulation problems, and tight jewelry are common causes of peripheral cyanosis.

In this article, we take a close look at peripheral cyanosis, including its causes, symptoms, and treatment. We also look at another type of cyanosis called central cyanosis that affects central parts of the body, the lips, or the tongue.

Cyanosis gets its name from the word cyan, which means a blue-green color.

Symptoms of peripheral cyanosis

People with peripheral cyanosis may notice the following symptoms:

  • the skin on the fingertips, toes, palms, or feet is bluey-green
  • the affected body part feels cold to the touch
  • the color returns to normal after warming up the body part

Causes of peripheral cyanosis

Peripheral cyanosis causes the extremities to turn blue.
Image credit: WaltFletcher, (2013 June 3).

All organs and tissues of the body need oxygen to carry out their functions. A person’s body absorbs oxygen from the air that they breathe. The blood contains a protein called hemoglobin that carries oxygen to the body’s cells. If the body cannot deliver enough oxygen to parts of the body, cyanosis may occur.

Certain medical conditions can prevent oxygen-rich blood from reaching parts of the body. Sometimes, people are born with abnormal hemoglobin, which affects the hemoglobin’s ability to bind to oxygen and carry it to the cells.

People tend to experience cyanosis in the extremities of their body, such as their fingertips and feet. This is because these body parts are furthest away from the heart, so the blood has further to travel.

Common causes of peripheral cyanosis include:

  • Raynaud’s syndrome. Raynaud’s disease is a condition where the fingertips and toes become painful and become blue or white in cold temperatures. This happens when the blood vessels narrow, preventing blood from reaching the extremities.
  • Low blood pressure. Low blood pressure is when there is not enough pressure to push blood and oxygen to the hands and feet. Low blood pressure is also called hypotension.
  • Hypothermia. This is where the body temperature drops to dangerously low levels. Hypothermia is a medical emergency.
  • Vein or artery problems. If a person has problems with their veins or arteries, their bodies may not send enough blood and oxygen to their hands and feet. Possible causes include venous insufficiency, peripheral vascular disease, or blockages in the veins or arteries.
  • Heart failure. When a person has heart failure, their heart may not be able to pump blood around the body effectively.
  • Problems with the lymph system. Lymphatic dysfunction is a condition where the lymph fluid does not flow and drain as it should. This often results in tissues that swell up with lymph fluid.
  • Deep vein thrombosis. This is caused by clots that form in the veins in the leg or limb extremities.
  • Hypovolemic shock. When a person experiences hypovolemic shock, their body diverts blood from the skin towards the internal organs.

Peripheral vs. central cyanosis

The key difference between peripheral and central cyanosis is how they affect the body.

Peripheral cyanosis affects a person’s hands or legs, especially the extremities, such as fingertips, fingernails, and feet. It may affect just one side of the body or both sides equally.

Central cyanosis affects the core organs of the body, causing a blue-green tint across central areas of the body, the lips, or the tongue. The symptoms of central cyanosis do not get better when the body part is heated up.

Both central and peripheral cyanosis have similar causes, including problems with the heart, blood, lungs, or nervous system.


Doctor holding lung x-ray
A doctor may recommend an x-ray to diagnose the cause of peripheral cyanosis.

Doctors diagnose peripheral cyanosis through a combination of physical tests, imaging scans, such as X-rays, and blood tests.

These tests can identify the presence of other conditions that affect the heart or lungs or that alter the body’s normal oxygen levels.

It is vital to follow the doctor’s advice about diagnosing the underlying cause of peripheral cyanosis.


Treatment for peripheral cyanosis depends on the underlying cause of the problem.

Doctors may prescribe specific medicines to treat heart and lung conditions. These medications help improve blood flow and oxygen supply to the organs and tissues. Some people may need oxygen therapy to restore normal levels of oxygen supply.

Doctors may recommend that a person with peripheral cyanosis stops taking any medications that restrict blood flow. Medicines include beta blockers, birth control pills, and certain allergy medications. A doctor may also recommend that people make lifestyle changes, such as quitting smoking or drinking caffeine.

When to see a doctor

In most cases, peripheral cyanosis is a symptom of another condition rather than being a medical condition by itself.

Some of the underlying conditions could be life-threatening, so anyone experiencing any of the following signs and symptom must seek medical treatment immediately:

  • difficulty breathing or gasping for breath
  • chest pain
  • profuse sweating
  • sudden pain or numbness in the limbs, hands, or feet
  • inability to concentrate or disorientation
  • fever- or flu-like symptoms

Peripheral cyanosis in babies

Mother holding baby to her chest.
Newborns and babies can experience peripheral cyanosis.

Peripheral cyanosis can occur in people of all ages, including newborns.

An estimated 4.3 percent of newborns have cyanosis that requires oxygen therapy. Cyanosis can develop in babies and newborns for many reasons. It may be related to the heart, nerves, or lungs, or the result of abnormal or dysfunctional cell functioning.

It is sometimes difficult to detect peripheral cyanosis in babies, particularly newborns, because other factors, such as jaundice and skin color may mask the blue-green skin color.

Peripheral cyanosis is usually not a medical emergency. However, central cyanosis is more likely to be a sign of something more serious that requires immediate medical attention.


The outlook depends on the cause of peripheral cyanosis and the seriousness of the underlying cause

People should consult their doctor if their symptoms do not go away after they have warmed up their hands or feet or massaged them to increase blood flow. Timely diagnosis of the problem can provide the right treatment at an early stage, which helps avoid further complications.

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