What Is Acrocyanosis?

A condition that causes the hands and feet to turn blue

Acrocyanosis is when the hands and feet turn blue due due to blood vessel constriction. If you have ever gotten out of a cold pool and noticed a blue tinge in these areas, you have experienced acrocyanosis.

While acrocyanosis can be due to a blood vessel abnormality, it is typically due to one's environment. Acrocyanosis is also particularly common in newborns in their first few hours of life as their circulation changes.

Though less common, there are also times when acrocyanosis can be a sign of an underlying medical condition that requires treatment.

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A person with acrocyanosis with a purple looking toe

Reproduced with permission from ©DermNet New Zealand and © Waikato District Health Board www.dermnetnz.org 2023.

Learn more about the symptoms and underlying causes of acrocyanosis, as well as how it is diagnosed and treated.

Types and Symptoms of Acrocyanosis

The most common symptoms of acrocyanosis are:

  • Blue-colored fingers or toes
  • Cold and sweaty hands and feet
  • Low skin temperatures
  • Slow blood flow
  • Swelling in hands and feet

Symptoms of acrocyanosis improve with warm temperatures and worsen with cold temperatures. Skin color may improve with movement, especially in the hands.

The hands and feet are most commonly affected in acrocyanosis. However, the condition can also affect the nose, ears, lips, nipples, wrists, and ankles.

Depending on the type of acrocyanosis, symptoms may affect one or both sides of the body:

  • Primary acrocyanosis: May affect both sides of the body equally (e.g., if one palm is blue, the other one is as well
  • Secondary acrocyanosis: Only one side of the body is affected and skin color changes are usually accompanied by pain and potentially tissue loss

It's important to note that acrocyanosis is not the same as the more serious central cyanosis, which is when the head and torso turn blue. If this occurs, seek immediate medical attention.

What Causes Acrocyanosis?

Primary acrocyanosis is caused by constriction of the small blood vessels that deliver oxygen-rich blood to the extremities. Secondary acrocyanosis is due to an underlying medical condition.

Primary Acrocyanosis

This constriction may be due to:

  • Cold temperatures
  • Living in areas of high altitudes with lower oxygen pressure and increased cold temperatures and wind
  • Genetic defects in the blood vessels
  • Changes in circulation after birth 

Primary acrocyanosis in newborns occurs because blood and oxygen flow to the brain, lungs, kidneys, and other important body parts first—not the hands and feet.

Newborns with bluish-colored hands and feet will improve within the first few hours once the body gets used to the new blood circulation pattern.

Primary Acrocyanosis vs. Raynaud's Disease

Cold temperatures may cause primary acrocyanosis. It's not harmful, but it's often confused with Raynaud's disease—a disorder where the body overreacts to certain situations and causes coldness and numbness in the hands and feet. However, Raynaud's is often a cause of secondary acrocyanosis.

Secondary Acrocyanosis

The most common causes of secondary acrocyanosis are Raynaud’s disease and eating disorders.

Other causes of secondary acrocyanosis include:

  • Infections
  • Vascular diseases
  • Blood disorders
  • Cancer
  • Genetic conditions


A diagnosis of acrocyanosis is made by physical examination and medical history, including the assessment of symptoms.

It is a good idea for anyone with symptoms of acrocyanosis to contact their healthcare provider.
Primary acrocyanosis is a generally harmless condition with a good outlook, but underlying causes of secondary acrocyanosis can be serious.

Physical Exam

A primary acrocyanosis diagnosis is based on a bluish color of hands and feet (and sometimes the nose and ears), when hands and feet are cold and sweaty, and when symptoms are not causing pain.

When there is no pain, the blue color is not associated with a disease of impaired circulation.  


Circulation in the small blood vessels can be measured using a non-invasive technique called capillaroscopy, which examines the capillaries at the nailbeds. 

When secondary acrocyanosis is suspected, other testing and imaging may be done to determine the cause of the symptoms.

Acrocyanosis Treatment 

There is no specific treatment for acrocyanosis; however, symptoms can be managed. 

In newborns, the condition dissipates on its own or can be resolved by warming the body temperature. Once symptoms resolve, acrocyanosis doesn't usually return.

In older children and adults, keeping hands and feet warm and covering up their body parts can protect them from cold temperatures.

Severe cases may be treated with medications, including alpha blockers or medicines that relax muscles and help small blood vessels to remain open.

Secondary acrocyanosis symptoms resolve when the underlying condition is treated and managed.                                                                              

Frequently Asked Questions

  • What are signs of acrocyanosis in a baby?

    Signs of both primary and secondary acrocyanosis in a baby can include:

    • Fingers or toes that are a shade of dark blue or purple
    • Cold, sweaty hands or feet
    • Low skin temperature
    • Reduced blood flow
    • Hand and feet swelling
  • Dp drugs cause acrocyanosis?

    Some do, yes. Drugs and medications that can cause acrocyanosis include:

  • What is acrocyanosis vs. cyanosis?

    Acrocyanosis is blue discoloration found only on the hands, feet, and around the lips. Cyanosis (a.k.a. central cyanosis) is found in the center of the body: on the lips, tongue, head, or torso. It's usually caused by a lower amount of oxygen in the blood due to a heart, lung, or blood condition.

  • Is central cyanosis normal for a newborn?

    No. If you notice signs of central cyanosis in a baby—skin on the mouth, head, torso, or other central areas of the body that is blue, cold, or sweaty—seek treatment ASAP. This is often linked to the blood not receiving enough oxygen.

  • Is Raynaud's disease dangerous?

    For many people with Raynaud's disease, it is not dangerous as long as symptoms are effectively managed. This can be done by keeping the hands and feet warm and avoiding potential triggers. Severe cases can cause skin sores or tissue death.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Chadachan V, Eberhardt RT. Acrocyanosis. In: Creager MA, Beckman JA, Loscalzo J, eds. Vascular Medicine: A Companion to Braunwald's Heart Disease. 2nd ed. Philadelphia: Saunders; 2013. doi:10.1016/B978-1-4377-2930-6.00049-5

  2. Cincinnati Children's Hospital Medical Center. Cyanosis in infants and children.

  3. Drapkin Z, Franchek-Roa K, Srinivas GL, Buchi KF, Miescier MJ. Is my baby normal? A review of seemingly worrisome but normal newborn signs, symptoms and behaviors. Am J Emerg Med. 2019;37(6):1153-1159. doi:10.1016/j.ajem.2019.03.028

  4. Das S, Maiti A. Acrocyanosis: An overview. Indian J Dermatol. 2013;58(6):417-420. doi:10.4103/0019-5154.119946

  5. Wollina U, Koch A, Langner D, et al. Acrocyanosis – a symptom with many facettesOpen Access Maced J Med Sci. 2018;6(1):208-212. doi:10.3889/oamjms.2018.035

  6. MedlinePlus. Raynaud's disease.

By Lana Barhum
Lana Barhum has been a freelance medical writer since 2009. She shares advice on living well with chronic disease.