Skin Health More Skin Conditions What Is Blanching of the Skin? By Sherry Christiansen Sherry Christiansen Sherry Christiansen is a medical writer with a healthcare background. She has worked in the hospital setting and collaborated on Alzheimer's research. Learn about our editorial process Updated on April 11, 2023 Medically reviewed by Leah Ansell, MD Medically reviewed by Leah Ansell, MD Verywell Health's LinkedIn Leah Ansell, MD, is board-certified in cosmetic and medical dermatology. She is an assistant professor at Columbia University and works in private practice in New York City. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents What Skin Blanching Looks Like Causes Blanching Test Treatment When to See a Provider Blanching skin is a term used to describe skin that remains white or pale for longer than normal when pressed. This indicates that normal blood flow to a given area does not return promptly. Skin blanching can help healthcare providers identify certain health conditions. When blanching of the fingers occurs, it could be a sign of a condition called Raynaud’s syndrome, but there are also other reasons why blanching can happen. This article discusses blanching, what it is, and how healthcare providers use it to diagnose certain conditions. Inside Creative House / Getty Images What Does Blanching of the Skin Look Like? Skin that blanches has a few characteristics: The skin appears white (or not as reddened) when pressure is applied.The whitish color that appears when pressure is applied to the skin does not return to normal within a few seconds of removal of the pressure.Often the skin appears cooler than normal if blood flow is occluded.Bluish discoloration of the skin may be present if blood flow is severely occluded.There is numbness or pain in the affected area. What Are the Causes of Blanching of the Skin? There are several reasons why blanching occurs, from simple to more complex. These include: Spider veins: Small damaged or “broken” blood vessels that often appear on the surface of a person’s legs or face. Spider veins are not painful; they occur in a variety of disorders (such as rosacea, liver disease, sun-damaged skin, or pregnancy). Inflammation of the skin: This could include drug eruptions, hives, and more. Obstruction of blood flow to an area of the skin: Chemicals, cold, trauma, radiation, or chronic conditions can impair blood flow. Pressure sores: Skin abnormalities caused by unrelieved pressure, such as lying in the same position for extended periods. Frostbite: A condition caused by exposure to cold external temperatures in which there is a resulting loss of blood flow to the affected area. Raynaud’s syndrome: This condition impacts approximately one-third of the people who have lupus (a condition that involves inflammation of the skin). It involves spasmodic constriction of the arteries and subsequent loss of adequate blood flow that usually affects the blood flow at the end of the fingers and toes. Bier's spots: These small, irregular, hypopigmented macules are usually found on the arms and legs. Livedo reticularis: A particular kind of skin discoloration, it consists of a reddish-purplish, web-like pattern that forms circles, typically on the legs or arms. How to Recognize the Early Symptoms of Lupus How the Blanching Test Is Performed A blanching test can be performed without any type of diagnostic tool. A healthcare provider presses the fingertips against the skin, exerting mild pressure for a short period, then quickly withdraws them, to check and see if whitening occurs. Blanching can be tested by following a few simple steps: Press on the skin with your fingertips (select any suspicious areas, such as a red, darkened, or pink area).The area should turn white when pressure is applied.Remove the pressure from your fingertips.Within a few seconds (after your fingertips are removed) the area should return to its original color (indicating that the blood flow to that specific area is good). What Is Diascopy? Diascopy is a slightly more advanced technique to check skin blanching (compared to using the fingertips). This method of checking the blood flow to an area of the skin involves several steps, including: Placing a piece of clear glass (such as a glass slide for a microscope) or clear plastic against the skin to view whether the skin blanches and fills properly under pressurePressing on the glass with the fingertips and viewing the color of the skin under pressureWithdrawing the fingersChecking to see if blanching occurs; note that blanching occurs when the area that has pressure placed on it turns whitish-colored but does not return to its original color (such as the surrounding tissue). Blanching and Darker Skin Blanching may be harder to see on those with darker skin. Thus, it’s vital to assess other signs that may indicate a lack of proper blood perfusion, such as the temperature and sensation of the skin. How Is Blanching of the Skin Treated? The treatment of blanching skin will vary greatly, depending on the underlying cause. Examples of types of treatment for blanching may include: Spider veins: Treatment may involve a procedure called sclerotherapy (an injection into the veins of a solution that closes the spider veins). Raynaud’s syndrome: Treatment includes keeping hand warmers for winter use, avoiding cigarettes and caffeinated foods and beverages, and taking prescription medications such as nifedipine or amlodipine. Pressure sores: There are many different treatments pressure ulcers, depending on the severity of the ulcer. Preventative measures include frequent repositioning, walking/exercising, and massage to help improve blood flow to the affected area. Causes and Prevention of Varicose and Spider Veins When to See a Healthcare Provider There are some circumstances in which blanching of the skin is severe enough that a medical professional should be consulted. Call your healthcare provider when: Skin ulcers are visible on the area of the skin that is blanched (particularly when the toes or fingertips are affected). You have severe pain and blanching of the skin. You have any symptoms of anaphylaxis. Summary Blanching of the skin occurs when the skin remains pale for longer than normal after it has been pressed. Healthcare providers use this test to help identify certain skin conditions such as spider veins, frostbite, and Raynaud’s syndrome. If you have blanching of the skin and the cause has not been identified, it is important to speak to your healthcare provider. Treatment depends on the underlying cause. 3 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. Johns Hopkins Medicine. Lupus-specific skin disease and skin problems. University of Washington. Skin care and pressure sores. Sivakumar A, Thappa DM. Glass slide—An indispensable tool for the dermatologist. CosmoDerma. 2022;2:27. doi:10.25259/CSDM_23_2022 By Sherry Christiansen Sherry Christiansen is a medical writer with a healthcare background. She has worked in the hospital setting and collaborated on Alzheimer's research. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit