An Overview of Blue Lips

A Potential Symptom of Many Different Medical Problems

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Under certain medical circumstances, people can get a bluish tinge to their lips. Blue lips can be one form of cyanosis, the medical term for bluish discoloration of the skin and mucous membranes. This can result when not enough oxygen is available in the blood in the region.

a cyanotic blue baby crying in pain and distress
 Arindam Ghosh/ iStock/ Getty Images Plus

Symptoms of Blue Lips and Cyanosis

With blue lips, the lips take on a dusky blue or bluish coloring that looks unnatural. The word cyanosis is derived from the word “cyan,” which denotes a greenish-blue color.

Different kinds of cyanosis can look different on people with various skin colors. For example, it might be harder to notice the blue lips of someone with darker skin tone, so it is important to check for it even more carefully.

Blue lips often occur along with cyanotic color changes to other parts of the body. It’s most likely to be seen on areas of the body that have a thin layer of skin with a lot of underlying blood vessels. For example, you might notice bluish coloration in the following areas as well:

  • Tongue
  • Gums
  • Nails
  • Earlobes
  • Nose
  • Tips of the fingers and toes

Some people have a bluish discoloration to much of their skin in addition to their blue lips. This is called central cyanosis, and it generally indicates a medical condition that needs to be treated more urgently.

Peripheral cyanosis is a type that usually just affects the hands and feet, usually because blood vessels in the area have decreased in diameter (in response to a problem like intense cold). Blue lips are more likely to occur with a central type of cyanosis than with the peripheral type.

Cyanotic changes like blue lips can come on suddenly. In other circumstances, the change might happen more gradually. The blue lip color should go away after the underlying medical problem is addressed.

Causes

Blue lips and other forms of cyanosis aren’t diseases themselves. Rather, they are indicators that an underlying medical issue is present. Usually, it indicates that part of your body isn’t getting enough oxygen, which is a serious concern. Blue lips might also occasionally be caused by exposure to a very cold environment.

The red blood cells in your body use hemoglobin to carry oxygen to all the tissues. When they dump off oxygen, it changes the configuration of the hemoglobin, which darkens its color a bit. That’s usually the reason for cyanotic change like blue lips—the blood traveling through the area isn’t as high in oxygen as it normally should be.

Medical Causes of Blue Lips

In general, blue lips and other cyanotic features can be found in people with a variety of different kinds of medical problems.

Heart disease is a major potential cause that must be investigated. In a newborn, it might be a sign of a congenital heart problem that might need a surgical repair. In an adult, it might be a sign of heart failure, a heart valve problem, or another type of heart issue.

Serious lung problems are another potential concern. Many different types of lung issues might lead to blue lips and other cyanotic symptoms. Some examples include asthma, pulmonary embolism, chronic obstructive pulmonary disease (COPD), or pneumonia.

Another cause is a serious problem with the central nervous system. If the brain is causing the person to breathe less frequently than normal (hypoventilation), this can cause blue lips. For example, this might happen during a drug overdose, a tonic-clonic seizure, or from a major bleed inside the brain.

Some other potential causes include:

Rarely, blue lips and other cyanotic characteristics might be caused by exposure to a toxin (such as silver salts) or to certain medications, like amiodarone. This sort of circumstance, called pseudocyanosis, does not indicate a problem with the amount of oxygen in circulation.

Even though it is concerning, blue lips don’t necessarily indicate that part of your body is suffering damage from not getting enough oxygen.

For example, an infant born with certain kinds of heart disease might have blue lips and lower than normal levels of oxygen carried in the blood. However, they still may be getting enough oxygen to the tissues so that nothing is being damaged.

Other mechanisms in the body may be able to compensate for the issue, at least temporarily (like through increased production of red blood cells).

On the other hand, lack of blue lips (or other cyanotic symptoms) doesn’t necessarily mean that a person is getting enough oxygenated blood out to all parts of their body.

Diagnosis of an Underlying Cause

If someone has blue lips, it’s important to promptly investigate the underlying cause. Depending on the situation, it might not be a true life-threatening emergency, but it needs to be evaluated quickly. Whatever is causing the issue needs to be dealt with.

The health professional evaluation relies heavily on the medical context—the person’s history of past medical problems and current symptoms. The medical exam also can provide key information about the individual’s heart, lungs, and other important body systems.

It’s also important to check the body for other areas of cyanosis using good lighting. Other areas prone to cyanosis should be checked, like the tongue, the inside of the mouth, and the hands and feet. It’s also important to check for changes in the shape of the fingertips (called “clubbing”) which might mean a long-term problem of reduced oxygen transported in the blood.

Many tests can help your health provider determine how much of an emergency your blue lips could indicate. These tests also can give clues about potential underlying causes. Some of these might include:

The narrowing of the diagnosis will depend on the specific clinical situation. Blue lips that are present at birth are often from a congenital heart defect. In an adult with a chronic health condition, like COPD, it might be a sign that their health condition has gotten worse.

In infants, a usually harmless condition called acrocyanosis can cause a bluish tinge to the arms and legs. This is temporary, and it should go away when the infant is warmed. Acrocyanosis can sometimes affect the area around the mouth, but blue lips themselves are not usually found.

Treatment of the Underlying Cause

The treatment will differ based on the underlying cause. It is important to make sure the airway is clear and that the person can breathe and get enough oxygen into their body. In some situations, the person will need to breathe in extra oxygen, or they might need support with a ventilator to help them breathe.

For a problem like congenital heart disease, surgery may ultimately be needed. Other causes will need other treatments, like antibiotics for pneumonia or a diuretic medication for people with heart failure.

When to Call 911

You should call 911 immediately if your lips turn blue suddenly. You should also seek immediate attention for serious symptoms, like

  • Difficulty breathing
  • Chest pain
  • Dizziness or fainting

If your lips turn bluish gradually and you have a known medical condition that might cause this, get in touch promptly with your primary care provider.

A Word From Verywell

Unless they go away quickly in response to warmth, blue lips usually are a sign of a medical problem that shouldn’t be ignored. If you have serious symptoms along with your blue lips, seek immediate medical attention. 

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