An Overview of Peripheral Cyanosis

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Peripheral cyanosis is a condition in which the extremities—usually the hands, feet, fingers, and/or toes—develop a distinctive bluish discoloration because they are not receiving enough oxygen-rich blood.

Peripheral cyanosis is rarely a serious condition but anyone whose hands and feet don’t restore to normal color and blood flow after warming and massaging may have an underlying condition and should seek medical attention.

Peripheral cyanosis is almost always caused by reduced blood circulation to the affected extremities, making the tissues starved for oxygen. Oxygen-rich blood is a bright red while oxygen-poor blood is dark red and will reflect a bluish-green color through the skin.

It is vital for oxygen flow to be restored to prevent potential complications. Peripheral cyanosis can affect anyone regardless of age, even newborns.

Research reported in the medical journal BMJ Best Practice finds up to 4.3% of newborns who have cyanosis will require oxygen treatment. Cyanosis in newborns may be related to heart, nerve, lung, or cell function problems. Peripheral cyanosis is sometimes hard to diagnose in newborns because of other skin discoloration issues, including jaundice. 

peripheral cyanosis symptoms

Verywell / Jessica Olah

Peripheral Cyanosis Symptoms

Adults and children with peripheral cyanosis may experience the following symptoms:

  • Skin on the fingertips, toes, palms of the hands and/or feet to appear blue-green
  • Bluish areas that feel cold to touch
  • Returned color after the body part is warmed

When to Call 911

Peripheral cyanosis can be a life-threatening emergency. Anyone experiencing blue discoloration with the following symptoms should seek immediate medical attention by calling 911 or going to the nearest emergency room:

  • Gasping for air, shortness of breath, and/or other breathing issues
  • Fever
  • Headache
  • Chest pain
  • Excessive sweating
  • Pain or numbness in the arms, legs, hands, feet, fingers, or toes
  • White or pale appearance of the arms, legs, hands, feet, fingers, or toes. This symptom is a sign of obstructed blood flow.
  • Dizziness or fainting


Peripheral cyanosis is often associated with being cold, but it is possible to have this condition and be warm, due to poor oxygenation.   

Common causes for peripheral cyanosis may include: 

  • Tight clothing or jewelry
  • Deep vein thrombosis (DVT): A serious condition causing a blood clot in a vein deep inside the body
  • Venous insufficiency: A condition that causes blood to pool into the veins
  • Heart failure: Affecting the heart’s ability to pump enough blood to the body
  • Raynaud’s phenomenon: Causes restricted blood flow to the fingers, toes, ears, and/or nose in response to cold or stress
  • Lymphedema: Causes dysfunction in the lymphatic system resulting in swelling of arms or legs and fluid retention in the fingers or toes, may also affect the head and neck
  • Arterial insufficiency: Sluggishness/stoppage of blood flow to the arteries
  • Severe hypotension: Low blood pressure
  • Septic shock: Usually the result of an infection, can be life-threatening
  • Hypovolemia: A decrease in blood volume throughout the body


Bluish skin isn’t usually a serious condition. However, any time skin color does not return to normal color, it is important to find out the cause.

A doctor can determine an underlying cause with a physical examination, listening to the heart and lungs, and also with blood work. Computerized tomography (CT) scans and X-rays can determine if there are abnormalities in the lungs and heart.

A non-invasive pulse oximeter is a helpful tool for measuring blood oxygen saturation. Unfortunately, it cannot help determine the metabolism of oxygen or the amount of oxygen a person is using.

Peripheral cyanosis can also be diagnosed using an arterial blood gas test. This test measures acidity, carbon dioxide, and oxygen levels in the blood.


Treatment starts by identifying and correcting the underlying reasons for constricted blood flow. Timely and appropriate treatment can help reduce any potential complications. 

Medications for treating peripheral cyanosis relax the blood vessels and may include antidepressants, anti-hypertension medications, or erectile dysfunction drugs.

Medications that restrict blood flow should be avoided by people with conditions causing bluish skin decoration, including beta blockers, birth control pills, and drugs containing pseudoephedrine (i.e. cold and allergy medications). 

It is also a good idea to limit caffeine consumption and quit smoking as both are known for constricting blood vessels and affecting blood flow.  

Cyanosis in babies tends to go away when the underlying condition is managed. Cases of cyanosis with no known source can be treated with supplemental oxygen. 

A Word From Verywell 

Peripheral cyanosis is rarely a medical emergency. However, it is important to determine the underlying cause and treat the condition appropriately and timely. Ongoing symptoms of bluish and cold skin and restrictive blood flow should be brought to the attention of a doctor to avoid serious and life-threatening complications.

Frequently Asked Questions

  • What is the primary cause of peripheral cyanosis?

    Low levels of oxygen in the blood, clinically known as hypoxia. Blood oxygen levels typically must fall below 80% to 85% for skin to take on the bluish tint that characterizes cyanosis.

  • What is the difference between peripheral cyanosis and central cyanosis?

    Both conditions are a sign of hypoxia—low levels of oxygen in the blood. However, while peripheral cyanosis affects the extremities, especially the fingers and toes, central cyanosis shows up as bluish discoloration of the entire body, especially in mucus membranes such as the lips.

  • Can massage make peripheral cyanosis go away?

    If the condition is caused by extreme cold or Raynaud's phenomenon, gently massaging and warming the affected body parts will stimulate the flow of oxygenated blood and help them to pink up to a normal color.

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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.
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