COPD What Is Cyanosis? Blue, gray, or purple skin, lips, or nails may signal a lack of oxygen By Deborah Leader, RN Deborah Leader, RN Deborah Leader RN, PHN, is a registered nurse and medical writer who focuses on COPD. Learn about our editorial process Updated on April 08, 2023 Medically reviewed by Sanja Jelic, MD Medically reviewed by Sanja Jelic, MD Sanja Jelic, MD, is board-certified in sleep medicine, critical care medicine, pulmonary disease, and internal medicine. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Symptoms Emergency Signs Causes Diagnosis Treatment Cyanosis is a medical term to describe blue, grayish, or purple skin, lips, or nail beds. It occurs when there isn't enough oxygen in your blood. Cyanosis is a symptom of various heart and lung conditions, autoimmune disease, and drug overdose. The blue tinge of cyanosis means your muscles, organs, and other tissues may not be getting the oxygen they need to operate properly. In some cases, cyanosis can indicate a serious medical concern. This article provides an overview of cyanosis and the reasons why you may have blue or purple skin. It also explains conditions associated with it and when cyanosis may signal a medical emergency. virusowy / Getty Images Cyanosis Is a Symptom Cyanosis is a bluish, grayish, or purplish cast to the skin and mucous membranes. It is a sign that your blood isn't carrying enough oxygen. Normal blood oxygen saturation is in the range of 95% to 100%, which means almost all of your blood's hemoglobin (protein in red blood cells) is carrying oxygen. The bluish tinge to your skin might not appear until your oxygen saturation falls below 85%. Depending on your skin tone, cyanosis may be difficult to detect. The first signs typically appear on lips, gums, nail beds, and around the eyes. The mucous membranes and skin can appear white, gray, bluish, or purplish. Signs Cyanosis May Be an Emergency Cyanosis may signify a serious medical condition, especially if it occurs suddenly. Seek immediate medical help if any of the following accompanies cyanosis: Chest painBreathing becomes harder or fasterUnable to take a deep breathNeed to lean forward to breathe when sittingUse the muscles around your ribs, neck, or shoulders to help you breatheFrequent headachesUnusual fatigue ConfusionFeverCoughing up dark or blood-tinged mucusLoss of conciseness If you or someone you are with shows any of the above signs, call 911 immediately. What Causes Cyanosis? Getting enough oxygen through your lungs and circulating it effectively throughout your body is what gives your skin a normal pink or red tinge, regardless of your skin tone. If cyanosis is present, it's because something is disrupting this process. Oxygen is the element in blood that makes it red. Blood that doesn't have much oxygen is carrying mainly carbon dioxide waste from your cells to be exhaled from your lungs. This oxygen-poor blood is darker in color and more bluish-red than true red. It's normal for your veins to show this bluish color since veins deliver blood—with its waste cargo—back to the heart and lungs to get rid of the carbon dioxide. But when other parts of your body turn blue or purple due to cyanosis, there's an underlying issue that's limiting blood flow or oxygen that must be addressed immediately. Cyanosis can be caused by a wide variety of medical conditions, such as: Chronic obstructive pulmonary disease (COPD) Pulmonary hypertension (a complication of COPD) Pneumonia Infections of the respiratory tract Asthma Congestive heart failure Raynaud's phenomenon, a condition that causes your blood vessels to narrow, mainly in your fingers and toes Epiglottitis, a serious condition involving swelling of the small flap in your throat that covers your windpipe Hypothermia Seizures Drug overdose Suffocation Other Complications of COPD Diagnosis While a healthcare provider may note cyanosis as a symptom, this will not be your diagnosis. To figure out the underlying condition causing it, your healthcare provider will take a detailed health history, listen to your heart and lungs, and possibly order bloodwork or imaging scans. In addition to a physical examination, diagnostic testing for cyanosis may include: Blood oxygen saturation by pulse oximetry Arterial blood gas analysis (ABG) Complete blood count (CBC) Electrocardiogram or Echocardiogram Chest X-ray Chest computed tomography (CT) scan How Cyanosis Is Treated Oxygen therapy is the first line of treatment for cyanosis. This should help boost your blood oxygen levels quickly. Timely and swift treatment can help prevent any further complications of low blood oxygen. Any additional treatment you may receive for cyanosis will depend on its root cause. For example, COPD treatment may include inhaled corticosteroids and pulmonary rehabilitation. Pneumonia treatment may involve antibiotics or antiviral medications, depending on its cause. Diuretics and anticoagulants may be recommended to treat pulmonary hypertension. When a congenital heart condition causes cyanosis, surgery may be required. Cyanosis due to a suspected opioid overdose should be quickly treated with Narcan (naloxone hydrochloride). In March 2023, the Food and Drug Administration (FDA) approved Narcan Nasal Spray as an over-the-counter (OTC) emergency treatment for opioid overdose. Summary Cyanosis—a bluish, grayish, or purplish hue of the skin, lips, or nails—can be a sign of a variety of medical conditions, including some serious ones. If you or someone you are with experiences cyanosis that comes on suddenly or is accompanied by chest pain, confusion, difficulty breathing, or loss of consciousness, call 911 immediately. 9 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. U.S. National Library of Medicine: MedlinePlus. Blue discoloration of the skin. Laskine-Holland ML, Kahr WH, Crawford-Lean L, et al. The association between cyanosis and thromboelastometry (ROTEM) in children with congenital heart defects: A retrospective cohort study. Anesth Analg. 2017;124(1):23-29. doi:10.1213/ANE.0000000000001708 Adeyinka A, Kondamudi NP. Cyanosis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022. McMullen SM, Patrick W. Cyanosis. Am J Med. 2013;126(3):210–2. doi:10.1016/j.amjmed.2012.11.004 U.S. National Library of Medicine: MedlinePlus. COPD (chronic obstructive pulmonary disease). U.S. National Library of Medicine: MedlinePlus. Pneumonia. U.S. National Library of Medicine: MedlinePlus. Pulmonary hypertension. The Texas Heart Institute. Cyanosis. U.S. National Library of Medicine: MedlinePlus. Naloxone nasal spray. By Deborah Leader, RN Deborah Leader RN, PHN, is a registered nurse and medical writer who focuses on COPD. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? 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