Blue Lips or Skin (Cyanosis): Symptoms & Treatment

By John Bernard, MD
Medically reviewed checkmarkMedically reviewed
May 7, 2020

If you notice that you have blue lips or blue skin, it can be an alarming symptom. Blue lips and skin could appear for a variety of reasons, from bruising, to physical exertion, cold temperatures, or vascular or respiratory conditions. The way discolored skin presents—and where—varies and can signal a variety of conditions or underlying causes, especially between adults and infants.

While not all reasons for skin and lip discoloration are cause for immediate concern, some causes and associated symptoms do require medical attention.

What Is Cyanosis?

Blood rich in oxygen is red, resulting in our body’s normal coloring. When your circulation deteriorates or there isn’t enough oxygen in your bloodstream, this can cause a bluish discoloration in different parts of the body, otherwise known as cyanosis.

Cyanosis is a symptom of lessened circulation of oxygen in the blood, altering your body’s normal coloring to a bluish or gray discoloration of the skin.

Cyanosis affects different areas of the body, such as in the finger, toes, nails, earlobes, and mucous membranes. The area of the body affected likely indicates which type of cyanosis you have.

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Circumoral cyanosis

Circumoral cyanosis refers to a blue or gray discoloration around the mouth, specifically around the upper lip. Most common in infants and children, this type of cyanosis can also present as white or gray tinting in children with darker skin. If discoloration appears outside of the mouth, hands or feet, seek emergency medical care.

Peripheral cyanosis

The blue discoloration of extremities—fingers, toes, hands, and feet—due to lack of oxygen in the blood is a sign of peripheral cyanosis. Reduced circulation deprives the tissues of oxygen and is usually remedied by warming and massaging the affected areas.

Central cyanosis

When there is less oxygen in the central arterial blood, usually because of a respiratory or cardiac issue, this is typically a sign of central cyanosis. You’ll likely notice a blue tint on the tongue or lips as a result—though if you’re experiencing central cyanosis, you likely also have symptoms of peripheral cyanosis, including the discoloration of extremities, resulting in mixed cyanosis

What Causes Blue Lips and Skin?

Inadequate levels of oxygen in the bloodstream and/or poor circulation are usually the reason lips, skin and other body parts can take on a blue discoloration. There are many reasons you may be experiencing blue lips or skin—though those reasons will differ depending on your age.

What causes blue lips and skin in adults?

Adults can experience skin discoloration of the lips and skin for many reasons, including:

  • Cyanosis: As noted above, cyanosis can cause parts of the body to take on a blue or gray color. There are different types of cyanosis depending on where discoloration occurs—circumoral, peripheral, and central—and the skin discoloration in general signals cyanosis.
  • Raynaud’s phenomenon: Extremities such as the ears, toes, fingers, and nose can become blue or white as a response to environmental stressors, such as stress or cold temperatures. With this condition, the arteries that feed blood supply become constricted, decreasing circulation.
  • Acute respiratory distress: A severe, acute episode of inflammation in lungs can result in fluid accumulation. When this occurs in the lungs, oxygen levels decrease as carbon dioxide levels increase in the bloodstream—which can potentially damage organs in the body. Immediate medical care may be necessary for this condition.
  • Asthma: Breathing can become difficult for those with asthma—a chronic, inflammatory lung disease.
  • Carbon monoxide poisoning: Inhaling carbon monoxide, an odorless and colorless gas, disables red blood cells in the body from transporting adequate levels of oxygen. You should seek immediate medical attention if you think you may have carbon monoxide poisoning.
  • Aspiration pneumonia: Lungs can become infected when food, saliva, or stomach acid accidentally enters the lungs, resulting in aspiration pneumonia. Impaired breathing or shortness of breath associated with aspiration pneumonia can cause blue lips or skin. This condition usually requires immediate medical attention.
  • Cardiac tamponade: Blood or other bodily fluid can crowd and put pressure on the sac that encases the heart, causing the heart to pump less effectively. This is a dangerous condition that requires immediate medical attention.
  • Chronic obstructive pulmonary disease (COPD): This chronic, progressive lung disease occurs when airways are damaged. This deteriorated respiratory capacity can account for discoloration in the lips or skin. If your breathing becomes acutely worse, you should seek immediate medical attention.
  • Pneumothorax: If air penetrates the area around the lungs, the change in pressure can cause lung(s) to collapse. Immediate medical care may be necessary for this condition.
  • Pulmonary edema: When fluid enters the lungs, the lungs are not able to move oxygen through the bloodstream. As a result, breathing is impaired and skin can turn blue. Immediate care may be necessary for this condition.
  • Sickle cell anemia: This genetic condition alters the shape of red blood cells. The sickle-shaped red blood cells block blood flow throughout the body and are more prone to damage, often resulting in anemia.
  • Heart attack: When muscles around the heart begin to fail because of a heart attack, oxygen-rich blood is unable to reach the heart. This can be a fatal condition—please seek immediate care if you suspect you’re experiencing a heart attack.
  • Acute mountain sickness: Those who find themselves at high elevations of at least 8,000 feet (2,400 meters) above sea level may experience blue lips due to the decreased air pressure and lower levels of oxygen available.
  • Pulmonary embolism: Blood can clot and prohibit blood flow to the lungs, restricting oxygen levels. Immediate medical care may be necessary for this condition.

What causes blue lips and skin in infants?

In young children, the discoloration of the lips or skin can be alarming. While not all causes merit immediate medical attention, it’s essential to understand the possible reasons your child’s skin or lips are discolored. If warming or massaging skin doesn’t improve the skin’s discoloration, or if you notice your child has trouble breathing, contact a doctor immediately.

Some causes of blue lips or skin in adults can also show in children, but the most common causes for lip and skin discoloration in children are:

  • Cyanosis: Circumoral cyanosis is mostly seen in infants. You may notice your child has blue discoloration around the mouth, particularly above the upper lip.
  • Respiratory syncytial virus (RSV): While this virus can affect all ages, it’s most commonly seen in infants and children. Mild symptoms of RSV resemble those of a cold, but more serious cases can result in lung complications—especially in infants.

Associated Symptoms

Blue lips or skin are likely caused by another (or underlying) condition—which is why if you’re experiencing a bluish discoloration of your lips or skin, you’re likely experiencing other symptoms. Examples of symptoms often seen alongside blue lips or skin include:

Diagnosing Blue Lips and Skin

A doctor can help determine the ultimate cause of your blue lips and skin, especially because there may be another underlying condition causing this symptom. When visiting the doctor, you’ll be asked to discuss your medical history and day-to-day activities, and should expect a thorough physical exam.

If a doctor suspects pulmonary issues may be the cause of your symptoms, they may order an x-ray, CT scan, or ultrasound of the chest area.

If a doctor believes that hypoxemia—low blood oxygenation relating to breathing or circulation—is the reason for your blue lips and skin, a pulse oximeter will be used to measure the oxygenation of your blood.

Treating Blue Lips and Skin

Because blue lips and skin can signal many different conditions—and because a doctor will need to treat the underlying issue—a medical professional will evaluate your symptoms to come to the appropriate diagnosis and next steps. Treatment may be necessary to bring back adequate levels of oxygen in the bloodstream, particularly to affected areas.

If you have a preexisting respiratory condition, discoloration in the lips and skin could indicate your issue has progressed. A doctor may suggest ways to improve your respiratory health, including boosting your fitness activity or quitting smoking. Your doctor will also review the results of any tests, like an x-ray, CT scan or ultrasound, to determine if a pulmonary issue needs to be addressed.

It’s important to let your doctor know if you’re taking medication, such as blood thinners, beta-blockers, or any type of medication to control high blood pressure. Your doctor may want to change your existing medications to ensure your red and white blood cell counts remain healthy.

When to See a Doctor

Discoloration of the skin and lips can be a sign of several different conditions. If your symptoms are severe or persistent, it’s a good idea to make an appointment with your doctor.

When should adults see a doctor about blue lips or skin?

The sudden onset of blue-tinted lips that can be explained by a triggering event (such as the result of bruising, blue lips after running, or an intense workout, or in high elevations) will likely resolve without medical intervention. But if your lips or skin become blue suddenly and the cause is unknown, you may need to seek help right away.

If you’re experiencing blue discoloration of lips and/or skin along with one or more these symptoms, you should seek medical attention immediately:

If the onset of your blue lips or skin is gradual, it’s a good idea to watch for other symptoms and wait a day or two to allow discoloration to resolve on its own. If the symptoms don’t resolve after that point, you may want to make an appointment with your care provider.

When should infants see a doctor about blue lips or skin?

Most infants contract RSV before they turn two, and the virus can cause blue lips. While RSV itself is likely to clear up without complication, you should bring your child to see a medical professional if their lips are blue. If your child doesn’t have RSV, but their head, tongue, or torso are blue, you should make an appointment with a physician. The blue discoloration of lips or skin can signify a respiratory or blood condition—or indicate your child has ingested a harmful chemical—so seeing a doctor is critical.

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K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

John Bernard, MD

Dr. Bernard is an emergency medicine physician. He graduated from Jefferson Medical College in Philadelphia, and did his residency in emergency medicine at the University at Buffalo.