Blue nails may specify that the blood is not carrying sufficient oxygen to the fingertips. There are several possible causes, some of which are serious. A person with blue nails should consult a doctor to determine the underlying cause.

Why do the Nails Turn Blue?

If only one nail is blue, it’s probably due to an injury causing blood to pool under the nail. If all nails are blue, this indicates cyanosis, a symptom of another condition rather than a disease in its own right. Blue nails arise because there is not enough oxygen in the blood.

Blue nails can also occur when the circulatory system doesn’t move blood around the body as it should, resulting in poor flow and a blue tinge.

Cold weather can temporarily cause poor circulation as blood vessels to constrict due to low temperatures. They do this to prevent blood from entering the extremities and to keep internal organs at optimal temperature.

If a low temperature is a cause, standard nail colour should return when the person warms their hands.

Conditions that Cause Blue Nails

Cause Blue Nails

Blue fingernails indicate that the fingers, toes, or both, lack oxygen.

Trusted Source The following conditions can cause cyanosis:

Chronic Obstructive Pulmonary Disease (Copd)

COPD is an umbrella term for progressive lung diseases, including emphysema and chronic bronchitis. Emphysema ends the air sacs in the lungs, while bronchitis causes the bronchial tubes to become inflamed and narrow, leading to mucus buildup. Around 30 billion persons in the United States live with COPD.


Asthma reasons the airways to narrow and swell and can also increase mucus production, leading to buildup. As a result, people with asthma may experience difficulty breathing, chest pain, coughing, and wheezing that can interfere with daily life. Sometimes asthma can cause life-threatening asthma attacks.

Acute Respiratory Distress Syndrome (ARDS)

People with ARDS have shortness of breath, and their breathing and heart rate are faster than usual, which leads to a drop in oxygen in the blood. Doctors treat ARDS with oxygen therapy to increase the oxygen level in the blood.


Bacteria, viruses and fungi can cause pneumonia, an infection of the lungs. After a severe flu infection, for example, pneumonia may develop. Signs can vary from minor to severe, but most people recover from pneumonia in 1 to 3 weeks.

Pulmonary Embolism (PE)

When one of the arteries in the lungs is blocked by a blood clot, it can cause a pulmonary embolism. The lump usually travels from the leg or another part of the body, causing a life-threatening blockage of blood flow to the lungs.

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Heart Disease

Some cases of blue toenails may be due to heart conditions, such as:

  • Congenital heart defects: Babies with abnormal hearts and blood vessels can be born. Although some cases are asymptomatic, others cause life-threatening symptoms.
  • Eisenmenger syndrome: This rare condition affects the heart and lungs and is often a late complication of a congenital heart defect. Eisenmenger syndrome causes high blood pressure and abnormal blood flow in the heart.
  • Heart failure: Heart failure causes heart problems and prevents blood from pumping as it should. Signs include shortness of breath, extreme fatigue, and swollen extremities.

Abnormalities of Blood Vessels and Blood Cells

Specific blood cell and blood vessel issues can also cause blue nails. These include:

  • Methemoglobinemia: This condition causes high methemoglobin levels, a form of haemoglobin that cannot release oxygen. People can develop this illness from birth or from exposure to certain chemicals or medications, such as antibiotics and local anaesthetics.
  • Carbon monoxide poisoning: Carbon monoxide blocks the oxygen-binding ability of haemoglobin.
  • Polycythemia vera: This system of blood cancer causes the bone core to produce too many blood cells.
  • Raynaud’s phenomenon: People with this condition have reduced blood flow to the hands and feet due to spasms in the blood vessels.

Diagnosis and Treatment of Blue Nails

A doctor will diagnose cyanosis by doing a physical exam to look at blue nails and check for clubbing. Club fingers can indicate congenital heart defects and lung problems. The doctor may also examine the person for cardiac or respiratory symptoms.

Blood oxygen tests are an essential tool for diagnosing cyanosis. A doctor will draw blood to measure arterial blood gases (ABG), which indicate the levels of oxygen and haemoglobin in the blood

They might also place a pulse oximeter on the person’s finger to measure the oxygen saturation in the blood. These tests help control why someone has blue nails. Because cyanosis is a symptom of an underlying disease, the aim is to treat the cause.

Depending on the effect of blue nails, treatments may contain:

  • Surgery to correct congenital heart defects
  • supportive oxygen therapy
  • Methylene blue for methemoglobinemia
  • Medicines that relax blood vessels, including medications to lower blood pressure and drugs for erectile dysfunction

Doctors may recommend that people with Raynaud’s phenomenon make long-term changes to their daily habits, such as eating. B. Avoid caffeine and nicotine.

Cyanosis is challenging; different medical specialists and teams may need to work together to treat the situation.

When to Seek Help?

It is not unusual for the nails to appear blue in cold weather, but they should return to their standard colour once the person has warmed up. However, if blue nails are not due to low temperature and the stain persists, it is essential to see a doctor.

Doctors will recognize and treat the underlying cause of cyanosis and treat it to restore optimal blood flow throughout the body. Prompt treatment should limit the likelihood of complications and improve the outcome for the person.

If a person with blue nails also has chest pain, shortness of breath, profuse sweating and dizziness, they should call 911 immediately. These symptoms may indicate a medical emergency.


You may have cyanosis if you have a blue tint to your nails or other body parts. It is caused by a lack of oxygen in the blood.

There are three types of cyanosis, each of which causes a blue discoloration in different body parts. The underlying medical condition that is causing cyanosis may also cause symptoms. To diagnose cyanosis, your doctor will review your medical history, perform a physical exam, and run specific tests.

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