Blue lips: When to seek help, causes, and other symptoms (2023)

Cyanosis is the medical term for discoloration to the lips, skin, tongue, or other mucous membranes. It occurs when the body does not receive enough oxygenated blood. Although people’s lips can change color when exposed to cold temperatures, cyanosis often requires medical intervention.

In white people, cyanosis causes the lips and skin to turn blue. In Black people, cyanosis may cause the lips and skin to become gray or whitish but might become more evident in the gums, and around the eyes and nails.

Cyanosis may indicate poor blood flow to other areas of the body.

According to the United Kingdom’s National Health Service (NHS), if a person has blue or gray lips, they need to seek emergency medical help.

If a person is experiencing cyanosis in the fingers or toes, they should see a doctor.

In this article, we cover some of the causes of cyanosis and when to seek help.

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People must call 911 if their lips or someone else’s lips change color, and the following symptoms occur:

  • lips, face, tongue, or skin suddenly turn blue or gray
  • difficulty breathing
  • chest pain

According to the American Lung Association (ALA), a person with COPD may experience flare-ups when their symptoms worsen.

A person may experience a flare after exposure to a trigger, such as allergens or air pollution, or if they have a chest infection.

Sometimes COPD flare-ups may cause cyanosis, chest pain, and confusion.

These are serious symptoms and require emergency medical attention. People with COPD flare-ups should not attempt to drive to the emergency room.

Treatment

According to the Canadian Lung Association, when a person experiences a flare, they must put their individual action plan into use.

This can include taking antibiotics or corticosteroid medications.

Treating a flare-up can reduce the chances of becoming severely ill.

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A severe asthma attack is another medical emergency.

Along with very pale or blue lips, fingers, or fingernails, people experiencing a severe asthma attack may also have accompanying symptoms.

According to the Asthma and Allergy Foundation of America, symptoms may include:

  • fast breathing with chest retractions
  • rapid movement of nostrils
  • deep and rapid movement of the ribs and stomach
  • expanded chest that does not deflate upon exhalation
  • infants who cannot respond or recognize their parents

People can prevent asthma attacks by knowing and avoiding their triggers.

Each person may have a different trigger, such as:

  • pollen
  • cats
  • cigarette smoke
  • fumes from household cleaners
  • cold and flu viruses

Treatment

A person should keep their rescue inhaler close to them so they can use it when they recognize the onset of an asthma attack.

When breathing becomes difficult, they can use the inhaler to ensure effective breathing.

Specialists will also create a customized rescue plan for asthma attacks.

According to the ALA, people experiencing ARDS have severe lung injury, usually due to trauma or infections.

ARDS typically occurs in people who are already in the hospital, but it can still happen outside a hospital setting. It is a medical emergency.

When a person has ARDS, fluid enters the lungs, making it difficult for people to breathe and get oxygen into their bloodstream.

With a lack of oxygen, the skin and lips may turn blue or white. This is a warning sign to call 911.

According to the ALA, other symptoms that may suggest ARDS include:

  • distressed breathing
  • rapid heart rate
  • blue or pale fingernails

In the hospital, the doctors will take an X-ray to evaluate the amount of fluid in the lungs and check the blood oxygen levels.

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Treatment

According to the ALA, treatment for ARDS includes ventilator support to ensure the person is getting enough oxygen. Ventilators also create airspaces that have closed to help the person breathe more easily.

Sometimes doctors need to place the person on their stomach, which helps deliver more oxygen into the blood.

Sedatives and medications to prevent movement help relieve anxiety and agitation.

Some medications that stop muscle movements are necessary to help place the person on the ventilator.

Doctors may also prescribe diuretic medications to help reduce fluid in the lungs.

People sometimes call pneumothorax a collapsed lung.

It happens when air that enters the space between the lung and chest wall pushes against the outside of the lung, causing it to collapse.

There are different types of pneumothorax:

  • Primary spontaneous: This type occurs when a person has no known history of pulmonary disease.
  • Secondary spontaneous: This type typically occurs due to pulmonary diseases, such as COPD, asthma, and cystic fibrosis.
  • Traumatic: This occurs due to an injury that allows air to leak into the cavity that surrounds the lungs.

Some people may not experience any symptoms. However, according to Johns Hopkins Medicine, symptoms can include:

  • difficulty breathing
  • gray or blue lips and skin
  • tight chest
  • a rapid heart rate
  • fatigue
  • shortness of breath
  • acute sudden chest pain localized at the area of pneumothorax

A pneumothorax is a medical emergency. Doctors will notice decreasing arterial oxygen and will immediately prescribe oxygen therapy. Some people may only need observation as the pressure stabilizes.

In other situations, people may require aspiration, which involves inserting a catheter into the pleural cavity to evacuate the air in the cavity.

An article in BMJ Clinical Evidence states that although death from pneumothorax is rare, it is a medical emergency. Anyone who thinks that they are experiencing a pneumothorax must go to the emergency room.

Treatment

Johns Hopkins Medicine state that although pneumothorax can resolve by itself, healthcare professionals may have to remove the air from the lung.

Healthcare professionals will place a chest tube between the ribs to drain the air and allow the lung to re-expand.

Sometimes, a person may need surgery.

Seizures

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According to an earlier article in Epilepsy Currents, cyanosis is common in people with tonic-clonic seizures and prolonged tonic seizures.

During the seizure, the person may experience apnea, where they temporarily stop breathing. This limits oxygen circulation.

According to a 2020 article, a person experiencing a tonic-clonic seizure may experience impaired awareness or loss of consciousness.

If someone notices a person is having a seizure, they should try to roll them onto their side to decrease the risk of suffocation and aspiration.

Although most tonic-clonic seizures resolve spontaneously, a person who experiences one should go to the emergency room. Some people may require anti-seizure medication to prevent seizures.

Sometimes dermatologists can tell if a person has a heart condition by the blue or purple hue to the skin.

The American Academy of Dermatology state that changes to skin or lip color can indicate a blockage in a blood vessel. Without treatment, a lack of blood and oxygen supply can cause the skin and underlying tissues to die.

If other symptoms accompany cyanosis, such as pain or numbness in the area, people should speak with a doctor.

If a person notices that an infant’s lips are blue or gray, they should contact a healthcare professional for advice.

Respiratory syncytial virus (RSV)

RSV is a virus that causes symptoms that resemble the common cold. Infants are a high-risk group, and 5–20% require hospitalization.

In mild cases, an infant may experience congestion, a fever, a cough, a runny nose, and a sore throat. The symptoms typically clear within a few days, according to the ALA.

However, If a parent or caregiver notices a wheezing or barking cough, this can indicate that RSV is more severe.

Other symptoms of severe RSV include short, shallow, rapid breaths, which causes caving of the chest between the ribs.

The infant’s nostrils may also flare. Blue or gray lips, mouth, and fingernails may also appear because of a lack of oxygen.

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Treatment

According to the Centers for Disease Control and Prevention (CDC), if an infant experiences severe RSV, they need to stay in the hospital for a few days.

In really severe cases, they may require oxygen or help to breathe with mechanical ventilation.

Newborn respiratory distress syndrome (NRDS)

According to the National Heart, Lung, and Blood Institute, respiratory distress syndrome often occurs in newborns or premature babies because their lungs may not have enough surfactant to keep the lungs expanded.

Surfactant is a foamy substance that helps keep the lungs fully expanded so that newborns can breathe air when they are born.

Without enough surfactant, the baby may have difficulty breathing and delivering oxygen throughout the body.

A lack of oxygen may turn their lips blue or gray.

Over time, NRDS may develop into bronchopulmonary dysplasia, which is another breathing disorder. Some babies may recover from RDS and never get bronchopulmonary dysplasia.

Treatment

To treat NRDS, doctors may prescribe surfactant replacement therapy, breathing support from a ventilator, or nasal continuous positive airway pressure. Treatment typically occurs in the neonatal intensive care unit.

To diagnose cyanosis, doctors will investigate the person’s medical records, which may indicate chronic lung disease.

Since cyanosis can occur with cardiovascular or pulmonary conditions, doctors must conduct thorough examinations.

Controlling the underlying condition is necessary to prevent blue or gray lips in the future.

Blue or gray lips and skin indicate a lack of blood flow or a lack of oxygen circulating in the blood. Sometimes lips that change color may be a warning sign of a medical emergency, such as a severe asthma attack or COPD flare-up.

If blue or gray lips appear suddenly, a person may require emergency medical attention, especially if they have other warning signs, such as shortness of breath.

If lips change color gradually, the person should monitor their symptoms and make an appointment with a doctor.

FAQs

What illness makes your lips blue? ›

Blue or grey skin or lips (cyanosis) happens when there's not enough oxygen in your blood, or you have poor blood circulation. It can be caused by a serious problem with the: lungs, like asthma or pneumonia.

What do blue lips look like from lack of oxygen? ›

The main sign of cyanosis is a dusky blue or bluish coloring on your lips that looks unnatural. The word cyanosis comes from the word “cyan,” which is a greenish-blue color. Cyanotic changes like blue lips can come on suddenly or gradually.

Can a viral infection cause blue lips? ›

But if the tongue, head, torso, or lips themselves appear bluish, the child needs to be examined by a doctor. Blue lips in children under 2 years old can be a symptom of a respiratory syncytial virus (RSV) infection.

Do you get blue lips with sepsis? ›

Signs of sepsis are: • Pale, blotchy or blue skin, lips or tongue. Blotchy skin is when parts of your skin are a different colour than normal. Sometimes it is hard to know if you or somebody you look after has sepsis, or if it is something else, like flu or a chest infection.

Can heart problems cause blue lips? ›

Some heart defects cause major problems right after birth. The main symptom of cyanosis is a bluish color of the lips, fingers, and toes that is caused by the low oxygen content in the blood.

Can iron deficiency anemia cause blue lips? ›

Low oxygen content in the blood or poor circulation can cause blueish discoloration in the skin and lips. This is known as cyanosis. Cyanosis occurs when the oxygen saturation levels in a person's blood fall below 85% . A person may also develop cyanosis if they have abnormal hemoglobin.

Can low blood pressure cause blue lips? ›

Blue lips can be a symptom of a low blood oxygen level. This warrants prompt evaluation in an emergency setting. If you have blue lips with other serious symptoms, seek immediate medical attention by calling 911.

What does mild cyanosis look like? ›

Cyanosis is a bluish color in the skin, lips, and nail beds caused by a shortage of oxygen in the blood. Cyanosis occurs because blood with low levels of oxygen turns blue or purple. This low-oxygen blood causes a blue-purple tint to the skin.

How do you get more oxygen in your blood? ›

How to Increase Your Blood Oxygen Level
  1. Stand or sit up straight. Rather than lying down, which may put pressure on your lungs and make it harder to breathe.
  2. Cough. If you have a cold or the flu, difficulty breathing can decrease oxygen saturation in your blood. ...
  3. Go outside. ...
  4. Drink lots of water. ...
  5. Take slow, deep breaths.
Nov 17, 2021

What infection affects the lips? ›

Oral Herpes. Oral herpes can cause outbreaks of fluid-filled blisters in the mouth or on the lips that last for a week to 10 days. When the blisters rupture, the scabs last for a few days without pain. This infection is caused by the herpes simplex virus.

Does COVID make your lips blue? ›

New confusion. Inability to wake or stay awake. Pale, gray, or blue-colored skin, lips, or nail beds, depending on skin tone.

Can anxiety cause blue lips? ›

Anxiety, Blackouts (Memory Time Loss), Blue Colored Lips And Body Aches Or Pains. These symptoms can be related to a wide variety of medical conditions. Anxiety can be a symptom of generalized anxiety or panic disorder.

When are blue lips an emergency? ›

Blue skin and lips is usually caused by low blood oxygen levels or poor circulation. It can be a sign of a serious problem. Call 999 or go to your nearest emergency department immediately if you notice an adult or child suddenly turning blue.

What are the 5 signs of sepsis? ›

You or someone else has symptoms like:
  • loss of consciousness.
  • severe breathlessness.
  • a high temperature (fever) or low body temperature.
  • a change in mental state – like confusion or disorientation.
  • slurred speech.
  • cold, clammy and pale or mottled skin.
  • a fast heartbeat.
  • fast breathing.
Jan 25, 2023

What are the early warning signs of sepsis? ›

The signs and symptoms of sepsis can include a combination of any of the following:
  • confusion or disorientation,
  • shortness of breath,
  • high heart rate,
  • fever, or shivering, or feeling very cold,
  • extreme pain or discomfort, and.
  • clammy or sweaty skin.
Aug 31, 2017

What is the color for congestive heart failure? ›

Red — as in the color of heart disease awareness, just as pink is the color we all take notice of in regard to breast cancer. Heart disease is more deadly than all forms of cancer combined.

Is there a color for congestive heart failure? ›

What is the Color for Heart Disease? The color that has been chosen for heart disease is red, and it is actually shared with a few other prominent conditions. Heart disease impacts a majority of families, which is why having a supporting color is so important.

How does heart failure affect the lips? ›

Blue lips

Blue lips are another symptom of reduced oxygen in the blood. While some experience blue lips temporarily due to high altitude or low temperatures, the phenomenon is most common in those with poor circulation.

Is cyanosis fatal? ›

Peripheral cyanosis is rarely a life-threatening medical emergency. However, it is essential to determine the underlying cause and its timely management to prevent potential complications.

What does anemia look like in the mouth? ›

A condition known as anemia gums causes gums to become pale and whitish. A lack of blood flow and oxygen can cause the gums to deteriorate or become infected, and the connective tissue holding the teeth in place becomes loose, potentially leading to tooth loss.

What is the difference between cyanosis and anemia? ›

Cyanosis is caused by an increase in the deoxygenated haemoglobin level to above 5 g/dL. In fact patients who have anemia do not develop cyanosis until the oxygen saturation (also called SaO2) falls below normal haemoglobin levels.

Does blue lips mean dehydration? ›

You could be severely dehydrated if, in addition to any of these symptoms, you become confused or disorientated, are difficult to rouse, your lips turn blue or your breathing or pulse becomes rapid. Severe dehydration is dangerous and you will need urgent medical treatment.

Can high blood pressure cause blue lips? ›

3 lesser-known causes of blue lips

Three less common causes of blue lips include: Polycythemia vera (a bone marrow disorder that leads to excess production of the red blood cells) Cor pulmonale (a decreased function of the right side of the heart caused by long-term high blood pressure)

Is cyanosis serious? ›

Over time, cyanosis will become life threatening. If left untreated, it can lead to acute or chronic respiratory failure, heart failure, and even death.

What are the symptoms of cyanosis in adults? ›

The main symptom of cyanosis is a bluish discoloration of your skin. The bluish tone may also affect your lips, tongue, gums, ears and nails. If you have darker skin, cyanosis may look more gray or white. It may also show up more around your lips, tongue, gums, nails and eyes.

Does blue lips mean hypothermia? ›

Signs and Symptoms

The symptoms of mild hypothermia are all to common, you may have come across someone displaying these yourself. They will be shivering, possibly be incoherent, will have bluish lips and pale, cold skin.

What are the symptoms of central cyanosis? ›

The most common symptom associated with central cyanosis is a blue discoloration of the tongue and lips. Discoloration caused due to cyanosis can also manifest itself with other heart or respiratory symptoms such as: Chest pain. Difficulty in breathing.

What are the symptoms of peripheral cyanosis? ›

Peripheral cyanosis is the bluish discoloration of the distal extremities (Hands, fingertips, toes), and can sometimes involve circumoral and periorbital areas. Mucous membranes are generally not involved. Peripheral cyanosis is rarely a life-threatening medical emergency.

Are lips peripheral cyanosis? ›

Inspection: Central cyanosis produces a blue discolouration of the mucous membranes of the lips and tongue as well as the extremities. Peripheral cyanosis affects the extremities and the skin around the lips but not the mucous membranes.

Can stress cause lip issues? ›

They're fluid filled lesions that often show up on or around your lips or the roof of your mouth. An outbreak of these annoying sores usually occurs during those times when you are going through a lot of stress and anxiety.

Can panic attacks cause purple lips? ›

Seek immediate medical care (call 911) for serious symptoms, such as sweating, severe difficulty breathing, and chest pain or pressure, which may be combined with pale or blue lips, fast heart rate, and anxiety. While these are symptoms of a panic attack, they may also be symptoms of a heart attack.

Can anxiety affect your lips? ›

Like depression and stress, anxiety can cause noticeable dryness of the lips and the mucus membrane that lines the inside of the mouth. Dry mouth can also occur when you're taking certain anti-anxiety drugs.

When should I go to the hospital for cyanosis? ›

Blue skin and lips is usually caused by low blood oxygen levels or poor circulation. It can be a sign of a serious problem. Call 999 or go to your nearest emergency department immediately if you notice an adult or child suddenly turning blue.

What are the stages of cyanosis? ›

Cyanosis can be divided into Central Cyanosis, Peripheral Cyanosis, Differential Cyanosis, or Cyanosis, amongst new-borns and babies.

What is cyanosis an indicator of? ›

The presence of cyanosis might be an indication of inadequate oxygen delivery to the peripheral tissues. It also could be related to an increased oxygen extraction by the peripheral tissues. Several factors play a significant role regarding oxygen delivery to the end organs.

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