Why Are My Fingernails Blue and What Should I Do About It?

It can be unsettling to notice that your fingernails have changed color to purple or blue. What causes this condition and is it dangerous?

Our fingernails can indicate that there is a serious health problem demanding our attention. In many cases, this isn’t a skin or nail problem, but rather an issue with your circulation. Let’s look at some of the causes behind this change.

A Cyanosis Diagnosis

When your nails, fingers, hands, or feet turn blue, you have peripheral cyanosis. Cyanosis is the medical word for when the skin or certain mucous membranes turn blue.

In the majority of cases, cyanosis happens because there is a low level of oxygen in your red blood cells. In the case of fingernails, this might just be a consequence of cold temperatures.

When your fingers are exposed to the winter air, the blood vessels constrict. This reduces the amount of oxygen that reaches your fingernails. In normal cases, this will go away as soon as you warm up your limbs. Massaging your hands and fingers can help.

However, there are cases when cyanosis is more permanent, which indicates that there is something else wrong with your health.

What Should You Do About Your Blue Fingernails?

If you’re wondering “Why are my fingernails blue all the time?”, there could be a serious issue at hand. A reoccurring bluish tint to your nails could indicate a problem with your heart health, your lungs, or your blood cells. In each case, the flow of oxygen to your nails is disrupted.

Does this require medical treatment? If your fingernails are often blue but you don’t have any other symptoms, you should bring it up with your doctor. They should be aware of the issue, and they might suggest some tests.

But there are cases when cyanosis is more urgent. If you’re experiencing chest pain, shortness of breath, dizziness, or intense sweating along with your nails turning blue, you need to call 911 immediately.

Why Are My Fingernails Blue? 5 Conditions That Cause Cyanosis

Now, let’s look at some specific illnesses and circumstances that cause your fingernails or toenails to change color to blue.

1. Carbon Monoxide Poisoning

CO poisoning comes with headaches, weakness, dizziness, vomiting, and chest pain. The condition can cause confusion as well. You probably know that it can be fatal – hundreds of people across the US die of unintentional carbon monoxide poisoning every year.

It’s not always easy to spot the symptoms, and cyanosis can be a good indicator that something is wrong. If you suspect, for any reason, that there are dangerous levels of CO in your home or your vehicle, leave immediately and contact emergency services.

2. Raynaud’s Phenomenon

Blue or pale fingernails are one of the top symptoms of Raynaud’s phenomenon. This disease comes with numb and cold fingers and toes. A Raynaud’s attack shouldn’t be excessively painful, but it’s uncomfortable and can disrupt your everyday routine. Once the attack passes, your fingers will start throbbing and stinging as they warm up again.

The causes behind this phenomenon aren’t clear yet, but doctors believe it comes from a spasm in the blood vessels. Cold temperatures can trigger it. People who work with vibrating tools, such as jackhammers, are at an increased risk. Repetitive motions like typing can put you at risk too.

Since the condition can cause serious complications, you should talk to your doctor about it. There are medications, like vasodilators, that can help reduce the frequency and severity of attacks. Chemical injections and surgery can be an option as well.

3. PVD

PVD stands for peripheral vascular disease, a painful blood vessel condition. People with PVD have narrowed blood vessels, which leads to pain and fatigue.

If you leave it untreated, this condition can have very serious consequences. Clots could form in the blood, blocking off your blood vessels entirely. This leads to irreparable organ damage.

Sometimes, PVD can be a direct response to the environment. For example, it can come from emotional stress or from operating vibrating machinery. But for many people, it comes from diseases that affect the blood vessels, such as diabetes and high blood pressure. Smokers are at an increased risk of PVD, and it tends to affect older people more often.

This condition can be treated with lifestyle changes and medication. When PVD leads to the formation of dangerous clots, surgery or angioplasty may be necessary.

4. Pulmonary Embolism

When a blood clot occurs in the lungs, it leads to pulmonary embolism. This is lethal in one of three cases, and it requires immediate medical attention.

In many cases, it causes blue nails and blue skin. You may also feel chest pain, an irregular heartbeat, lightheadedness, or anxiety. Sometimes, it leads to people spitting up blood, but that symptom isn’t always present.

Doctors can use a chest X-ray, an ECG, and many other forms of diagnostics to find the problem. In the case of minor clots, they’ll prescribe clot-dissolving drugs and anticoagulants. But in more serious cases, immediate surgery is necessary.

5. Emphysema

This is a serious and incurable respiratory condition that mainly affects smokers. Emphysema often comes with blue lips and fingernails. Other symptoms include a fast heartbeat, weight loss, depression and intense fatigue.

Coughing is the top symptom of emphysema. Additionally, people who have a mild form of this condition tend to get winded after strenuous physical activity. As it progresses, they feel out of breath even when they’re resting.

If you suspect you have emphysema, contact a doctor right away. There are ways they can slow the progression of the disease. Steroids and other drugs help keep your blood vessels in good condition. You may also need to take antibiotics to prevent infections like pneumonia that make emphysema worse.

Some people need surgery to remove the damaged parts of the lung. But before taking that option, your doctors may prescribe oxygen therapy. In extremely severe cases, emphysema patients need 24/7 oxygen therapy.

Pay Attention to Your Nails

Even when you’re not experiencing other symptoms, your fingernails becoming blue can be a danger sign. Any changes in your blood vessels and blood cells can be deadly if left untreated. Sometimes the condition can point to food poisoning or a drug overdose.

Red, yellow, pale, or striped fingernails can also be symptoms of a serious medical issue. Of course, fungal nail infections are a possibility too. These are typically very dark and can impact the shape of the nail. Whatever the root cause may be, you should take every change seriously and not ignore the problem.