Isla Bennett
A purple hue on the fingernails or nail beds is usually a harmless symptom of being cold. This occurs when the body is cold and trying to keep the internal organs warm rather than the extremities. However, it can also be a sign of something more serious, such as an underlying condition affecting the lungs or heart. This is known as cyanosis, which is caused by a lack of oxygen in the blood. If your nail beds don't return to a normal colour within a couple of hours, you should seek medical attention.
| Characteristics | Values |
|---|---|
| Condition | Harmless symptom of being cold, or possibly frostbite |
| Medical term | Peripheral cyanosis |
| Cause | Lack of oxygen in the blood due to cold temperatures |
| Other causes | Underlying conditions such as heart, lung, or blood conditions |
| Other causes | Vascular blockage, heart failure, shock |
| Other causes | Circulation problems, issues with hemoglobin |
| Other causes | Conditions affecting blood cells, e.g. polycythemia vera, methemoglobinemia |
| Other causes | Structural heart issues present from birth |
| Other causes | Lung conditions causing low oxygen levels in the blood (hypoxemia) |
| Other causes | High altitudes, choking, swelling around vocal cords, inflammation of the throat flap |
| Other causes | Infection in the respiratory tract, blood clot in the lung (pulmonary embolism) |
| Other causes | Central cyanosis, where parts of the body other than hands and feet are affected |
| Symptoms | Bluish or purplish discolouration of the skin, lips, tongue, gums, eyes or nails |
| Symptoms | White or grey discolouration for those with darker skin tones |
| Treatment | Oxygen therapy |
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What You'll Learn
Harmless symptom of being cold
It can be alarming to see your finger nails turn purple when exposed to cold temperatures. However, this phenomenon is usually a harmless symptom known as peripheral cyanosis, characterised by blue or purple discolouration in the nails, fingers, toes, and nose. It occurs when your blood lacks the oxygen it needs to reach different tissues in your body.
Peripheral cyanosis is often caused by cold exposure, which can be harmless, but it can also be indicative of more serious underlying conditions. For example, it can be caused by certain lung and heart conditions, circulation problems, issues with hemoglobin, and more. In some cases, it may be necessary to seek immediate medical attention.
In colder weather, the blood vessels in your hands, feet, and ears constrict to preserve your body temperature. This can cause the skin or membrane below the skin to turn a purplish-blue colour. This is a natural occurrence and is the body's way of prioritising keeping your organs warm.
If you notice that your finger nails are turning purple in the cold, it is important to monitor the situation. While it is usually harmless, if the discolouration does not go away within a few hours, or if it spreads, it could be a sign of frostbite or another serious condition, and you should seek medical attention.
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Peripheral cyanosis
However, if the discolouration does not disappear within a few hours or begins to spread, it may be a sign of frostbite or an underlying medical condition, and medical attention should be sought. Peripheral cyanosis can be a symptom of more serious health issues, including problems with arteries, heart failure, deep vein thrombosis, or hypovolemic shock. It can also be caused by Raynaud's disease, which causes the blood vessels in the extremities to constrict, limiting blood flow and often causing purple or white hands and feet.
The primary symptom of peripheral cyanosis is the blue or purple discolouration of the skin. This discolouration is typically more noticeable in people with lighter skin tones, but it can also be observed in people with darker skin pigmentation, where it may appear more grey or white. The condition usually affects the hands, fingertips, and toes, but can also be observed in the skin around the mouth, nails, tongue, gums, eyes, and ears.
The mechanism behind peripheral cyanosis is an increased concentration of deoxyhemoglobin on the venous side of the peripheral circulation. Deoxyhemoglobin is the form of haemoglobin that has a limited ability to bind to oxygen and carry it to the cells. This results in a decrease in the amount of oxygen bound to the haemoglobin in the red blood cells, causing the skin to appear bluish or purplish.
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Central cyanosis
The main symptom of central cyanosis is a bluish or purple discolouration of the skin, lips, tongue, gums, nails, or other affected areas. The hands and feet are usually a normal temperature or warm, unless there is associated poor peripheral circulation. Central cyanosis may also be accompanied by other symptoms, such as dyspnoea and tachypnoea, or secondary polycythaemia.
Treatment for central cyanosis focuses on addressing the underlying cause, as cyanosis is a symptom rather than a disease itself. Oxygen therapy is usually the first treatment option.
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Raynaud's phenomenon
There are two types of Raynaud's phenomenon: primary and secondary. Primary Raynaud's occurs on its own and is the most common type, often starting between the ages of 15 and 25. It is less severe than secondary Raynaud's, and people with primary Raynaud's rarely develop a related condition. On the other hand, secondary Raynaud's develops alongside other underlying diseases, such as lupus, scleroderma, and various connective tissue diseases. Adults who develop Raynaud's after the age of 35 are more likely to have the secondary form and are advised to undergo testing for these underlying conditions.
The symptoms of Raynaud's phenomenon include fingers that turn pale or white, then blue when exposed to cold or during stress or emotional upset. As the hands are warmed, they turn red as blood flow returns. In some cases, the hands may become swollen and painful when warmed. While Raynaud's phenomenon is not considered life-threatening, it can cause discomfort and impact an individual's quality of life. There is currently no cure for Raynaud's, but symptoms can be managed through preventive measures and proper treatment.
To manage Raynaud's phenomenon, it is crucial to stay warm, dress appropriately for cold weather, and avoid smoking. Yearly check-ups with a healthcare provider can help diagnose and treat any underlying conditions that may contribute to Raynaud's. Additionally, self-care practices, such as learning to avoid triggers and manage attacks, are essential for living with the condition. In severe cases, sores may develop on the finger pads, which can progress to gangrene if left untreated.
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Heart conditions
Purple nails are often caused by a lack of oxygen in the blood, known as cyanosis. This can be due to exposure to cold temperatures, as well as certain lung and heart conditions, circulation problems, issues with hemoglobin, and more.
Congenital heart disease: This is when babies are born with abnormal heart structures and blood vessels. Some cases are asymptomatic, while others cause life-threatening symptoms.
Eisenmenger's syndrome: A rare disorder that affects the heart and lungs, often as a late complication of congenital heart disease. It causes high blood pressure and abnormal blood flow through the heart.
Congestive heart failure: This condition leaves the heart unable to pump blood properly, leading to symptoms like shortness of breath, extreme fatigue, and swollen extremities.
Vascular blockage: A blockage in the blood vessels can lead to reduced blood flow and oxygen delivery to the nails, causing them to turn purple.
Heart defects present at birth: Structural issues with the heart from birth can cause cyanosis and lead to purple nails.
While having purple nails due to cold exposure is usually harmless, it is important to monitor the color change. If the discoloration persists for several hours or spreads, it may indicate frostbite or an underlying heart condition, and medical attention should be sought to prevent permanent damage.
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Frequently asked questions
It is usually a harmless symptom of being cold. This is because the body is trying to prioritize keeping your organs warm rather than your extremities. However, if your nail beds don’t turn back to a normal color within a couple of hours, or the discoloration spreads, you may be suffering from frostbite and should seek immediate medical care to prevent permanent damage.
The medical term for purple nails is cyanosis, which occurs when there is a lack of oxygen circulating in the blood.
Cyanosis can be caused by exposure to cold temperatures, certain lung and heart conditions, circulation problems, issues with hemoglobin, and more.
