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.
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
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.
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.
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:
- cigarette smoke
- fumes from household cleaners
- cold and flu viruses
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.
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.
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
- 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.
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.
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)
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.
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.
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.