While acrocyanosis can be due to a blood vessel abnormality, it is typically due to one’s environment. Acrocyanosis is also particularly common in newborns in their first few hours of life as their circulation changes.
Though less common, there are also times when acrocyanosis can be a sign of an underlying medical condition that requires treatment.
Learn more about the symptoms and underlying causes of acrocyanosis, as well as how it is diagnosed and treated.
Types and Symptoms of Acrocyanosis
The most common symptoms of acrocyanosis are:
Blue-colored fingers or toes Cold and sweaty hands and feet Low skin temperatures Slow blood flow Swelling in hands and feet
Symptoms of acrocyanosis improve with warm temperatures and worsen with cold temperatures. Skin color may improve with movement, especially in the hands.
The hands and feet are most commonly affected in acrocyanosis. However, the condition can also affect the nose, ears, lips, nipples, wrists, and ankles.
Depending on the type of acrocyanosis, symptoms may affect one or both sides of the body:
Primary acrocyanosis: May affect both sides of the body equally (e. g. , if one palm is blue, the other one is as wellSecondary acrocyanosis: Only one side of the body is affected and skin color changes are usually accompanied by pain and potentially tissue loss
What Causes Acrocyanosis?
Primary acrocyanosis is caused by constriction of the small blood vessels that deliver oxygen-rich blood to the extremities. Secondary acrocyanosis is due to an underlying medical condition.
Primary Acrocyanosis
This constriction may be due to:
Cold temperaturesLiving in areas of high altitudes with lower oxygen pressure and increased cold temperatures and windGenetic defects in the blood vesselsChanges in circulation after birth
Primary acrocyanosis in newborns occurs because blood and oxygen flow to the brain, lungs, kidneys, and other important body parts first—not the hands and feet.
Newborns with bluish-colored hands and feet will improve within the first few hours once the body gets used to the new blood circulation pattern.
Secondary Acrocyanosis
The most common causes of secondary acrocyanosis are Raynaud’s disease and eating disorders.
Other causes of secondary acrocyanosis include:
Infections Vascular diseases Blood disorders Cancer Genetic conditions
Diagnosis
A diagnosis of acrocyanosis is made by physical examination and medical history, including the assessment of symptoms.
It is a good idea for anyone with symptoms of acrocyanosis to contact their healthcare provider.Primary acrocyanosis is a generally harmless condition with a good outlook, but underlying causes of secondary acrocyanosis can be serious.
Physical Exam
A primary acrocyanosis diagnosis is based on a bluish color of hands and feet (and sometimes the nose and ears), when hands and feet are cold and sweaty, and when symptoms are not causing pain.
When there is no pain, the blue color is not associated with a disease of impaired circulation.
Testing
Circulation in the small blood vessels can be measured using a non-invasive technique called capillaroscopy, which examines the capillaries at the nailbeds.
When secondary acrocyanosis is suspected, other testing and imaging may be done to determine the cause of the symptoms.
Acrocyanosis Treatment
There is no specific treatment for acrocyanosis; however, symptoms can be managed.
In newborns, the condition dissipates on its own or can be resolved by warming the body temperature. Once symptoms resolve, acrocyanosis doesn’t usually return.
In older children and adults, keeping hands and feet warm and covering up their body parts can protect them from cold temperatures.
Severe cases may be treated with medications, including alpha blockers or medicines that relax muscles and help small blood vessels to remain open.
Secondary acrocyanosis symptoms resolve when the underlying condition is treated and managed.
Fingers or toes that are a shade of dark blue or purpleCold, sweaty hands or feetLow skin temperatureReduced blood flowHand and feet swelling
Reglan (metoclopramide)Tofranil (imipramine)Norpramin (desipramine)Prozac (fluoxetine)
