What Does It Mean When a Baby’s Hands or Feet Are Purple?

Generally, skin color changes to blue or purple when the area is cold or is not receiving enough oxygenated blood. Although abnormal in adults, purple hands and feet can be normal in children, even up to a few years old. The color change is called acrocyanosis, and it can be related to the temperature in the room but may happen at other times as well, like when a child is upset.

Read on to learn about acrocyanosis in babies as well as other reasons a baby's hands or feet may turn purple and when to talk to a health care provider.

Causes of Purple Hands and Feet in Babies

In babies, blue or purple hands or feet are most often caused by a common condition known as acrocyanosis. However, there are a few other things that can cause skin discoloration.

Acrocyanosis

Acrocyanosis is when extremities temporarily turn blue or purple because of blood vessel constriction. Most often, it's the result of a cold environment.

Acrocyanosis is common in newborns because their bodies are still adjusting to life outside the womb, and their circulation is changing. The condition most often affects the hands and feet but can also affect the face. Acrocyanosis is rarely concerning in babies, and warming them up helps.

Cyanosis

Unlike acrocyanosis, cyanosis is serious. It is caused by a lack of oxygen in the blood. One way to tell the difference between acrocyanosis and cyanosis is that cyanosis affects more than just the hands and feet.

With cyanosis, a baby's skin turns bluish or purplish on other body parts, including the trunk, head, and mouth. Since it occurs in the central part of the body, it's also called central cyanosis.

Central cyanosis is serious and is never normal in infants or the newborn period. According to Cincinnati Children's Hospital, it often indicates an underlying condition such as an airway blockage, lung disease, or congenital heart condition.

Raynaud’s phenomenon

Raynaud's phenomenon is similar to acrocyanosis except that Raynaud's attacks occur due to exposure to the cold or emotional stress; with acrocyanosis, purple hands and feet may be more consistent.

There are two types of Raynaud's—primary and secondary. There is no known cause with primary, but with secondary, an underlying medical condition like an autoimmune disease causes it.

Symptoms include skin on extremities that turn white, then blue or purple. In addition, as the areas warm, and circulation returns, it may feel painful and turn red.

Diagnosis of Purple Hands and Feet in Babies

If your baby has no other symptoms besides purple hands or feet, a health care provider may not feel further evaluation beyond a physical exam is necessary. That's because acrocyanosis is common and not a cause for concern in most infants.

If, however, your child exhibits other symptoms or a health care provider suspects another condition after listening to their heart or lungs, they may refer you to a specialist or run some tests. According to Children's Hospital Colorado, tests could include:

• Chest X-ray
• Electrocardiogram (a non-invasive test that records the electrical activity of the heart)
• Echocardiogram (a test that uses sound waves to look at the heart)
• Heart catheterization (a test where a long, thin tube is placed into a blood vessel and guided to the heart so doctors can see the heart)

Again, invasive tests are often unnecessary to diagnose a baby's purple hands or feet.

Treatment for Purple Hands and Feet in Babies

If your baby has acrocyanosis, no treatment is necessary. The best course of action is to keep your baby at a comfortable temperature, including dressing them in layers so it's easier to help them manage their body temperature.

If your child's purple hands or feet are caused by cyanosis, on the other hand, treatment may involve monitoring, medication, or even surgery. For Raynaud's phenomenon, if the condition is secondary, meaning an underlying health condition causes it, treatment will involve addressing that specific cause.

When to See a Health Care Provider

If your baby's purple hands or feet concern you, make an appointment for a complete physical examination. A health care provider may place a pulse oximeter on a finger or toe to ensure that the blood traveling to that extremity has adequate oxygen levels. If they have concerns about your child's heart or lung function, they will refer you to a specialist.