Blue Toe Syndrome; Threatening or Harmless?

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Blue Toe Syndrome; Threatening or Harmless? 

All you need to know about Blue Toe Syndrome; Causes, Symptoms, Treatment and Prevention. 

Have you ever had a purplish-blue toe and wondered what it was? You left it untreated and quite surprisingly, it only got worse and you had to give immediate medical attention to it.

You’re likely encountering the “Blue Toe Syndrome” which can or cannot be an emergency,  depending on the cause and severity of your case. 

What is Blue Toe Syndrome? 

Blue toe syndrome highly occurs due to acute digital ischaemia and affects the toes resulting in blue or purplish coloured toes. This indicates that your toes aren’t receiving adequate amounts of blood and oxygen in those areas.

You may even notice dispersed patches of bluish colouration on the forefoot or the soles of your feet which is commonly referred to as cyanosis. The medical term for this syndrome is known as “Occlusive Vasculopathy.” 

When your toes receive insufficient or poor blood circulation, it causes your feet to go numb and cold, weakening the cells and tissues of your toes and prompting the change of colour. You may feel excruciating pain in your feet or legs and find it difficult to walk causing you to limp. 

This could be caused due to several reasons which you need to find the diagnosis for by visiting the nearest hospital and getting the accurate treatment for it. 

Blue Toe Syndrome Causes: 

Causes of Blue toe syndrome can be:

  1. Cold Weather
  2. Embolism
  3. Subungual Hematoma
  4. Vasoconstrictive dysfunctions 
  5. Cyanosis
  6. Pharmaceutical and Recreational Drugs

Cold Weather: 

The most harmless cause out of all the above mentioned is cold weather. If you’re someone residing in an area where temperatures tend to drop really low in winters, it is very likely that you’d notice your nails turning blue or purplish if you aren’t wearing socks. It is actually the skin beneath which changes its colour due to the contraction of your blood vessels which slows the process of blood circulation in your toes. So, don’t forget to wear warm socks in winters to refrain from blue toes! 


Embolism is an obstruction created due to a blood clot in any artery of your body. The blood clots, caused by deep vein Thrombosis, could’ve come off from another location and made its way to a blood vessel blocking the flow of blood in that area.

If a clot travels and blocks an artery or arteries in your toes or feet, you might feel extreme pain, that area would be warmer than the whole body, change in colour and you might even see some swelling. This could worsen so you need to visit the doctor as soon as possible. 

Subungual Hematoma: 

Ever hit your toe or toe nail really badly while casually walking? There’s a high possibility that soon enough you’d find your toe turning blue. This is what Subungual Hematoma is. When your fingernail or toenail suffers from a trauma, it bruises, likely provoking a blood vessel to break, hence blood gets trapped in your nail. 

The skin beneath the nail starts bleeding and forming Subungual Hematoma with time. If the trauma was minor and it caused a small portion of Subungual Hematoma, the trapped blood will reabsorb over time, for a toenail up to 6-9 months.

If it still doesn’t go away, do not try to drain the blood at home as this could cause further infection. You can get the clotted blood drained or the nail removed by a doctor.

Vasoconstrictive Dysfunctions:

When your blood vessels narrow due to the small muscles in the walls of the vessels, the blood flow of that entire region slows down or gets blocked completely. This can also occur in our feet near the toes area causing the Blue Toe Syndrome.

It can be caused due to diseases such as Raynaud Phenomenon which is further originated by the reasons of arthritis, smoking, autoimmune conditions such as Sjogren’s Syndrome or Lupus. You might lose feeling of sensation in the affected areas and a tingling in your toes. 


Cyanosis occurs when oxygen is depleted in the bloodstream in an area. When the oxygen levels aren’t sufficient in blood, the blood turns blue or dark purple, giving a tint of blue on the skin.

Cyanosis is caused by abnormal haemoglobin and deoxygenated haemoglobin disorder which happens due to underlying conditions affecting the cardiovascular system or respiratory system. This problem can originate on your toes leaving behind a Blue Toe. 

Pharmaceutical and Recreational Drugs:

Excessive use of recreational drugs such as tobacco or cocaine can cause Blue Toe Syndrome and even pharmaceutical medicines that are used for treating blood clots or thinning of blood can cause blue toe nails. 

Blue Toe Syndrome Symptoms:

The symptoms can vary due to mild or severe conditions but collectively a person suffering from blue toe syndrome would like a face;

  1. Blue-purple discolouration
  2. Pain which can vary from mild to acute pain 
  3. Numbness; loss of sensation
  4. Mild swelling
  5. Lesions; their discharge having a bad odor. 

Blue Toe Syndrome Treatment: 

All the treatments should be done under the prescription of a doctor and by a doctor. The treatment also varies according to the source of diagnosis. The most viable treatment for blue toe syndrome is surgery. Surgeries like;

  1. A bypass surgery which would generate a bypass around the blockage caused by a clot. The surgeon will rationally take a healthy blood vessel from another area of your body. This would resolve the blue toe syndrome caused by Embolism, vasoconstrictive disorders, 
  2. A stent is directly inserted into the infected blood vessel which then unblocks the vessel and healthy, oxygenated blood is flowed into the affected blood vessel. This most likely resolves Cyanosis.
  3. The Blue Toe Syndrome caused by Subungual Hematoma can be treated by draining the clotted blood from the affected toe by a surgeon or amputating the toenail. 

After the surgery you need to rest well, keep the affected toe clean and warm and stay hydrated by drinking lots of water and healthy drinks. 

Prevention from Blue Toe Syndrome: 

Prevention of Blue Toe Syndrome can be easy for causes such as cold weather or drugs but for the other causes, it can be tricky to maintain as you need to keep your respiratory and cardiovascular system completely healthy:

  1. Make sure to stay warm and hydrated during cold weather. Wear socks and warm shoes to prevent blue toes. 
  2. Stop smoking or consuming drugs which aren’t just causing Blue Toe Syndrome but many more diseases. 
  3. Intake healthy foods like dark leafy vegetables, fish and fruits. 
  4. Exercise regularly.
  5. Get important tests such as CBC or blood pressure or blood sugar done time and again to keep your cardiovascular system in check. 

3 FAQs relating to Blue Toe Syndrome:

  1. Are Blue Toes Serious?

If the blue toe syndrome is caused by Cold weather, subungual hematoma, it isn’t really serious but if it is caused due to Vasoconstriction Disorders, Cyanosis or Embolism, it can be threatening as it means you have a underlying condition which needs to be treated as soon as possible and in some cases, can result in amputation of toes. 

  1. Can Blue Toe Syndrome go away?

Yes, it usually disappears in a course of a year but can also be treated through surgeries which would make the blue colour go away.

  1. How to diagnose Blue Toe Syndrome?

The doctor would perform an angiogram or an ultrasound of your toe to reach the source of Blue Toe Syndrome. 


You might face Blue Toes Syndrome once in your life and whenever you do, do visit your doctor and try to reach to the cause of it. Proper care of your health and toes can prevent Blue Toes from happening.

The natural remedy that you can follow for blue toes when caused by Subungual Hematoma is to put on an ice pack as soon as you stub your toe. This would reduce the pain and swelling. However, always follow the instructions prescribed by the doctor for such conditions, you never know what could trigger it and worsen the condition.