Acrocyanosis in Newborns – What is it, Causes and Symptoms

6 min read

Written by Aparna Hari

Aparna Hari

Acrocyanosis in Newborns

Do you wonder why your newborn’s fingertips get purple or bluish after a bath? It happens when your baby feels very cold and requires immediate warmth. This condition is medically known as Acrocyanosis. Acrocyanosis in newborns occurs because of the temperature change they face suddenly after birth.

Acrocyanosis due to cold temperature is quite normal in newborns and cures without medical help within the first few days after birth. But if acrocyanosis or the bluish discoloration of the skin occurs other than the peripheral organs like limbs, mouth, nose, ears, and nipples then it can be serious. Some underlying diseases and genetic disorders can also cause acrocyanosis in newborns. Here is all you need to know about acrocyanosis in newborns and when you need to concern.

In This Article

What is Acrocyanosis?

Acrocyanosis is a condition in which the skin of our hands and feet gets bluish due to a lack of blood supply. It can also occur in the nose, ears, around the mouth, and nipples. In acrocyanosis, the skin around the mouth and other extremities gets bluish or purple and colder than other parts of the body.

This condition can happen due to exposure to extreme colds which creates cold agglutinin antibodies that attack red blood cells and stagnant the blood flow mistakenly in our body. A lack of oxygen-rich blood supply in those particular areas of the body due to some underlying diseases can also cause acrocyanosis.

Causes of Acrocyanosis in Babies

There are two types of acrocyanosis i.e. primary acrocyanosis and secondary acrocyanosis. The cause of acrocyanosis depends on its type.

1. Primary Acrocyanosis

In the case of primary acrocyanosis, the cause is not clear because not enough studies are conducted regarding this topic. This is because primary acrocyanosis is considered to be harmless as it cures without medical help within a few hours or days.

According to a study published by NIH, the main reason behind primary acrocyanosis is the constriction of blood vessels that supply oxygen-rich blood to the limbs.

Another study published in Pediatric Rheumatology shows that in newborn babies, acrocyanosis occurs due to benign vasomotor changes. The sudden temperature shift from the mother’s cozy womb to the outside world usually results in this condition. The blood circulation of a newborn towards its vital central organs such as the brain, heart, or lungs before comparatively less important organs such as limbs can also cause primary acrocyanosis.

2. Secondary Acrocyanosis

There can be a lot of underlying causes behind secondary acrocyanosis in which bluish spots get painful. The causes of secondary acrocyanosis can be

  • Peripheral vascular disease
  • Down syndrome
  • Connective tissue disease
  • Hypoxemia
  • Neoplasms
  • Blood distribution disorders
  • Congenital heart abnormalities
  • Exposure to toxins or poison
  • Atopic dermatitis
  • Infection
  • Genetic problems

[Read : Down Syndrome And Your Child]

Symptoms of Acrocyanosis in Newborns

Acrocyanosis Newborn Symptoms

The basic symptom of acrocyanosis is painless discoloration of the skin mainly on the palms, feet, and around the lips. The additional symptoms that you may find in the case of acrocyanosis in babies are

  • Purple or bluish skin discoloration on limbs and around the mouth
  • Discoloration in the nose, ears, lips, nipples, and forearms in some cases
  • Cold and occasionally swollen fingertips
  • Comparatively colder body temperature in the bluish areas
  • Symmetrical or even distribution of the bluish discoloration
  • Excessive sweating on the limbs

In acrocyanosis in newborns, bluish discoloration usually occurs in the hands and feet of the baby just after birth. And it usually disappears within one to two days without any medical assistance.

Risk Factors For Acrocyanosis in Newborns

Acrocyanosis Newborns Risks

One cannot predict or prevent the risk of a newborn getting acrocyanosis. It can occur to any newborn after birth. But in certain conditions, the risks of getting acrocyanosis becomes higher such as

  • If the baby has a low birth weight or BMI (body mass index)
  • If the baby has circulatory system-related issues that can directly affect blood circulation
  • In case of prolonged exposure to colder temperatures after birth
  • A journal published in Sage Journals shows that a newborn girl is at a higher risk of having acrocyanosis than a newborn boy.

[Read : Low Birth Weight in Babies]

Diagnosis of Acrocyanosis

For the diagnosis of primary acrocyanosis or bluish skin without pain, only a physical examination is enough. The doctor may ask whether your previous baby (if any) or any other person in your family had acrocyanosis during infancy.

But in case of painful discoloration or discoloration in central regions of the body such as the chest or head, the doctor can conduct various diagnostic tests. The doctor can suggest a complete blood count test or CBC to check if there is any underlying disease or not.

Arterial blood gas tests can be done to check the oxygen level in the blood of the newborn. To detect any irregularities in the heartbeat of the newborn the doctor can conduct an electrocardiogram test.

Treatment For Acrocyanosis in Newborns

Acrocyanosis Treatment

In the case of primary acrocyanosis, the bluish discoloration will go away when you keep your baby wrapped and warm. There will be no need for medicines for acrocyanosis due to cold weather. You can use cotton socks and mittens to cover the feet and palms of your baby. Also, try to swaddle wrap the baby to give them the same feeling of warmth and coziness they used to get inside your womb. You can use room heaters if it is winter.

In the case of secondary acrocyanosis, treatments will be given according to the results of the diagnostic tests. Secondary acrocyanosis will recover when the underlying factor is treated appropriately. In case of genetic causes, you may have to follow a long-term treatment to avoid acrocyanosis in your baby.

[Read : How To Swaddle A Baby]

When to See a Doctor?

Acrocyanosis in newborns usually cures within a few hours or a day or two if you properly warm your baby. Thus, you can talk to the doctor about how to keep your baby warm. But you need to seek the doctor’s advice if the acrocyanosis persists over 5 days or if the discoloration expands or gets darker. Also, if acrocyanosis occurs in the central part of the body or if you suspect an underlying cause behind the acrocyanosis in your baby then talk to the doctor immediately.

So, there can be lots of reasons behind acrocyanosis in newborns. It is usually harmless but can sometimes indicate deeper complications. But in newborns, acrocyanosis is thankfully not that concerning. Acrocyanosis in newborns generally cures within a few days when the baby gets used to the outer world. So, give time to your baby to adjust to the new world but always keep an eye out for any unusual changes. And talk to the doctor immediately if anything concerns you about acrocyanosis in your baby.


1. Is Acrocyanosis an Autoimmune Disease?

All cases of Acrocyanosis are not autoimmune conditions. Acrocyanosis can be an autoimmune condition in case of the cold agglutinin disease. In this disease, our immune system creates antibodies named cold agglutinin in response to cold temperatures. The antibodies then mistakenly bind the surface of red blood cells and make them clump and clog the blood vessels and resulting in acrocyanosis.

2. Are There Any Complications or Long-Term Effects Associated With Acrocyanosis in Newborns?

Acrocyanosis in newborns generally does not have any complications or long-term effects as such. But in the case of secondary acrocyanosis, the underlying cause of the acrocyanosis can have a long-time effect or lead to further complications if not treated in time.

Read Also: Birth Asphyxia – Signs, Causes, Diagnosis and Treatment by Dr Lathiesh Kumar Kambham

Aparna Hari,MBA in Marketing,P.G. Diploma in Human Resource Management from IGNOU Bachelor of Sciences (Home Science) from Nagarjuna University

Her experience in impactful writing combined with her background in Home Sciences makes Aparna the perfect candidate for content writing in the pregnancy and parenting niche.Read more.

Responses (0)

Please check a captcha

Want curated content sharply tailored for your exact stage of parenting?

Discover great local businesses around you for your kids.

Get regular updates, great recommendations and other right stuff at the right time.


Our site uses cookies to make your experience on this site even better. We hope you think that is sweet.