Acrocyanosis In Newborn: Causes, Symptoms, Diagnosis And Treatment

This painless skin discoloration may appear even in healthy infants.

Medically reviewed by Dr. Ashraf Kasem, MS Dr. Ashraf Kasem Dr. Ashraf KasemMS MomJunction on FacebookFollow MomJunction on TwitterFollow MomJunction on YouTube Specialty: Pediatrics and Neonatology Experience: 10 years
Written by , BDS, CLC Dr. Ritika Shah BDS, CLC Follow MomJunction on Linkedin Specialty: Dental and General Health, LactationExperience: 10 years
Edited by , BSc, MBA Rohit Garoo BSc, MBA Follow MomJunction on Linkedin Specialty: Baby Health and WellnessExperience: 9 years
Fact-checked by , MSc (Biotechnology) Vidya Tadapatri MSc (Biotechnology) Follow MomJunction on Linkedin Specialty: Health and WellnessExperience: 5 years
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Acrocyanosis in newborn

Image: iStock

Peripheral cyanosis is a bluish-purple skin discoloration caused by a lack of oxygen. On the other hand, bluish-purple discoloration around the mouth and extremities, particularly the palms and soles, is called acrocyanosis. Acrocyanosis is usually considered normal in healthy newborns until there is no cyanosis in the central region of the body. Generally, acrocyanosis in newborns can happen due to benign vasomotoriNarrowing or widening of blood vessels causing changes in skin color and temperature. changes, which self-resolve during the first few days of life (1). However, the condition could develop due to other underlying issues as well.

This post discusses everything you need to know about acrocyanosis, including its symptoms, causes, risk factors, diagnosis, and treatment options for babies.

In This Article

Symptoms Of Acrocyanosis In Babies

Painless bluish discoloration of hands and feet is the most notable sign

Image: Shutterstock

The appearance of blue hands and feet, although painless, is the most notable sign of the condition. The following signs and symptoms may also be seen in acrocyanosis (2) (3).

  • Affected areas may feel cold
  • Bluish discoloration is symmetrically distributed
  • Cold and swollen fingers and extremities
  • Increased sweating in hands and feet
  • Cyanosis may occur around the mouth
  • Forearms, ears, lips, nose, or nipples may also be discolored in some cases

protip_icon Quick fact
Acrocyanosis often causes cool and clammy extremities and, rarely, may be associated with swelling (3).

Causes Of Acrocyanosis In Babies

The causes of acrocyanosis depend on whether the acrocyanosis is primary or secondary (4).

1. Primary acrocyanosis

Change in blood circulation could be the primary reason

Image: Shutterstock

The exact cause of primary acrocyanosis is unknown. In newborns, a change in blood circulation could be the primary reason. Constriction of blood vessels that transport oxygen-rich blood to the limbs may lead to acrocyanosis.

2. Secondary acrocyanosis

Secondary acrocyanosis usually happens due to an underlying condition and might be accompanied by pain in the discolored areas. It may be seen along with central acrocyanosis. It may happen in conjunction with one of the following conditions.

  • Down syndrome in babies
  • HypoxaemiaiLack of adequate oxygen in the blood.
  • Connective tissue diseases
  • NeoplasmsiAlso called tumors, masses of tissue that arise when cells divide and multiply more than they should.
  • Peripheral vascular diseasesiNarrowing or blockage of the blood vessels transporting blood from the heart to the limbs and brain, thus affecting their functioning.
  • Malnutrition
  • Blood disorders
  • Sepsis
  • Exposure to toxins
  • Infections
  • Mitochondrial diseases
  • Ehlers-Danlos syndromeiA set of inherited conditions affecting the connective tissues.
  • Buerger’s diseaseiA condition that causes clotting of blood in parts of hands and legs.
  • Spinal cord injury
  • Atopic dermatitisiA skin condition that causes dry, itchy, and irritated skin in response to an allergen.

protip_icon Things to know
Congenital heart abnormalitiesiA structural and functional abnormality with the heart that is present from birth. may also cause cyanosis in newborns (6).

Is It Normal For Newborns To Have Acrocyanosis?

It is normal for most newborns to have acrocyanosis for 24 to 48 hours after birth. The reason is the new blood circulation pattern in the baby’s body. The blood and oxygen circulate to the vital organs, such as the brain, lungs, and kidneys, instead of hands and legs. Once the baby’s blood circulation adjusts itself, the acrocyanosis goes away. It might reappear when the baby is cold after a bath but goes away by itself soon.

Risk Factors For Acrocyanosis

Low body mass index is a risk factor

Image: Shutterstock

The following risk factors may put the baby at a higher risk of developing acrocyanosis (2) (5).

  • Low body mass index (BMI)
  • Sustained exposure to colder temperatures
  • Presence of circulatory system-related problems that primarily affect blood vessels
  • Girls are noted to have a slightly higher risk than boys

Diagnosis Of Acrocyanosis

Physical examination and a thorough medical history along with detailed symptom assessment

Image: Shutterstock

Physical examination and a thorough medical history along with detailed symptom assessment are key contributors to the diagnosis of acrocyanosis. No pain with bluish discoloration is the main sign of acrocyanosis. If the doctors suspect secondary acrocyanosis, they will perform other tests and imaging.

Treatment For Acrocyanosis In Babies

The baby should be kept warm to avoid acrocyanosis due to cold weather

Image: Shutterstock

In most cases, primary acrocyanosis does not need any treatment. Pharmacological intervention is not necessary most times. The baby should be kept warm to avoid acrocyanosis due to cold weather. Make sure to wrap the baby in a towel after a bath to prevent them from feeling cold.

Treatment of secondary acrocyanosis depends on the underlying cause and the symptoms. Secondary acrocyanosis resolves when the underlying condition is treated. Some conditions, such as genetic disorders, may require long-term management to avoid secondary acrocyanosis.

Outlook For Babies With Acrocyanosis

Primary acrocyanosis is usually a harmless condition. In newborn babies, it usually resolves on its own and does not recur in most cases. Secondary acrocyanosis must be thoroughly investigated by the doctor, and the underlying condition must be addressed.

Frequently Asked Questions

1. Is acrocyanosis an autoimmune disease?

Acrocyanosis can occur as a primary or secondary response to autoimmune, neurologic, infective, and metabolic disorders or causes (6).

2. What is the Apgar score for acrocyanosis?

The healthcare professionals perform a test on the newborn baby at one and five minutes after birth. The test measures the baby’s breathing efforts, muscle tone, heart rate, skin color and reflexes to gauge how well the baby tolerated the birthing process (7).

3. Are there any complications or long-term effects associated with acrocyanosis in newborns?

Generally, acrocyanosis is a painless discoloration of the skin that resolves on its own. But in rare cases, trophic changes and ulcerations may occur in remittent necrotizing variety. Remittent idiopathic necrotizing acrocyanosis is a rare condition, which is characterized by pain, tenderness of fingers and toes. It is incensed by cold temperatures and may persist even in the summer (8).

4. What is the difference between Raynaud’s and acrocyanosis?

Acrocyanosis is rarer than Raynaud’s syndrome. Raynaud’s is a temporary discoloration of fingers and toes caused by cold or stress. It typically lasts a few minutes to an hour, whereas acrocyanosis causes persistent blue-like discoloration of the hands and feet. It mainly affects females more than males (9).

Acrocyanosis in newborns is normal and may occur as the circulatory system takes time to adjust to the changes in the body and environment. Most cases of primary acrocyanosis in neonates resolve by themselves. However, secondary acrocyanosis may be associated with underlying health issues. Talk to your doctor if you notice any bluish-purple discoloration around the mouth (also known as circumoral cyanosis) or extremities of your baby. To avoid primary acrocyanosis, infants should be kept warm after birth. If secondary acrocyanosis is detected, it may be necessary to treat associated underlying issues as well.

Infographic: What Are The Signs Of Acrocyanosis In Babies?

Babies may develop acrocyanosis for various reasons, including exposure to colder temperatures or secondary to a particular condition. Therefore, knowing the signs can help manage it effectively. Check out the infographic below to learn about possible signs of acrocyanosis in babies.

acrocyanosis symptoms in babies to look for (infographic)

Illustration: Momjunction Design Team

Key Pointers

  • The most notable sign of acrocyanosis in babies is painless bluish discoloration of hands and feet.
  • A change in blood circulation could be the primary reason for this condition in newborns.
  • It is normal for newborns to have acrocyanosis for 24 to 48 hours after birth.
  • Girls are more at risk of having this condition than boys.

References

MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.
  1. Central and Peripheral Cyanosis.
    https://www.ncbi.nlm.nih.gov/books/NBK559167/
  2. Acrocyanosis.
    https://www.sciencedirect.com/topics/medicine-and-dentistry/acrocyanosis
  3. Dustin E. Fleck and Mark F. Hoeltzel Hand and Foot Color Change: Diagnosis and Management.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3827510/
  4. Acrocyanosis.
    https://dermnetnz.org/topics/acrocyanosis
  5. Skin Color Changes in the Newborn.
    https://www.saintlukeskc.org/health-library/skin-color-changes-newborn
  6. Sudip Das and Arunasis Maiti; (2013); Acrocyanosis: An Overview
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3827510/
  7. Apgar score
    https://medlineplus.gov/ency/article/003402.htm
  8. Acrocyanosis: An Overview
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3827510/
  9. Functional vascular diseases: Raynaud’s syndrome, acrocyanosis and erythromelalgia
    https://pubmed.ncbi.nlm.nih.gov/20186674/#:~:text=There%20are%20several%20different%20therapy
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Dr. Ashraf Kasem
Dr. Ashraf KasemMS
Dr. Ashraf Kasem is a pediatric specialist with 10 years experience in pediatrics, neonatology and pediatric nutrition. Having a pediatrics practice in Mansoura, Egypt, he is an influencer in Egypt and Arabic countries with more than 500,000 followers on his Facebook page.

Read full bio of Dr. Ashraf Kasem
Dr. Ritika Shah
Dr. Ritika ShahBDS, CLC
Dr. Ritika Shah is a certified lactation counsellor (CLC) from iNational Health Care Academy, Singapore and a dental surgeon with more than seven years of clinical experience across various cities in India. She did her graduation in Dentistry from KM Shah Dental College.

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Rohit Garoo
Rohit GarooBSc, MBA
Rohit Garoo is a writer-turned-editor with over 9 years of experience in content writing, editing, and content marketing. He did his bachelors in Science at St. Xavier's College, Hyderabad, and masters in Business Administration at Osmania University.

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Vidya Tadapatri
Vidya TadapatriMSc (Biotechnology)
Vidya did her post-graduation in Biotechnology from Osmania University, Hyderabad. Her interest in scientific research and writing made her pursue a career in writing, in which she now has over five years of experience. She has done certified biotechnology-related training programs under renowned organizations such as Centre For Cellular & Molecular Biology and Department of Biotechnology.

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