Nail Ailments

Why Do I Have Blue Toenails? Symptoms, Causes, & Treatment Options

There are several possible causes of blue underneath the toenails. Whether they are bright blue or blackish blue spots, it can be a somewhat unnerving sight. While most people can easily agree that a blue tint to the nails isn’t ‘normal,’ determining the official cause is what’s important. Some reasons may be more serious than others.

Typically, blue toenails are caused by poor circulation of red blood cells throughout your body. If your nails aren’t getting enough blood flow, the membranes beneath your skin can turn a dark blue or purple color. This is a condition that can range in how difficult it is to treat or manage.

Poor circulation can be dangerous, especially for those dealing with illnesses like diabetes. So, it’s important to pay attention to the color of your nails and know the real cause of any discoloration.

Your nails are a great indicator of your overall health. While many of the causes of blue nails have to do with blood flow, there are other possible conditions to consider. Sometimes, other symptoms will occur along with the discoloration of your nails. These symptoms can be great indicators of something bigger going on.

What Are the Causes of Blue Toenails?

This article will focus on a few different causes and conditions associated with toenails getting blue spots or turning a purple color. Sometimes, the change in color is caused by a medical condition. Other times, the reason(s) may be circumstantial, depending on what you’re doing.

In any case, treating toenails that have turned blue for any reason is necessary. It should never be considered ‘normal.’ Let’s look at some of the most common causes, any symptoms that shouldn’t be ignored, and what you can do to treat blue toenails.

How Toenail Color Is Connected to Your Health

The color and texture of your nails can determine a lot of different things. That’s why it is so important to pay attention to your feet. Normal, healthy toenails should be slightly pink and warm in color. The nail bed itself will be pinker, while the nail should be a white or slightly off white color.

Nails can turn red, white or pale, black, etc. Different discolorations are connected to different conditions. Keeping track of what these discolorations mean will allow you to stay ahead of many health problems by recognizing the symptoms and getting the necessary treatment.

What Are the Symptoms?

Obviously, the biggest ‘sign’ of having blue nails is the color itself. This might show up as blue spots, a purple color, or different shades of light/dark blue. However, it isn’t always the first sign of a problem.

There are sometimes additional symptoms that can go along with the change in color. Some of these symptoms can be quite serious and may require medical attention. See a doctor immediately if you experience any of the following in addition to your blue nails:

  • Dizziness
  • Difficulty breathing
  • Chest pains
  • Numbness in the feet or toes
  • Excessive sweating

These symptoms are usually associated with a lack of proper blood flow. A combination of a few of them (including the nail discoloration) can signify a much bigger problem that shouldn’t be ignored for too long.

Along with improper blood flow and poor circulations, there are other circumstances to be aware of that can cause a darkening of the nail. Let’s look at a few of these, so you can be more aware of how to treat them properly.

Cold Temperatures

Extreme cold is a major culprit in nails that turn blackish blue. Often, blue nails and cold feet go hand-in-hand. It’s important to recognize whether this is due to poor circulation or cold temperatures. Cold temperatures do affect the blood and can be linked to a slower blood flow, so the two tend to be related.

When your toes get very cold, your blood vessels start to constrict. This makes it difficult for oxygen to reach your nails through such narrow pathways. This is why the toes, fingers, nose, etc., are usually the first areas to get frostbite when they have been exposed to extreme cold for too long. As the blood vessels constrict and warm blood isn’t allowed to pass through, the cold can freeze the tissue beneath these areas. They may go permanently numb as a result.

The good news about blue nails due to cold weather is that they will return to normal once your body warms up again. Of course, it is never a good idea to stay that cold for too long. If your nails start to change color because of extreme temperatures, return to warmth as soon as possible.

This will encourage proper blood flow and the right movement of oxygen. If your toenails remain blue even after your body temperature has returned to normal, it’s time to look at possible health conditions.


Just like cold temperatures limit the oxygen carried through your body, anemia is a more ‘constant’ problem of that condition. When you are anemic, you usually have a lower count of red blood cells throughout the body. This limits the amount of oxygen that can be transported through your body and can lead to things like:

  • Discoloration of the nails
  • Low iron levels
  • Brittle nails
  • Fatigue
  • Headache
  • Cold hands and feet

Anemia is often associated with not getting enough iron in your body. Treatments usually include some iron-rich supplement that can help to increase this necessary mineral. You may also have to make dietary changes to boost your iron intake and allow oxygen to flow through your blood stream properly. This is the easiest and most effective way to get more iron in your system. Some foods rich in the mineral include:

  • Spinach
  • Lentils
  • Lean beef
  • Tomatoes
  • Sardines

Blue Toenails After Running

Runners face different issues with their feet and toes. Whether you’re walking, hiking, running a marathon, or playing a sport, overall foot health is extremely important. It’s easy to ignore the health of your toenails until there is a problem. But, keeping track of the way your toenails look and feel as an athlete should be part of your daily routine.

Aside from circulatory issues, the common cause of a darkened toenail after running is trauma to the nail. This is often referred to as ‘black toenail.’ However, the nail usually appears blackish blue in color.

When trauma to the nail occurs, it can cause bleeding or bruising underneath the nail. This is usually caused by the toe repeatedly striking against the inside of a shoe. With each step you take, your toe could be sliding forward, and ‘hitting’ the shoe.

It doesn’t cause a lot of pain, but your nails may start to thicken over time. Larger shoes or special running shoes may be needed to fix the problem. You can also use some of the following tips to keep your nails safe, whether you’re running or on the hiking trail:

  • Find shoes with adequate protection on the top
  • Try a shoe-stretching device to make sure your footwear is the right size
  • Wear hiking boots with extra toe protection
  • Use silicone toe pads to absorb some of the pressure while running
  • Never tie your laces too tight

Are blue nails due to circulation issues?

Trauma to the Nail

In more serious cases, extreme trauma to the toe can cause a subungual hematoma. This occurs when something heavy is dropped on the toe, or it experiences a lot of sudden force at once. It can cause blood to start pooling beneath the nail. In certain instances, a hole may need to be drilled into the nail to release pressure.

It’s not only athletes who experience this problem. Trauma to the toe can happen to almost anyone. Unfortunately, it’s impossible to protect your toes from every potential risk. Accidents happen. Whether you drop a hammer on your toes or stub them by accidentally hitting them against something, you can’t always avoid these issues.

If you do experience a sudden trauma that seems to be affecting the nail or causing blood to pool underneath, it’s necessary to release the pressure as soon as possible. If you don’t, the condition could become extremely painful and even make it difficult to walk.

Heart Disease

Heart disease tends to be more common in men than women. For anyone, though, a symptom of a heart problem can be blue fingernails and toenails. When the heart isn’t able to pump enough oxygen throughout the body, blue lips, skin, and nails can occur.

There are other noticeable symptoms associated with heart diseases. You’ll likely notice your lips turning a blueish color before anything else. Again, it’s a matter of how efficiently your blood is pumped throughout your body. If you experience these symptoms, don’t panic immediately. It could be a variety of other circulatory conditions. However, it is important to get yourself diagnosed as quickly as possible.

Raynaud’s Disease

Raynaud’s disease is a disorder that directly affects your arteries. It specifically affects the arteries in the fingers and toes. The arteries narrow for periods of time. This reduces blood flow and can cause discoloration of the nails. In some cases, you’ll even experience discoloration of the lips, nose, and ears.

The good news is that Raynaud’s disease is usually easy to keep under control. There is no one solid treatment for the condition yet. Most people manage it by making sure they are as warm as possible. Protecting your extremities from cold temperatures is a great way to fight back against the condition. In some cases, you may need to avoid taking certain prescriptions or other medications that can affect blood flow.


Asthma, along with other lung or breathing disorders, can commonly be associated with your skin or nails turning blue. It makes it difficult for your blood to carry enough oxygen to the extremities of your body. More often than not, that means your nails are among the first areas to change color.

Blood is reddened by oxygen. When your body doesn’t receive enough oxygen, blood will appear much darker, and almost black in color. If your oxygen levels are lower, it can cause that blood to show up under the nails, giving them their bluish appearance.

If you have asthma or another condition that makes it difficult to breathe sometimes, it may not be uncommon for your skin or nails to change to a light blue or even darken to a purple-black color. The good news? This should only occur during asthma attacks, not all the time. Attacks can typically be managed through specialized medication, like inhalers.

Pregnancy and Toenail Health

Being pregnant can come with a lot of new and somewhat strange symptoms your body isn’t used to. For some women, that includes blue toenails. It can be a scary sight to look down and see a blue tinge on your toenails. The good news is it may be something that is easily remedied.

Your body goes through a lot of changes when you’re pregnant, and circulation/blood flow can change as well. Many pregnant women experience swelling in their hands and feet, which can also relate to how smoothly your blood is flowing through your system.

Try propping your feet up as much a possible throughout the day. This will help with circulation and will likely make your feet feel less swollen. If that doesn’t take care of the problem, you may want to invest in a circulation booster machine or a foot massager. Make sure any machine you use is approved by a doctor and is safe to operate throughout your pregnancy.

Toenails have Changed to Blue

Nails Change Color When Sitting

If your nails turn blue when you’re sitting and relaxing, it could be a sign of poor circulation throughout your body. Your blood isn’t being pumped throughout your feet and legs as efficiently as it should be. Your feet don’t necessarily have to feel cold to the touch for you to have poor circulation. Blue nails are a strong symptom of this problem.

In most cases, if you don’t have another medical condition, you can try a circulation booster machine. You should also try regularly massaging your feet, and keep them elevated. If you have a condition like diabetes, paying close attention to your feet is crucial. Diabetics tend to have poor circulation that can lead to even bigger problems. If you’ve noticed that your toenails seem to turn blue even when you’re just sitting down, you may want to get tested for this condition.


Most people would recognize an abnormal spot, discoloration, or growth elsewhere on their body. It’s not always easy to notice something like that when it shows up underneath your toenails. Unfortunately, melanoma can reveal itself on toenails in the form of blue spots.

Subungual melanoma typically occurs as a dark purplish stripe underneath the nail. If left untreated or unnoticed, it will increase in size and become wider over time. When it continues to be left untreated, it can cause the nail to lift from the nail bed.

In many cases, melanoma underneath the toenail can be found to be benign. However, you should always go to a podiatrist or a doctor for an official diagnosis in case it turns out to be malignant. This is typically a more common condition for people with a darker complexion. However, it can affect everyone.

What Does It Mean When White Nails with a Blue Base?

Sometimes, discoloration of the toenails can be more than just your entire nail turning blue. Some people may experience blue dots or a thick stripe. There is one condition that is often associated with a white nail and blue base: An insulin deficiency.

This can also be linked to diabetes. However, it doesn’t always have to be that extreme. Your body simply may have a harder time to process sugars the way it should. You should get an official diagnosis as quickly as possible. But, you can also start out by decreasing the amount of sugar you intake on a regular basis. It will help you to conserve energy and the nutrients your body needs.

What Are the Symptoms of Poor Circulation in the Feet?

As you can see, many of the conditions that cause blue toenails are linked to circulation and blood flow. Bad circulation can be caused by anything from an improper diet, to a lack of physical activity. Even thing like tobacco use has been associated with slow blood flow.

It’s usually not enough to go by the color of your toenails alone to determine whether or not your circulation is bad. However, having poor circulation is something to take very seriously. So, knowing what additional symptoms you should look out for can make a difference. The sooner you recognize that you may have bad circulation, the sooner you can take care of it. Some additional symptoms include:

  • Cramping during physical activity with the legs
  • A tingling sensation in the feet
  • Swelling
  • Aches
  • Coldness

If you have any combination of these symptoms, along with blue toenails, take the proper steps toward boosting your circulation. We’ll list some helpful tips you can use below.

Why have my toenails turned a blue color?

How to Improve Circulation in Your Feet

There are multiple ways to get circulation back in your toes. After you make sure your poor circulation isn’t linked to any other underlying medical conditions, lifestyle changes are the best way to combat against it.

Some of the best ways to get circulation back in your feet and toes include:

  • Monitor your blood pressure. Keeping your blood pressure within a healthy range will help with overall circulation and blood flow. You can keep it in check through things like lowering stress or changing your activity levels. In some cases, medication may be required to keep it at a proper level.
  • Wear supportive socks specifically designed to help with circulation.
  • Elevate your legs regularly. Sitting in a recliner at the end of the day and propping your feet up is an easy way to support proper circulation throughout the feet.
  • Stop smoking.
  • Avoid sitting still for too long. Exercise can help with blood flow, but any light activity is better than remaining sedentary for hours at a time.

By improving your circulation, you should notice a difference in how your feet/toes look and feel. While a lack of blood flow and coldness aren’t always related, they can go hand-in-hand. When your circulation improves, your toes should feel warmer. They will also go back to a natural, healthy pink state. If you experienced any numbness or tingling due to a lack of blood flow, a normal feeling should also return.

How Do I Treat Toenails That Have Turned Blue?

Now that you know how many different conditions and circumstances can be linked to blue nails, you can better determine what may be causing yours. Obviously, some conditions will be easier to treat than others. Some can be dealt with by changing a few habits, while others may require medical attention.

The most important thing to keep in mind is that blue toenails should never be considered normal. While they may not be the first sign of a health problem, they should be looked at as a symptom of an underlying condition. Simply put, you should do something about it right away!

More often than not, the discoloration of your toenails will be linked to improper circulation. Again, this can be something serious like diabetes, or a problem with your diet or how sedentary you are on a regular basis. Determining the cause of the problem will make it easier to treat and manage in the long run.

We hope that we have given you an insight into why your toenails are blue. Or, what to do if they do start to discolor. You can use many of the circulation tips here as preventative measures, as well as the precautionary tips for keeping your toes safe.