Toenail discoloration is a common problem. Often, the discoloration is the result of some kind of injury. You stubbed your toe, dropped something on it, or wore shoes that were too tight. But what happens when your toenail turns purple and you don’t remember injuring it?
That purple color in your toenail is worth paying attention to. In this article, we’ll look at some of the potential causes of a toenail turning purple without injury, what other symptoms you might experience, and when it’s time to see a doctor.
One potential reason for a purple toenail is cyanosis. But other causes are possible as well.
What is cyanosis?
If your toenail is turning purple without an injury, it could be a sign of cyanosis.
Cyanosis is when your skin and mucous membranes turn a bluish or purplish color. It means your blood isn’t carrying enough oxygen to your tissues. While cyanosis can show up in different parts of your body, it’s definitely noticeable when it affects your toenails.
There are several types of cyanosis:
- Central cyanosis: This happens when there’s not enough oxygen in your arterial blood, often because of heart or lung issues.
- Peripheral cyanosis: This occurs when blood flow to your hands and feet is reduced. When blood moves more slowly, your tissues extract more oxygen from it. Exposure to cold can cause peripheral cyanosis.
- Differential cyanosis: This is when cyanosis appears in one limb but not another.
If your toenail is turning purple and you’re not sure why, it’s important to figure out what’s going on. The next section will help you understand some potential reasons.
Potential causes of purple toenails without injury
If you haven’t stubbed a toe or dropped something heavy on your foot, but one of your toenails is turning purple, it could be a sign of an underlying health issue.
Circulatory issues
Problems with blood flow can lead to a purple toenail, even without an injury.
Peripheral artery disease (PAD)
PAD happens when the arteries that carry blood to your legs and feet become narrow. This can reduce blood flow and potentially cause cyanosis in the toenails. If you have PAD, you might also experience leg pain when you exercise (called claudication).
Raynaud’s phenomenon
Raynaud’s is a condition where blood vessels in your fingers and toes constrict when you’re cold or stressed. This constriction can lead to temporary cyanosis, causing your toes to turn purple or blue.
Blood disorders
Certain blood disorders can also affect the color of your toenails.
Polycythemia vera
Polycythemia vera is a blood disorder that causes your body to make too many red blood cells. This can thicken your blood and potentially contribute to cyanosis in your toes.
Other blood abnormalities
There are other, less common blood disorders that can affect how oxygen is transported in your body, which could lead to cyanosis.
Medications
In rare cases, certain medications can cause cyanosis as a side effect. Usually, this type of cyanosis will go away when you stop taking the medication. But it’s essential to talk to your doctor if you suspect your medication is causing your toenail to turn purple.
Other symptoms to watch for
If your toenail is turning purple without an injury, it’s important to pay attention to any other symptoms you might be experiencing. These symptoms can help your doctor figure out the underlying cause and determine the best course of treatment.
Here’s a list of symptoms to monitor:
- Pain or discomfort in the toe or foot
- Changes in skin temperature (coldness)
- Numbness or tingling in the toe
- Swelling or inflammation
- Changes in the nail’s texture or how it grows
- Shortness of breath
- Chest pain
- Fatigue and weakness
If you experience shortness of breath or chest pain along with the purple toenail, seek immediate medical attention. These symptoms could indicate a more serious underlying condition.
When to seek medical attention
If your toenail turns purple and you didn’t injure it, you should seek medical care, especially if you have any other symptoms.
Get medical attention immediately if you experience any of the following:
- Sudden blue discoloration of your toe
- Blue discoloration accompanied by shortness of breath or chest pain
- Severe pain or numbness
- Signs of infection, like redness, swelling, or pus
A healthcare provider can figure out the cause of your discolored toenail and recommend treatment.
Diagnosis and Evaluation
If you see a doctor about your purple toenail, here’s what you can expect:
- Medical History: Your doctor will want to know about your medical history, including any health conditions you have, medications you take, and your family history.
- Physical Examination: The doctor will examine your toenail and the surrounding area, and they’ll check for other signs of cyanosis or circulatory problems.
- Diagnostic Tests: To assess your condition, your doctor may order:
- Pulse oximetry to measure oxygen saturation
- Arterial blood gas (ABG) test to assess blood oxygen and carbon dioxide levels
- Blood tests to check for blood disorders
- Imaging studies (X-ray, ultrasound) to evaluate blood flow and rule out other conditions
Pseudocyanosis
Sometimes, a toenail looks like it’s turning purple, but it’s not actually a sign of cyanosis (low oxygen). This condition is called pseudocyanosis. It can be caused by certain medications, dyes, or even exposure to specific chemicals.
The distinction between true cyanosis and pseudocyanosis is important for doctors to make the correct diagnosis and give you the right treatment.
Frequently Asked Questions
What do B12 deficiency nails look like?
While a purple toenail is unlikely to be caused by B12 deficiency, B12 deficiency can manifest in nail changes. These changes might include brittle nails, darkened nails (hyperpigmentation), or longitudinal dark streaks. Keep in mind that nail appearance can vary widely.
Do purple toes mean diabetes?
Purple toes can sometimes be associated with diabetes, particularly if it’s due to poor circulation (peripheral artery disease), potentially leading to issues covered in this guide about diabetes and nail loss. However, purple toes aren’t a definitive sign of diabetes. It’s essential to consider other symptoms and consult a healthcare provider for a proper diagnosis.
Can heart problems cause purple feet?
Yes, certain heart problems that affect circulation can contribute to purple or bluish discoloration of the feet and toes (cyanosis). This is because the blood isn’t being effectively oxygenated and circulated to the extremities. Seek immediate medical attention if you experience this along with other concerning symptoms like chest pain or shortness of breath.
What autoimmune disease causes purple toes?
Several autoimmune diseases can potentially cause purple toes, including Raynaud’s phenomenon, lupus, and vasculitis. These conditions can affect blood vessels and circulation, leading to discoloration. A thorough medical evaluation is necessary to determine the underlying cause.
What illness affects toenails?
Many illnesses can affect toenails, ranging from gout, toenail fungus, and psoriasis to more systemic conditions like thyroid disorders and anemia. Nail changes can be a clue to underlying health issues, so it’s always best to consult a healthcare professional for proper diagnosis and treatment if you notice unusual changes.
The Bottom Line
If your toenail turns purple and you haven’t injured it, it could be a sign of something going on with your health. Some of the possible causes are circulatory problems, blood disorders, and even side effects from medications.
If you notice your toenail turning purple and you don’t know why, especially if you have other symptoms that concern you, it’s important to see a doctor to find out what’s going on.
Getting a diagnosis early and starting treatment can help you manage the underlying cause of the discoloration and prevent more serious problems from developing.