Purple Skin

Medically Reviewed By William C. Lloyd III, MD, FACS
Was this helpful?
284

What is purple skin?

Purple skin is a common symptom of injury and of heart and lung disorders. Purple skin results from bleeding and bruising, broken blood vessels (hemorrhage), and low levels of blood oxygen (hypoxemia). Purple skin may occur in conditions affecting the skin itself or along with a more generalized disorder resulting from conditions such as drowning or chronic heart and lung diseases.

Bruising from skin injuries is a common cause of purple skin. Other common causes include broken blood vessels and pooling of blood under the skin. Chronic obstructive pulmonary disease (COPD, including emphysema and chronic bronchitis) is commonly associated with purple skin, which may be accompanied by cough, difficulty breathing, and clubbing of the fingers.

Heart disorders, such as cyanotic heart disease, cardiac arrest, and heart failure, are common causes of purple skin. Rarely, purple skin is a symptom of a serious blood clot, such as a pulmonary embolism. Drug overdoses from sedatives, Benzodiazepines or narcotics can cause purple skin. Obstructions in the airway, including choking, croup and epiglottitis, are further possible causes of purple skin. Additionally, prolonged seizures, high altitude, and cold air or water can all lead to purple skin.

Purple skin can be a sign of a serious condition. If purple skin is accompanied by difficulty breathing or shortness of breath, rapid heart rate (tachycardia), chest pain or pressure, or bluish coloration of the lips or fingernails, seek immediate medical care (call 911).

If your purple skin is persistent or causes you concern, seek prompt medical care.

What other symptoms might occur with purple skin?

Purple skin may accompany other symptoms that vary depending on the underlying disease, disorder or condition. Symptoms that frequently affect the skin may also involve other body systems.

Skin symptoms that may occur along with purple skin

Purple skin may accompany other symptoms affecting the skin including:

  • Dryness
  • Easy bleeding or bruising
  • Redness, warmth or swelling

Pulmonary symptoms that may occur along with purple skin

Purple skin may accompany symptoms related to the lungs including:

  • Coughing up blood (hemoptysis)
  • Coughing up clear, yellow, light brown, or green mucus
  • Difficulty breathing or rapid breathing
  • Loose, wet cough that produces thick white or yellow phlegm
  • Respiratory arrest
  • Wheezing (whistling sound made with breathing)

Cardiac symptoms that may occur along with purple skin

Purple skin may accompany symptoms related to the heart including:

    Other symptoms that may occur along with purple skin

    Purple skin may accompany symptoms related to other systems including:

    • Fainting or change in level of consciousness or lethargy
    • Fever and chills
    • Severe fatigue

    Serious symptoms that might indicate a life-threatening condition

    In some cases, purple skin may be a symptom of a life-threatening condition that should be immediately evaluated in an emergency setting. Seek immediate medical care  (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

    • Bluish coloration of the lips or fingernails or skin
    • Chest pain or pressure
    • Difficulty breathing or rapid breathing
    • Fainting or change in level of consciousness or lethargy
    • Rapid heart rate (tachycardia)
    • Wheezing (whistling sound made with breathing)

    What causes purple skin?

    Common causes of purple skin include bleeding, bruising, and broken blood vessels under the skin. A severe lack of oxygen in the blood (cyanosis) results in purple skin.

    Injuries may be a cause of bleeding and purple skin. Congenital heart disease, heart failure, cardiogenic shock, or chronic obstructive pulmonary disease (COPD, includes emphysema and chronic bronchitis) may be accompanied by purple skin as the result of a lack of oxygen in the blood. Purple skin can also result from drug overdoses from sedatives or narcotics, such as morphine.

    Skin causes of purple skin

    Purple skin may be caused by injuries to the skin including:

    • Ecchymosis (a large area of the skin that is bruised)

    • Petechiae (broken blood vessels characterized by small red dots on the skin)

    • Purpura (collection of blood under the skin due to internal bleeding, and not trauma)

    Pulmonary causes of purple skin

    Purple skin may be caused by pulmonary disorders including:

    Cardiac causes of purple skin

    Purple skin may be caused by heart conditions including:

    • Cardiogenic shock (shock caused by heart damage and ineffective heart function)

    • Cardiomyopathy (weakened or abnormal heart muscle and function)

    • Congestive heart failure (deterioration of the heart’s ability to pump blood)

    • Cyanotic heart disease (congenital heart defect characterized by cyanosis)

    • Severe valvular heart disease

      Other causes of purple skin

      Purple skin may have other causes including:

      • Being at high altitude (lower levels of oxygen reduce oxygen in blood)
      • Cancer treatment (radiation therapy and chemotherapy cause ecchymosis)

      • Cold air or water exposure (decreased temperature reduces blood flow to skin)

      • Henoch-Schonlein purpura (type of vasculitis or blood vessel inflammation)

      • Idiopathic thrombocytopenic purpura (low levels of platelets)

      • Medications

      • Methemoglobinemia

      • Near drowning or drowning (breathing stops, lungs may fill with water, and cyanosis develops)

      • Overdose (especially medications, such as sedatives and narcotics)

      • Prolonged seizures (if breathing stops for a significant period of time, cyanosis will develop)

      • Sickle cell disease

      Serious or life-threatening causes of purple skin

      In some cases, purple skin may be a symptom of a serious or life-threatening condition that should be immediately evaluated in an emergency setting. These include:

      • Cardiogenic shock (shock caused by heart damage and ineffective heart function)

      • Near drowning or drowning (breathing stops, lungs may fill with water, and cyanosis develops)

      • Pulmonary embolism associated with deep vein thrombosis (blood clot in the leg that can break loose from the leg and cause a pulmonary embolism in the lung, a heart attack, or stroke)

      • Sepsis (life-threatening bacterial blood infection)

      Questions for diagnosing the cause of purple skin

      To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your purple skin including:

      • When did you first notice purple skin?

      • Have you recently been ill?

      • Is your skin always purple?

      • Do you have any other symptoms?

      • What medications are you taking?

      What are the potential complications of purple skin?

      Because purple skin can be due to serious diseases, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including:

      • Adverse effects of treatment

      • Brain damage

      • Heart failure

      • Respiratory failure and respiratory arrest

      • Spread of infection

      • Spread of cancer

      Was this helpful?
      284
      Medical Reviewer: William C. Lloyd III, MD, FACS
      Last Review Date: 2021 Jan 2
      View All Skin, Hair and Nails Articles
      THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
      1. Cyanotic heart disease. MedlinePlus, U.S. National Library of Medicine.     https://medlineplus.gov/ency/article/001104.htm
      2. Bleeding into the skin. MedlinePlus, U.S. National Library of Medicine. http://www.nlm.nih.gov/medlineplus/ency/article/003235.htm
      3. Skin discoloration - bluish. MedlinePlus, U.S. National Library of Medicine. http://www.nlm.nih.gov/medlineplus/ency/article/003215.htm
      4. Ferri FF. Ferri’s Differential Diagnosis, 2d ed. Philadelphia: Mosby Elsevier, 2011.
      5. Kahan S, Miller R, Smith EG (Eds.). In A Page Signs & Symptoms, 2d ed. Philadelphia: Lippincott, Williams & Williams, 2009.