It can be rather frightening to discover that, out of nowhere, your toe has suddenly turned a deep shade of purple or blue. There are several reasons why your toe might have taken on this purplish hue.
Of course, the only way to be sure is to see your doctor or foot specialist, but here are some of the possible reasons why you might be suffering from a purple toe:
Purple Toe Syndrome
One of the more serious causes of purple toes is Purple (or Blue) Toe Syndrome. Purple Toe Syndrome (also known as “trash foot”), appears as a blue or purple discoloration of one or more toes without any prior physical injury or cold trauma (such as hypothermia). 1 This painful condition can develop quite suddenly.
This is usually due to a buildup of cholesterol or plaque (fatty acids, cholesterol, and calcium) in the blood vessels, which effectively starts to “strangle” parts of the foot. 3
Purple Toe Syndrome can seriously threaten both “life and limb” due to the lack of blood flow. In the most extreme cases this could cause gangrene (requiring amputation) if the tissue were to die. 4
Purple Toe Syndrome can also be a rare complication of certain preventive blood clot medications. 5
Peripheral Artery Disease
Peripheral Artery Disease (PAD) is a similar condition that may also cause purple feet or toes.
While Purple Toe Syndrome is more localized to the foot, PAD is caused by clogged arteries in the lower part of the body and most often shows itself as pain and cramping in the legs. In more serious cases, the toes may turn a bluish color. 6
The arterial system delivers oxygenated blood from the heart to the organs and tissues. If the feet or toes are cut off from this oxygen supply the tissue in these regions are at risk of dying.
PAD is an easily treatable condition if medical attention is sought early.
Severe kidney damage can induce the conditions of anoxia (a deficiency of oxygen reaching the tissues) and ischemia (an inadequate blood supply to the organs) in the body.
Without an adequate supply of oxygen and blood, many health problems can occur. These can include organ and nerve damage and even the discoloration of the nails.7
The onset of blue toenails has been linked to both anoxia and ischemia.8
Kidney disease and its related conditions can be life-threatening so seeking medical advice is always a priority.
Acral Lentiginous Melanoma (ALM) is a type of skin cancer that is often overlooked as it appears very similar to a bruise under the finger or toe nail. 9 It may appear as a black, brown, or purple discoloration. 10
Although ALM it is a rare type of melanoma (making up just 5% of melanomas) it’s advised to have the nail checked by a medical professional. Especially if no physical injury has occurred.
Did you know? Reggae musician Bob Marley passed away in 1981 from complications of ALM melanoma, which originated under his toenail.
If you know you’ve banged up your toes, playing sport or by accident, then a purple toe may be just a sign of bruising, known as a subungual hematoma. 11
This black/purplish discoloration is caused by an injury to the blood vessels under the toenail. 12 Bruises tend to change color over time which can be a good indicator that you’re dealing with a bruise. However, badly bruised toenails may need the help of a doctor to drill a small hole in the nail to allow the blood to leak out and relieve painful pressure. As a new nails grows it may cause your old nail to fall off entirely. 13
But nails, thankfully, tend to grow back.
Anemia is a decrease in the amount of oxygen-carrying protein, known as hemoglobin, that is found in red blood cells. There are many types of anemia, but iron-deficiency anemia tends to be the most common. 14
Symptoms of anemia include weakness, pale skin, fatigue and, in severe cases, it may cause blue nails. 15
Each type of anemia is treated differently but a doctor will usually prescribe medication or supplements to set things right.
Chilblains is a painful inflammation of small blood vessels in the skin that usually occurs in response to cold exposure. It usually affects the extremities, such as the toes, fingers, ears, and nose.
Chilblains can cause itching, red patches, swelling, and even blistering on the hands and feet. It can also turn the skin a shade of dark blue or purple.16
Chilblains are the result of an abnormal reaction to the cold.
When the skin is cold, blood vessels near its surface get narrower. When the skin is warmed back up, blood vessels near the surface of the skin often can’t handle the increased blood flow which can cause swelling, itchiness, and that purple tinge.17
Chilblains usually heal within a few weeks and don’t cause any permanent problems.18
Blue Toes, No Pain
Sometimes it’s possible to get blue or purple toes with no pain. This could be caused by Raynaud’s Syndrome – a condition that’s especially common in Europe, where up to 20% of the population can experience it. Raynaud’s syndrome is commonly induced by cold weather or stress and can cause the toes to turn a bluish, red or purple color.19
If it’s not associated with any other disease (known as Primary Raynaud’s) then it’s considered a benign condition and won’t result in any tissue damage. You may be more sensitive to the cold, especially during the winter months which can leave you more susceptible to frostbite – so do take care. Most patients with primary Raynaud’s don’t have painful episodes, though they may experience discomfort or mild tingling.20
The treatment for Raynaud’s syndrome is usually focussed on avoiding the cold and managing stress. Though your doctor may also suggest medications that can help to keep the blood vessels open. Soaking feet in warm water at the onset of an attack may also help. Raynaud’s is more common in women, especially those over 30. It may also be inherited from family members.21
Purple Toe: The Takeaway
As you can see, the onset of a purple toe should definitely warrant some attention due to the fact that there are some very serious conditions that can display as a purple toe.
There is never any harm in seeking a professional opinion from your doctor if you have any doubts as to what may be causing your purple toe.
Article updated: March 13, 2018