Circumoral Cyanosis: Causes, Symptoms, and How to Treat It

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Circumoral CyanosisThere are times when our skin appears to have a bluish hue, as when we are at high altitudes or in extremely cold temperatures. When it happens due to a health situation or is seen in the face of a newborn, it can send us into a panic.

Circumoral cyanosis can present as a serious condition requiring medical attention, or it may be a normal reaction for some. To distinguish when we should take action, let’s learn what signs to watch for and what to do in this situation.

What Is Circumoral Cyanosis?

To fully understand this condition, it is best to break down the meaning of its definition. Circumoral refers to the area surrounding or circling the mouth. Cyanosis refers to the bluish color of the skin resulting from low oxygen supply or blood circulation.

We can expect to see circumoral cyanosis frequently in newborns since they have very fine skin surfaces. The bluish hue of their skin is actually from the blood vessels contained near the surface. Many also have a pinkish color to their skin due to strong blood circulation. However, this is decreased around the mouth region, intensifying the blue color of the veins.

Circumoral cyanosis is the result of two cyanosis conditions called central cyanosis and peripheral cyanosis. Cyanosis conditions associated with central cyanosis are linked to serious cardiovascular diseases, whereas peripheral cyanosis relates to lung conditions.

What Are the Symptoms of Circumoral Cyanosis?

There are circumoral cyanosis symptoms to be mindful of aside from the bluish hue encompassing the mouth.

These symptoms include:

  • Extreme fatigue
  • Anorexia
  • Loss of appetite
  • Irritability
  • Breathing difficulties

What Causes Circumoral Cyanosis?

As circumoral cyanosis causes may affect both newborns and some adults, we will now look into the conditions behind it. Not all circumoral cyanosis in newborn cases lead to a serious issue.

1. Neonates with Cyanotic Heart Disease

Babies with this condition may have circumoral cyanosis due to an obstruction of the pulmonary blood flow, which often results in critical pulmonary stenosis, Tetralogy of Fallot, and pulmonary atresia. It may also result from problems arising between connections of the ventricular and arterial blood vessels.

2. Neonates with Primary Pulmonary Disorder

There are differentiating factors that come into play with pulmonary disorders that have circumoral cyanosis as part of the condition. These can include cases where the air becomes trapped between the lungs and chest cavity as seen with pneumothorax. And, this, along with a defective diaphragm, causes a congenital diaphragmatic hernia.

Other pulmonary disorders resulting in circumoral cyanosis can include congenital pneumonia, meconium aspiration syndrome, and respiratory distress syndrome. This form of cyanosis may be a consequence of severe polycythemia, methemoglobinemia, persistent pulmonary hypertension, and asphyxia.

3. Adult Cases of Circumoral Cyanosis

Circumoral cyanosis in adults is not as prevalent as in newborns. Perhaps you have experienced it yourself when exposed to extremely cold temperatures or high altitudes. Health conditions such as shock, epiglottitis, and bronchitis can also affect the body’s circulation and oxygenation. Carbon monoxide poisoning will also give signs of circumoral cyanosis.

How to Diagnose Circumoral Cyanosis

A physical exam for other possible  symptoms in addition to the bluish skin around the mouth region is crucial for proper circumoral cyanosis diagnosis. Also, your doctor will do a pulse oximetry test, as well as airway, breathing, and circulation tests.

Please note that circumoral cyanosis itself is not a dangerous condition. However, if the bluish color is present on the surface of the lips or is accompanied by other symptoms, it has extended beyond cyanosis and requires emergency medical assistance.

How to Treat Circumoral Cyanosis

Since it is a serious and possibly life-threatening condition, a medical team will look after circumoral cyanosis treatment. Treatment involves a variety of applications dependent on the underlying cause and any symptoms that may accompany it.

First, the main focus is to regulate the breathing by clearing the airway and restoring blood circulation. The doctors will use oxygen to ensure proper ventilation and establish a good airway. The team may need to stabilize the pH level by attending to metabolic acidosis with bicarbonate therapy. They will use antibiotics in cases of infection.

Circumoral cyanosis can be a scary sight, especially for first-time parents of a newborn. The bluish tint often seen with babies can be a common treatable condition alone.

The bluish tint can also be a sign of a serious underlying health condition that may lead to life-threatening conditions. It is crucial to remember that while circumoral cyanosis can be a normal situation, treatment is required if the color spreads to the lips or accompanied by other symptoms.

Kerkar, P., “Circumoral Cyanosis: Causes, Symptoms, Treatment, Diagnosis,” ePain Assist;, last accessed May 5, 2017.