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For people with Down syndrome, family members, caregivers and professionals.


December 2022 | Brian Chicoine, MD - Medical Director, Adult Down Syndrome Center

What is acrocyanosis?

Acrocyanosis is the bluish discoloration of the extremities (usually the hands and/or feet) due to decreased oxygen being delivered to those areas. The small blood vessels in the hands and feet constrict and reduce blood flow. This is a normal response to cold temperatures (to preserve body temperature), but it can also occur when the temperatures are not cold. Acrocyanosis is typically painless and is not associated with a serious health condition.

Acrocyanosis is more common in people with Down syndrome likely due to differences in the function of the autonomic nervous system (the part of the nervous system that functions without us thinking about it). It tends to be more noticeable when the person is cold, frightened, or anxious. We have also noted that it tends to be more prominent when some of the individuals we provide care for develop Alzheimer's disease.


How is acrocyanosis treated?

Treatment typically includes:

  • Reassurance that it is not a serious condition.

  • Keeping the hands and feet warm including using gloves and warm socks.

  • Limiting exposure to cold.

  • Not smoking (not a common behavior in the individuals with Down syndrome we see at our clinic).

  • Using moisturizing cream to keep the skin healthy.

Other causes of blue hands and feet

There are other causes of blue hands and feet. Here are some that should be considered: 

Peripheral cyanosis

An obstruction of a blood vessel in the arms or legs can cause the hands or feet to be blue. When there is an obstruction, the pulse tends to be diminished, and the oxygen saturation is lower. This is sometimes referred to as peripheral cyanosis. Diagnosing and treating the obstruction is required.

Central cyanosis

Cyanosis can also affect the whole body. For example, this can be seen in someone with pneumonia who is not getting enough oxygen through their lungs. It can also be seen in a person with untreated congenital heart disease in which blood that hasn't received oxygen from the lungs is being pumped to the rest of the body. This is sometimes referred to as central cyanosis. This finding requires investigation for and treatment of the underlying cause.

Raynaud's syndrome

Raynaud's syndrome or Raynaud's phenomenon is a condition in which small arteries spasm causing reduced blood flow to the hands and/or feet. Typically, the feet, toes, hands, and/or fingers turn white, then blue, and then red. This most commonly occurs in response to cold temperatures. It is often painful. Sometimes it can cause ulcers of the skin. In addition to avoiding exposing extremities to cold temperatures, Raynaud's syndrome can be treated with medication to reduce spasms of the arteries. 


Find More Resources

We offer a variety of resources for people with Down syndrome, their families and caregivers and the professionals who care for and work with them. Search our collection of articles, webinars, videos, and other educational materials.

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Please note: The information on this site is for educational purposes only and is not intended to serve as a substitute for a medical, psychiatric, mental health, or behavioral evaluation, diagnosis, or treatment plan by a qualified professional. We recommend you review the educational material with your health providers regarding the specifics of your health care needs.