Purple is a beautiful color, isn’t it? A couple of my aunts really love purple, and when they go to a wedding, they always wear purple hats. 

However, while purple is wonderful for hats, unless you just got your nails painted it’s definitely not a color you want to see anywhere on your feet. If one of your toes has suddenly turned this deep, colorful shade, you need to pay attention!

There are several reasons why toes can turn purple. Here are a few of the most common:

Toe Trauma

If you know you’ve banged up your toe playing soccer or tripping over a small branch while hiking, then a black/purplish toe may just indicate a bruise caused by a subungual hematoma. Also known as a “black toenail,” this indicates that you’ve suffered a bruise (and quite possibly bleeding) underneath the nail.

Typically, bruises change color over time, which is a good indicator that you’re dealing with just a bruise. However, if the toenail is badly bruised, you may need to visit a podiatrist who can drill a small hole in the nail to allow the blood to leak out and relieve painful pressure.

Seek immediate medical attention if you notice any possible signs of infection. These include severe pain, fever, warmth to the touch, appearance of red streaks, or drainage of pus.

Chilblains

Chilblains are caused by small blood vessels in the skin becoming inflamed, usually in response to exposure to cold temperatures. They are itchy and can cause red patches, swelling, and blistering on the feet. They can also turn the skin a shade of dark blue or purple. 

Note that “cold” does not mean “freezing”; in fact, chilblains do not involve the freezing of cells and can occur in temperatures as warm as 60 degrees Fahrenheit, depending on conditions.

While painful, chilblains usually heal quickly and don’t cause permanent problems. However, do call us if your pain seems particularly severe or symptoms don’t improve on their own within 1 to 2 weeks. In the meantime, take care to keep your feet protected from cold and damp conditions.

Raynaud’s Syndrome

If you have blue or purple toes but there is no associated pain or obvious trauma, the cause could be a condition called Raynaud’s disease, also known as Raynaud’s phenomenon or syndrome (or just Raynaud’s). It is commonly brought on by cold weather or stress, which narrows the blood vessels in your toes and can cause them to turn a bluish, red, or purple color.

If this condition is not associated with any other disease (Primary Raynaud’s) then it is very unlikely to result in any lasting tissue damage. However, Raynaud’s can also be a side effect of a separate underlying problem, such as connective tissue diseases, disease of the arteries, and smoking. These episodes of Secondary Raynaud’s have a much higher risk of leading to serious consequences (such as ulcers, dead tissue, or even amputation).

If you aren’t sure whether your Raynaud’s is primary or secondary (or if you even have Raynaud’s in the first place), it’s never a bad idea to come in and have us take a look.

Anemia

Anemia is a condition caused by a decrease in the amount of an oxygen-carrying protein called hemoglobin found in red blood cells. In severe cases, this may cause your toenails to appear blue or purple (and will often produce many other symptoms as well, such as cold feet, fatigue, dizziness, and more).

Although there are many types of anemia, the most common is caused by an iron deficiency. Iron is a crucial component your body needs to manufacture hemoglobin. Altering your diet and taking regular dietary supplements (as directed by a qualified medical professional or dietary specialist) can usually help.

Melanoma

Acral Lentiginous Melanoma (ALM) is a rare but extremely serious type of skin cancer that is easy to overlook, as it often appears like a bruise under a fingernail or toenail. The discoloration may be black, brown, or purple.

We cannot overstate the importance of early diagnosis and treatment. When caught in the early stages, when the cancer remains only within a small section of skin, it can usually be entirely removed with no further problems. If melanoma has spread beyond the skin, however, it is often fatal. The famous Reggae musician, Bob Marley, passed away in 1981 from complications of ALM melanoma that originated under a toenail.

Purple Toe Syndrome

Purple toe syndrome (also known as trash foot) is one of the more serious conditions associated with a toe suddenly turning purple or blue without any obvious evidence of direct trauma, cold injuries, or other common triggers.

The most common reason for purple toe syndrome is a blockage of blood vessels in the foot. This blockage usually occurs because of a buildup of plaque in the blood vessels, reducing blood circulation to one or more toes. Purple toe syndrome has also been connected to a rare complication associated with certain medications prescribed to prevent blood clots, and may be more likely to occur in those who have recently undergone cardiovascular surgery.

In extreme cases, gangrene can develop, leading to the amputation of dead tissues. Early detection and treatment is critical in order to avoid the worst outcomes.

Peripheral Artery Disease (PAD) / Peripheral Vascular Disease (PVD)

PAD and PVD result from clogged blood vessels in the lower part of the body. The usual symptoms are pain and cramping in the legs. In more serious cases, the toes may turn a bluish color. When the oxygenated blood supply is cut off from the feet and toes, the tissues in this area begin to die.

PAD and PVD are easily treatable if medical attention is sought early enough. However, the unfortunate reality is that obvious symptoms may not develop for some people until the later stages of the disease. If you are over 65, or you are over 50 with diabetes, you should be screened regularly for PAD and PVD.

Kidney Disease

Severe kidney damage can lead to anoxia (a deficiency of oxygen reaching the tissues) and ischemia (an inadequate blood supply to bodily organs). The onset of blue toenails has been linked to both anoxia and ischemia.

Purple Toes – What’s The Takeaway?

Not to sound like a broken record, but if you discover you have a purple toe, pay attention! While we certainly hope that what you’re experiencing is only a temporary bruise or inflamed tissue that will cause no lasting damage, there are also many possible causes that are far more dangerous—and time may be of the essence.

If you’re located in the Treasure Valley, give us a call to set an appointment with one of our friendly foot doctors who will answer all of your questions and give you options for treatment. We have clinics in Meridian and Caldwell to serve you.