When you think about heart disease, you might picture living with symptoms like chest pain, shortness of breath, or fatigue. However, one surprising, more unexpected sign involves a change in skin color.

Certain types of heart disease may lead to gray or ashen skin, which can signal that your heart isn’t moving blood around your body as well as it should. This can be a warning sign for complications of heart disease. Graying on darker skin tones may be more noticeable around the lips, gums, eyes, and nails. In people with lighter skin, color typically changes on the face, lips, or extremities.

This article explores why gray skin can be a symptom of heart disease. We’ll discuss what causes these changes, when to see a doctor, and how to better manage your heart health.

What Heart Problems Cause Gray Skin?

Gray or ashen skin, often referred to as “pallor,” is more than a cosmetic issue. This change can indicate a serious underlying issue with oxygenation or blood circulation, two key functions that are directly related to heart health.

Low Oxygen Levels in Your Blood

Oxygen gives blood its bright red color. If the body’s oxygen levels are low, blood appears darker and can make skin appear gray or bluish. This is called cyanosis, and it can occur slowly over time or happen suddenly, along with other symptoms.

When heart disease prevents your heart from pumping blood properly, your body may not get enough oxygen. Many health conditions, including diseases of the lungs or heart, can lead to cyanosis. Examples include congenital heart disease, cardiac arrest, and heart failure.

Reduced Blood Flow

Heart failure occurs when the heart can’t pump blood efficiently. Blood is important because it delivers oxygen to your tissues, which keeps them healthy. When less oxygen-rich blood flows through your body, your tissues, including your skin, might not get enough oxygen. This can cause your skin to look pale or gray.

In severe heart failure, blood flow to the skin can be reduced because the body prioritizes sending oxygen where it’s needed most. Vital organs like the heart and brain get first dibs. Less oxygen-rich blood flows to your skin, causing it to appear pale or gray.

Difficulty Circulating Blood

Other heart diseases can also lead to issues with blood circulation. For example, peripheral artery disease (PAD) causes arteries to become narrowed or blocked. This can lead to poor circulation, especially in the legs and feet, because they’re farther from the heart. Depending on skin tone, the skin in those areas may become blue, purple, or gray.

Severe PAD can lead to serious complications, such as skin ulcers or infections, which can cause additional changes in skin appearance and color. People who have diabetes and PAD are more at risk of these complications. If you have these conditions, be sure to check your skin daily for sores, injuries, or signs of infection such as discoloration, swelling, and pus. If one leg or foot suddenly becomes blue or pale and colder than the other, call 911 immediately. This could indicate a blockage of blood flow to your leg.

When To See a Doctor

It’s important to take any change in your skin color seriously, especially if your skin looks gray or ashen. Although gray skin can be caused by temporary factors, such as exposure to cold temperatures, it can also be a warning sign of more serious heart problems, particularly if it happens suddenly. Call your cardiologist or 911 or go to the emergency room if you also have symptoms such as:

• Chest pain
• Shortness of breath
• Fever
• Headaches (that are more frequent or painful than usual)
• Difficulty breathing
• Confusion or sleepiness

These symptoms, in addition to a change in skin color, could indicate a serious issue that requires immediate treatment.

How To Prevent Skin Changes

If you have heart disease, managing your condition can help prevent changes in skin color and other related symptoms. Here are some steps you can take to keep your heart healthy and maintain good circulation.

Follow Your Treatment Plan

Be sure to follow the treatment plan prescribed by your doctor. Medications you take to manage blood pressure, cholesterol, or heart failure can help improve your circulation and oxygenation, which will reduce the likelihood of skin changes. Your doctor will also recommend lifestyle changes to benefit your overall health.

Schedule regular follow-ups with your health care provider to monitor your heart health, get medication refills, and discuss any side effects or symptoms that you’re experiencing.

Stay Active

Physical activity, especially cardiovascular exercise (cardio), is one of the best ways to keep your heart healthy and improve its ability to work well. By doing cardio exercises like swimming, walking, and biking, you help your heart pump blood more effectively and lower the chance of symptoms like fatigue, shortness of breath, and gray skin.

If you have heart disease, talk to your doctor about safe limits for exercise. Low-impact activities like walking, yoga, and swimming can keep your body moving without putting too much strain on your heart.

Eat a Heart-Healthy Diet

A balanced diet of fruits, vegetables, whole grains, and lean proteins can help support your heart health and prevent circulatory issues. Try to limit how much salt, sugar, and saturated and trans fats you eat. These ingredients can contribute to high blood pressure, high cholesterol, and diabetes, which are risk factors for heart disease.

Tell Your Doctor About Skin Changes

Pay attention to your body by monitoring the symptoms you experience on a daily basis. If you notice changes in your skin color, energy levels, or other symptoms, take note and discuss them with your doctor. Keeping track of patterns can help you and your doctor adjust your treatment plan, detect issues early, and make lifestyle changes that benefit your heart health.

Your doctor may ask about when your skin changes started and what other symptoms you’ve been experiencing. They might order tests such as blood work or heart imaging to find out the underlying cause. The results can help guide your treatment plan and prevent further symptoms.

Your skin can be a window to your overall health, revealing important clues about what’s happening inside your body. If your skin suddenly looks gray or ashen, plus you have symptoms like shortness of breath or chest pain, seek immediate medical attention.

Talk to Others Who Understand

MyHeartDiseaseTeam is the social network for people with heart disease and their loved ones. On MyHeartDiseaseTeam, more than 61,000 members come together to ask questions, give advice, and share their stories with others who understand life with heart disease.

Have you noticed skin color changes with heart disease? Did discuss about this concern with your doctor? Share your experience in the comments below, or start a conversation by posting on your Activities page.