Overview
Some numbing sprays used for throat procedures can cause it.
Babies given formula made with well water high in nitrates are at risk.
Symptoms
Common signs:
- Blue or gray skin
- Shortness of breath
- Pale skin
Less common
- Headache
Look up a symptom: Getting winded easily with activity or stairs · Headache
When to get medical care
Causes
Medicines, chemicals.
Does it spread or run in families?
- It isn't contagious. You can't catch it from someone else.
Who is more likely to get it
- Babies on well water formula
Diagnosis
This is diagnosed in the emergency room or hospital.
The exam
A physical exam.
Tests
Tests, if needed:
- Blood gas:
Treatment
Emergency care is needed. While waiting for help:
Self-care
- Call 911
Prevention
To lower your risk or prevent problems:
- Test well water before using for formula
Which doctor treats this
- Emergency doctors treat it first, in the ER.
- They may send you to a hematologist (blood doctor).
Living with it
Support groups and helplines
- Genetic and Rare Diseases Information Center (GARD): Free NIH information on rare diseases, including where to find experts and patient groups.
- National Organization for Rare Disorders (NORD): Patient groups, help finding care, and aid programs for rare diseases.
Back to school, work, or sports
- Recovery time varies. Ask your care team when you can drive, lift, work, and exercise.
Children, pregnancy, and older adults
- Babies under 6 months: Higher risk.
Pregnancy and breastfeeding
- If you're pregnant or planning to be, tell your prenatal provider about this condition.
- Don't start or stop any medicine on your own. Some are safe in pregnancy and some need to be changed.
- Ask before taking any pain reliever. The FDA advises avoiding ibuprofen and naproxen after 20 weeks unless your doctor says to.
- Breastfeeding: Most medicines are fine, but ask. The NIH LactMed database lists what's known about each one.
For caregivers
- Go to visits when you can and take notes.
- Keep a list of medicines, allergies, and doctors in one place.
- Learn the warning signs that need fast care.
- Learn CPR. Many hospitals and the Red Cross offer classes.
- Take breaks and ask for help. Caregivers need care too.
Outlook
Methylene blue treats it quickly.
Getting ready for your visit
Bring a list of your symptoms and medicines.
What to bring
- A list of your medicines and supplements
- Notes on when symptoms started and what makes them better or worse
Questions to ask
- What follow-up care do I need?
- How can I prevent this from happening again?
Research studies
Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.
Search ClinicalTrials.gov for studies on Methemoglobinemia (blue skin from changed blood)
Sources
Last updated 2026-11-12.