The Fugates: an Inbred Appalachian Family with Blue Skin

No, these aren’t smurfs or smurf-wannabes. This is the Fugate family, a people who live in the impoverished hills of Kentucky.

The blue lineage of the Fugates began in the early 1800s. They were an isolated family in eastern Kentucky, and they startled everyone by producing children who were blue. Due to all the intermarriage and inbreeding, many members of the Fugate family and their descendants were born with this rare condition of being, well, blue. You would think they are wearing makeup or had their photos Photoshopped, but science proves that this rare skin condition is very real.

History of the Blue Fugate Family:

It all started with Martin Fugate, a French orphan, who settled on the banks of eastern Kentucky’s Troublesome Creek. He married a red-haired American named Elizabeth Smith. Smith had a very pale (non-blue) complexion. Their genetic chemistry together, along with a certain strong recessive gene, formed a mutation that resulted in their descendants being born with blue skin. The blue skin also set them apart and so they began inbreeding more than ever.

Today, this skin condition is recognized by science and is called methaemoglobinaemia (commonly known as met-H). The reason a person turns blue is because of their inability to carry oxygen in their blood. That is why their blood is darker than the dark red color typically in people without the disease.

In 1958 one of the blue men, Luke Combs, a descendant of a branch of the Fugate family, took his white wife to the University of Kentucky Hospital and doctors paid more attention to him than his wife. This was, perhaps, the first time the condition was documented.

Soon after, a nurse named Ruth Pendergrass and the hematologist Madison Cawein III, observed their condition and ancestry in great detail before Cawein treated the family with methylene blue, which eases symptoms and reduces the blue coloring of their skin.


As eastern Kentucky has become vastly more populated than the early 19th century, and as more genes are married into the Fugate family tree, there were far fewer children born blue. This is perhaps a good thing, but it’s sad in a way too. There are still some blue people left in the world, mainly in the same region as the Fugates. People assume they are from the same lineage but there have been no conclusive investigation into this theory.