How can I get rid of sallow skin (pale yellowish skin)?
My original skin tone is medium–dark. Since 2024, my body skin has become paleness. But gradually, from December 2024, my skin started turning a light yellow. Even now, it still looks pale and yellowish and sallow skin. Initially, I thought it might be jaundice, but my eyes are a normal colour, and the skin is not a deep yellow—it's more of a light, pale yellow. I noticed another sign: when I exercise, like running or cycling, my skin turns even lighter yellow. This never happened before. Earlier, after exercising, my face, hands, and feet would become red and look healthy. Another sign I noticed was that when I clench my hand for a while, it doesn’t turn red—it stays white with only a little redness. This never happened before. Earlier, when I did any activity at home, my hands and face would become red. I also sometimes feel weak or fatigued. I thought the pale yellow skin was happening due to vitamin D deficiency, but when I take sun exposure, my skin turns a yellow-orange mixed color. I don’t understand what is happening inside my body. I do several blood tests: Complete Blood Count (CBC) with ESR Hemoglobin: 14.6 gm% Total WBC count : 9110 cell/cumm DLC NEUTROPHILS : 73 % LYMPHOCYTES : 18 % MONOCYTES : 02 % EOSINOPHILS : 07 % PCV (PACKED CELL VOLUME) MCV : 76.3 fL MCH : 25.8 pg MCHC : 33.8 g/dl TOTAL RBC COUNT : 5.66 million/ cumm. PLATELET COUNT : 3.07 lakhs/cumm. ESR : 05 mm RDW-CV : 12.7 % -------------------- IRON Profile Test Serum Iron Total : 96 ug/dl TIBC : 347 ug/dl Serum ferritin : 32.6 ng/ml Transferring Saturation: 27.6 ---------------- Folate ( Folic acid) : 22.0 ng/ml -------------- Reticulocytes count : 0.6 % of RBC --------------- Vitamin B12 : 430.0 pg/ml ------------ LIVER FUNCTION TEST (LFT) Bilirubin Total : 0.9 mg/dl D.Bilirubin : 0.3 mg/dl I.D.Bilirubin : 0.6 mg/dl SGPT : 40 U/L SGOT : 44 U/L Alkaline Phosphatase : 68 u/l Total Protein : 7.4 gm/l Globulin : 2.8 gm/l Albumin; serum : 4.6 g/dl A/G Ratio : 1.64 ------------------------ Kidney Function Test (KFT) Creatinine; Serum : 1.1 mg/dl -------------------------- BP : 120/80 ------------ RBS : 91 mg/dl --------------- TSH : 3.14 mIU/L --------------------------- Sir, I want to know if it is possible to give any tips or advice without knowing the exact cause of my pale yellowish skin. Is there anything I can do or eat that might help the pale yellow skin disappear and bring back my normal skin color? Would it be possible to give such advice?
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Doctors' responses
The symptoms you’ve described—pale yellowish skin, fatigue, and changes during and after exercise—are peculiar and suggest a few possibilities that merit further exploration. Your blood tests show some findings worth noting. The slightly low MCV and MCH could hint at a form of mild anemia, potentially microcytic, which is common with iron deficiency. However, your iron studies seem fairly within the normal range. Although the serum ferritin is on the lower end of normal, this may not fully account for your symptoms. Given the normal bilirubin levels and low reticulocyte count, severe hemolytic anemia or jaundice seems less likely. Your vitamin levels (B12 and folate) also appear adequate, thus making nutritional deficiencies a less probable cause. However, even seemingly normal values in isolation can sometimes overlook subtle deficiencies or metabolic dysfunctions.
Given your normal liver function tests, simple jaundice is less likely without much increase in bilirubin. With your skin’s unusual color changes during sun exposure and exercise, a dermatological or perhaps metabolic condition might be at work. One possibility to investigate further is carotenemia, which can occur if your diet is overly high in carotene-rich vegetables like carrots and sweet potatoes, leading to yellowish skin, especially on the palms and soles. It doesn’t affect the sclera of the eyes, differentiating it from jaundice. You might want to review your dietary intake of such foods.
Fatigue can have various underlying causes, including subclinical hypothyroidism, even if your TSH is within the normal range. Consulting with an endocrinologist might provide further insight into any borderline thyroid dysfunction or adrenal issues that might explain your symptoms. Perhaps considering a more comprehensive metabolic panel, and specifically repeating your thyroid antibodies test, could uncover subtler signs of thyroid dysfunction. I would advise visiting a dermatologist or an internal medicine specialist for a more in-depth examination. Further serological tests or specific imaging may be required based on initial evaluation. In the meantime, ensure you have a balanced diet with adequate protein and micronutrients, and try to maintain regular sleep and exercise routines. Consider reducing excessively carotene-rich foods if they are exceptionally high in your diet. Importantly, don’t delay seeking medical follow-up, especially if symptoms change or worsen.
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