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Paleness, also known as pale complexion or pallor, is an unusual lightness of skin color as compared to your normal complexion. Paleness may be caused by reduced blood flow and oxygen or by a decreased number of red blood cells. It can be generalized (all over) or localized. Localized paleness usually involves one limb. You should see your doctor if you have sudden onset of generalized paleness or paleness of a limb.
Anemia is a condition in which the body doesn’t produce enough red blood cells. It’s one of the most common causes of paleness. Anemia can be acute, meaning it has a sudden onset, or chronic, meaning it develops slowly.
Acute anemia is usually the result of rapid blood loss from trauma, surgery, or internal bleeding, often from the stomach or intestinal tract.
Chronic anemia is common. It can be caused by a lack of iron, vitamin B-12, or folate in your diet. There are also genetic causes of anemia, such as sickle cell disease and thalassemia. In these conditions, the body makes ineffective hemoglobin. This is the protein in red blood cells that carries oxygen. Chronic anemia can also be caused by diseases such as chronic kidney failure or hypothyroidism (when the body does not produce enough thyroid hormone). Certain cancers that affect the bones or bone marrow can also cause anemia due to poor production of blood cells over a period of weeks to months.
Other causes of paleness include:
Skin color is determined by several factors, such as the amount of blood flowing to the skin, the skin’s thickness, and the amount of melanin in the skin.
Paleness may also be noted in the following areas:
Paleness can be a nonlife-threatening manifestation of emotions such as fear ("pale as a ghost"), or it can be a sign of serious medical problems such as severe anemia, bloodstream infection, or frostbite.
Paleness in the inner eyelids is a reliable sign of anemia, regardless of race. It is also considered a sensitive indicator of severe anemia.
Paleness often occurs along with other symptoms, such as those associated with anemia. Symptoms of anemia vary based on the severity.
Symptoms of acute onset anemia can include:
In women, heavy menstrual bleeding is a common cause of chronic anemia. In many parts of the world, poor nutrition is a common cause. Chronic anemia may have no symptoms other than paleness, fatigue, or sensitivity to cold.
Arterial blockage, or a lack of blood circulation, can cause localized paleness. This typically occurs in the arms or legs. The limb becomes painful and cold due to lack of circulation.
Call your doctor right away if you suddenly develop generalized pallor. Paleness is considered a medical emergency when it’s accompanied by symptoms such as:
Other serious symptoms that require immediate medical attention include shortness of breath, pain and coldness of a limb, and chest pain with sudden onset of paleness.
People who have a sudden onset of pallor as well as severe symptoms such as fainting, fever, and abdominal pain should be seen in the emergency room. People with paleness and symptoms such as fatigue and mild shortness of breath can usually be seen in the doctor’s office.
Pallor, low blood pressure, and a faint, rapid pulse are signs that you’re seriously ill. Abdominal pain and tenderness might mean that internal bleeding is causing your pallor. If you experience any of these symptoms, your doctor may need to order additional tests right away to determine the underlying cause of your condition.
Your doctor will review your symptoms to choose which tests will help them make a diagnosis. They will also review your medical history, perform a physical examination, and check your heart rate and blood pressure. Pallor can often be diagnosed by sight, but it can be hard to detect in people with dark complexions. In these people, pallor can be detected by checking the inner eyelids and mucous membranes for a loss of color.
The following tests are used to evaluate causes of paleness:
Treatment depends on the cause of your pallor. The options can include:
The consequences of untreated paleness depend on the underlying cause. Acute cases of pallor require immediate medical attention. Ongoing paleness can often be treated with medication. However, having the correct diagnosis about what’s causing your paleness is key to timely and proper treatment.
Written by: Verneda Lights
Medically reviewed on: Oct 25, 2016: Judith Marcin, MD
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