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Iron Deficiency, Sepsis, Anemia & 7 Other Pale Skin Causes

Pale skin can signal a variety of health problems ranging from simple nutrient deficiencies to dangerous changes in blood flow. Learn about pale skin causes.

Pale skin symptoms

You've been saving and planning for a year and the time has finally come. You're headed out on a two-week cruise in the morning. There's just one problem. Your pale skin is putting a major damper on your beach plans.

If your skin has always been pale, you can blame genetics. But if your skin normally has a darker or warmer glow to it, pale skin can signal a variety of health problems. Possible causes range from simple nutrient deficiencies to dangerous changes in blood flow.

If you are experiencing any of the following symptoms along with your pale skin you should seek immediate medical attention

Call 911 or go to the emergency room for:

Skin includes three pigments: melanin, carotene, and hemoglobin. Your unique combination of the three determine your natural skin tone. Melanin is the main pigment that determines your unique shade. If you spend your summers outside and in the open, an increase in pigment production from melanocytes, or cells that produce melanin, are the scientific cause behind your tan.

Changes in our skin tone can signal a variety of conditions. If you see a major change in all or a small part of your skin, a trip to the dermatologist can rule out the scary causes, like skin cancer. But in most situations, there is a treatable cause behind the change.

What is causing your pale skin?

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Causes of pale skin


Certain nutritional deficiencies can result in pale skin, such as the following.

  • Iron: Iron deficiency is among the most common deficiency in the United States and the most common worldwide. Symptoms include fatigue, difficulty maintaining body temperature, and paleness due to anemia. Infants, toddlers, and pregnant women are at a higher risk of developing an iron deficiency.
  • G6PD: Glucose-6-phosphate dehydrogenase deficiency is a genetic disorder that affects red blood cells. As the blood cells prematurely break down, paleness, yellowed eyes, and dark urine are some experienced symptoms.
  • Vitamin B-12: B-12 deficiencies are common in the elderly but can develop at any age. Our bodies need B-12 to produce red blood cells and DNA. Weakness, a pins-and-needles sensation in the hands or feet, and pale or yellowed skin are all symptoms.


Infections can result in pale skin, such as the following.

  • Sepsis: This potentially deadly infection is usually caused by bacteria. As the body's blood becomes more infected, fatigue, weakness, and pale skin can quickly develop.
  • Influenza: Commonly known as the flu, this infection affects the respiratory system. As less oxygen flows through the body, skin can take on a paler appearance.

Conditions and diseases

The following conditions may be present from birth, resulting in pale skin.

  • Cystic fibrosis: CF is typically diagnosed before or quickly after birth in infants, but some cases are difficult to diagnose. Symptoms include difficulty breathing, a swollen abdomen, and pale skin linked to a lower than average blood oxygen level.
  • Leukemia: A variety of cancers are linked to paler skin as the body weakens. But leukemia directly affects blood cells, making pale skin one of the first symptoms of the disease.
  • Vitiligo: If your pale skin is patchy compared to uniform, vitiligo could be to blame. There are no proven treatments of the condition, but it is harmless.
  • Anemia: Anemia causes fatigue, headaches, and pale skin.

Lifestyle choices

Lifestyle choices can contribute to pale skin, such as the following.

  • Poor diet: Eating junk food and skipping healthier options can lead to paler skin over time. Skin may also lose elasticity and appear dry and flakey.
  • Heat exhaustion: Spending the day out in the hot sun without getting enough rest or water can take its toll on the body. The skin might take on a bright red shade or appear paler.

This list does not constitute medical advice and may not accurately represent what you have.

Iron deficiency anemia

Iron deficiency anemia is a condition in which the body does not have enough iron to form hemoglobin, the protein in red blood cells that carries oxygen throughout the body.

The condition can be caused by acute blood loss through injury, surgery, or childbirth;chronic b..

Low blood cell counts due to a chronic disease

Anemia is a condition in which the body does not have enough healthy red blood cells, which are cells that provide oxygen to body tissues. Anemia of chronic disease is anemia that is found in people who already have certain long-term (chronic) medical conditions.

Rarity: Common

Top Symptoms: fatigue, shortness of breath on exertion, decreased exercise tolerance, dizziness when standing up, pale skin all over

Urgency: Primary care doctor

Folate (vitamin) deficiency

Folate is also called folic acid or vitamin B9. It is needed to create red blood cells, which carry oxygen throughout the body. A shortage of folate leads to a shortage of healthy red blood cells, which is also called anemia.

Folate deficiency can be caused by poor diet; alcohol use; some medications; diseases of the large intestine; and pregnancy, since the growing baby requires folate in larger amounts.

Symptoms include severe fatigue; loss of appetite; diarrhea; paleness; sore tongue; and irritability. The same symptoms can appear in other conditions, especially blood disorders.

Folate deficiency is also a cause of abnormal brain and spine development in a fetus. For these reasons, it is very important to see a medical provider if these symptoms occur.

Diagnosis is made through patient history, physical examination, blood tests, and sometimes digestive tract studies.

Treatment involves immediate supplementation of folate with injections, followed by folate and other vitamin and mineral tablets; improvement in diet; and treating any underlying digestive or blood disorder.

Rarity: Rare

Top Symptoms: fatigue, depressed mood, irritability, nausea or vomiting, diarrhea

Symptoms that never occur with folate (vitamin) deficiency: abdominal swelling

Urgency: Phone call or in-person visit


Hypothyroidism, or "underactive thyroid," means that the thyroid gland in the neck does not produce enough of its hormones. This causes a slowing of the body's metabolism.

The condition can occur due to autoimmune disease; any surgery or radiation treatment to the thyroid gland; some medications; pregnancy; or consuming too much or too little iodine. It is often found among older women with a family history of the disease.

Common symptoms include fatigue, constantly feeling cold, weight gain, slow heart rate, and depression. If left untreated, these and other symptoms can worsen until they lead to very low blood pressure and body temperature, and even coma.

Diagnosis is made through a simple blood test.

Hypothyroidism is easily managed with daily oral medication. The patient usually starts feeling better after a couple of weeks and may even lose some extra weight. It's important for the patient to be monitored by a doctor and have routine blood testing so that the medication can be kept at the correct levels.

Rarity: Rare

Top Symptoms: fatigue, depressed mood, difficulty concentrating, weight gain, muscle aches

Urgency: Primary care doctor


Vitiligo is a condition where white patches develop on the skin, which is due to a loss of color (pigment) from affected areas. There are usually no other symptoms apart from the strange appearance.

Rarity: Uncommon

Top Symptoms: loss of skin color around the lips, skin changes resembling vitiligo, loss of skin color on the arm or hand, loss of skin color on the neck

Urgency: Self-treatment

So... which condition is actually causing your pale skin?

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Pale skin treatments and relief

There are a few symptoms you should look out for if your skin has recently changed.

When pale skin is an emergency

Seek care immediately if you experience pale skin and:

At-home treatments for pale skin

If you want to help your body develop a healthier glow, consider these treatments:

  • Supplements: If your pale skin is caused by a deficiency, your doctor may prescribe you take a supplement of either iron, B-12, or folate.
  • Balanced diet: Eating a healthier diet can reverse skin paleness if related to deficiencies. Consume foods like peanut butter, avocados, and sweet potatoes.
  • Medication: If your paleness is related to an underlying condition or disease that can be treated with medication, proper dosages should return your skin to its normal shade.
  • Surgery: Blockages in the body are a rare but possible cause of paleness. Surgical intervention is usually a requirement to treat this cause.

If your pale skin is causing you stress, ruling out a serious condition is the first step. Once you're in the clear, starting treatment will get your healthy glow back.

FAQs about pale skin

What are the symptoms of anemia?

The signs and symptoms of a low red blood cell count, or anemia, depends on how severe the anemia is and how fast it has occured. Symptoms include fatigue, weakness, shortness of breath, dizziness or lightheadedness, headache, and pale skin. Anemia can also cause cold hands and feet, irregular heartbeats, and chest pain depending on any previous medical condition.

Why am I so pale and tired?

You may have anemia. Anemia is a low red blood cell count. It can occur because you are not producing enough red blood cells due to some sort of deficiency (iron or certain vitamins) or because you are losing blood by bleeding either externally (outside of your body) or internally (within your body). Other potential causes include a viral illness, malignancy and hypothyroidism.

What causes pale skin and dark circles?

Pale skin is most commonly caused by anemia or a low red blood cell count. The constriction of blood vessels in the face and limbs to heighten blood temperature during a fever causes a pale "sickly" appearance as well. Dark circles under the eyes are caused by fatigue most commonly, but can be caused by venous congestion from allergies or a cold.

Why are my palms pale?

Palms are usually given color by blood flow. If your palms are pale, it may be because of a decrease in the amount of blood that usually supplies them. Anemia is a common reason for pale palms as well as the constriction of blood vessels of the palms in cold weather, or, a more severe version of the same phenomenon, called Raynaud's syndrome.

What is making my eyelids pale?

Pale eyelids are a common sign of anemia. Physicians may check this by pulling down the eyelid and checking the amount of time it takes the eyelid to return to a normal pink color. Anemia can be caused by multiple diseases, some more benign than others, but all requiring treatment. If you suspect that you have anemia, you should seek treatment.

Questions your doctor may ask about pale skin

  • Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?
  • Have you been experiencing dizziness?
  • Have you ever been diagnosed with cancer?
  • Have you ever been diagnosed with an inflammatory bowel disease (IBD), like Crohn's or Ulcerative colitis?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

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  1. Berman K. Paleness. U.S. National Library of Medicine: MedlinePlus. Updated April 14, 2017. MedlinePlus Link.
  2. Skin Pigmentation Disorders. U.S. National Library of Medicine: MedlinePlus. Updated October 23, 2018. MedlinePlus Link.
  3. Miller JL. Iron Deficiency Anemia: A Common and Curable Disease. Cold Spring Harbor Perspectives in Medicine. 2013;3(7):a011866. NCBI Link.
  4. Glucose-6-Phosphate Dehydrogenase Deficiency. NIH: Genetics Home Reference. Published November 27, 2018. GHR Link.
  5. Septic Shock. NHS inform. Updated April 30, 2018. NHS inform Link.