Yellow Skin: Carotenemia, B12 Deficiency, and Other Causes

Carotenemia (Most Common Benign Cause)

Excess β-carotene from supplements or high intake of carrots, sweet potatoes, squash, papaya, mango → yellow-orange discoloration of palms, soles, nasolabial folds. Sclerae remain white (vs. jaundice). Reversible with dietary reduction.

Vitamin B12 Deficiency

Pernicious anemia or malabsorption → megaloblastic anemia → pale/yellowish skin (from hemolysis + reduced RBC production). Accompanied by neuropathy, glossitis, fatigue.

Other Causes

• Jaundice (hyperbilirubinemia): Yellow sclerae + skin; liver disease, hemolysis, biliary obstruction.
• Hypothyroidism: Impaired carotene → vitamin A conversion → carotenemia.
• Medications: Quinacrine, phenytoin, sulfasalazine.
• Renal failure: Carotenoid retention.
• Lycopenemia: Excess tomatoes → orange-red skin.

When to See a Doctor

If sclerae are yellow, or if accompanied by fatigue, abdominal pain, dark urine, pale stools, weight loss, or neurologic symptoms.