What should you know about healthy pale skin?

Some people naturally have lighter skin, and their colour remains fairly consistent across the face, lips, hands and nail beds. Temporary paleness can also follow cold, fear, pain or feeling faint because blood flow changes briefly. A lasting change may reflect reduced red blood cells, low iron, vitamin B12 deficiency or an inherited blood condition. Anaemia can present with pale skin and may also cause tiredness, breathlessness on exertion, headaches or a racing heartbeat. The symptom alone cannot identify its cause.

Compare the change with your usual colour in good daylight and note when it began, whether it is general or limited to one area, and any fatigue, dizziness, bleeding or dietary changes. Arrange a primary-care assessment if the paleness persists or is accompanied by symptoms. A clinician may examine your skin, eyes and nails and consider blood tests. Do not start iron supplements without advice, because treatment depends on the cause; discuss [Iron Supplementation](/treatments/medical-management/iron-supplementation/) if deficiency is suspected. Further information is available about [Pale Skin](/symptoms/pale-skin/) and [Anaemia](/conditions/anaemia/).

Seek urgent help for sudden marked paleness with fainting, chest pain, severe breathlessness, confusion, heavy bleeding or a cold, clammy feeling. Arrange prompt medical review for ongoing paleness with worsening tiredness, breathlessness, unusual bruising, dark stools, weight change or repeated dizziness. Mention any family history of [Thalassaemia](/conditions/thalassaemia/), [Sickle Cell Disease](/conditions/sickle-cell-disease/) or [Vitamin B12 Deficiency](/conditions/vitamin-b12-deficiency/).

Could my colour change be related to anaemia, iron levels or vitamin B12? Which examination or blood tests would clarify the cause? Should I change any medicines or supplements while this is being assessed?