Pale skin care: what to know and do

Paleness may be easiest to see on the face, lips, inside the lower eyelids, gums, or palms, depending on your natural skin tone. It can follow cold, fright, dehydration, or a brief change in circulation. Persistent pallor can occur when the blood carries less oxygen, when blood flow is reduced, or when red blood cells are low. Anaemia, including iron deficiency, vitamin B12 deficiency, thalassaemia, or sickle cell disease, are possible explanations; a pale appearance alone cannot identify the cause.

Compare the colour with a usual photograph or a well-lit area, and record whether the change is general or limited to one region. Note fatigue, dizziness, headaches, racing heartbeat, breathlessness, fever, weight change, heavy menstrual bleeding, dark stools, or changes in diet. Eat regular meals with iron- and vitamin-rich foods, but do not start iron tablets without advice because treatment depends on the cause. A clinician may examine your skin and eyes and arrange blood tests.

Seek urgent help for sudden marked paleness with fainting, confusion, severe shortness of breath, chest pain, cold clammy skin, or heavy bleeding. Arrange a prompt appointment if pallor is new and lasting, repeatedly returns, or is accompanied by worsening tiredness, dizziness, unexplained bruising, or reduced exercise tolerance. New paleness in a child, older adult, or pregnant person also deserves timely assessment.

Ask whether you need a blood count, iron studies, vitamin B12 testing, or assessment for blood loss. Tell the clinician when the change began, what body areas are affected, your medicines and diet, and whether relatives have a blood disorder. Ask what result would change the treatment plan and whether follow-up testing is needed.