What are the possible solutions for my pale, yellowish skin?

Question

Hi doctor,

My original skin tone is medium-dark. For two years, my skin has become pale. At first, I thought pale skin looked beautiful, so I did not pay much attention.

However, gradually, my skin began to take on a light yellow hue. Even now, it appears pale and yellowish. Initially, I suspected it might be jaundice, but my eyes are a normal color, and the yellowing is not deep; it is more of a light, pale yellow.

I have noticed another change: when I exercise, like running or cycling, my skin turns an even lighter yellow. This never happened before. Previously, after exercising, my face, hands, and feet would turn red and look healthy.

Another sign I observed is that when I clench my hand for a while, it does not turn red; it remains white with only a slight redness. This also never happened before. Previously, whenever I engaged in any activity at home, my hands and face would become red. Additionally, I sometimes feel weak or fatigued.

To address this issue, I have avoided all kinds of fast food, tea, sugar, vegetables, food cooked in oil, spices, and turmeric. I also refrain from eating meat and eggs, opting instead for boiled vegetables and rice.

I have undergone several blood tests, and here are the results:

Complete blood count

WBC: 6.62 ×10⁹/L.
RBC: 5.13 ×10¹²/L.
Hemoglobin (HGB): 13.3 g/dL.

Thyroid

TSH: 3.14 mIU/L.

Liver function test (LFT)

Total Bilirubin: 0.9 mg/dL.
Direct Bilirubin: 0.3 mg/dL.
Indirect Bilirubin: 0.6 mg/dL.
SGPT (ALT): 40 U/L.
SGOT (AST): 44 U/L.
Alkaline Phosphatase: 68 U/L.
Total Protein: 7.4 g/dL.
Serum Albumin: 4.6 g/dL.
Globulin: 2.8 g/dL.
A/G Ratio: 1.64.

Kidney function test (KFT)

Serum Creatinine: 1.1 mg/dL.

Due to my skin tone, I feel ignored by others when talking, working, or even when they look at me. People keep their distance, as if I am contagious. They also avoid visiting my home. I never realized society had such unwritten rules.

Because of my skin tone, I feel very insecure in social situations. I often feel alone and sometimes wish I did not want to live because it seems my life is already ruined. It feels as if there is no other option, but I continue to live with hope.

I would like to know if it is possible to receive any tips or advice without knowing the exact cause of my pale, yellowish skin. Is there anything I can do or eat that might help restore my normal skin color? I would appreciate any advice you could provide.

Please guide.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and understand your concern.

Based on your test results (attachment removed to protect the patient's identity), your liver and kidney functions appear normal, as indicated by bilirubin, SGPT (serum glutamic-pyruvic transaminase)/SGOT (serum glutamic-oxaloacetic transaminase), and creatinine levels within standard ranges.

Your hemoglobin is also normal for a male, so anemia is unlikely. Some of the possible reasons for your pale, yellowish skin, despite the normal tests, are the following:

Mild carotenemia: This can occur if you are consuming large amounts of certain vegetables, such as carrots, pumpkin, or spinach.
Mild iron deficiency: Low ferritin levels may indicate a slight iron deficiency or possible deficiency of vitamin B12 or folate, which may not be fully captured in a basic complete blood count (CBC).
Hypothyroidism: Your TSH (thyroid-stimulating hormone) level is 3.14 mIU/L, which is borderline high and could contribute to pale or dry skin.
Dietary issues: Relying solely on boiled vegetables and rice may result in a lack of protein and essential nutrients, potentially worsening your skin health.
Psychological distress: Stress or depression can amplify your perception of changes in your skin.

To improve your skin health, I suggest the following tips for you. You can make these modifications to your diet to improve your overall health.

Increase your protein intake. Incorporate more protein-rich foods such as lentils, beans, and dairy (if possible) to support albumin levels and tissue repair.
Add vitamin C-rich foods to your diet. Include foods like lemons, amla, and bell peppers to enhance iron absorption, especially if you follow a vegetarian diet.
Include healthy fats in your diet. Try to consume healthy fats from sources like nuts, seeds, and a small amount of oil for better skin health.
Monitor your vegetable intake. Check if yellow vegetables like carrots and pumpkin are frequently in your diet; consider reducing them temporarily.
Try to stay hydrated. Ensure you drink enough water and protect your skin from sun exposure.

Following these suggestions may help improve your skin and overall well-being. You can also consider doing some additional tests. When possible, test for vitamin B12, folate, ferritin, and thyroid antibodies to get a clearer picture of your health. Please follow up with your test results.

I hope I have addressed all your questions. If there is anything else, please let me know.

Thank you.