What pale skin and pallor might be telling you

Skin colour is strongly genetic and pale skin can be totally normal for you and your family. Children are usually slightly paler-skinned than their parents, and females tend to be a little paler than males. However, if you or your child look and feel more washed out and paler than normal, then this may well be something called pallor. Pallor can indicate that something is not quite right within the body. Let’s explore what this can mean.

Common causes of pallor

• Illness: sometimes when you’re feeling under the weather, your skin might turn “sheet white” for a few days until the infection is fought off. This is very normal and a great barometer to know when you or your child is on the mend. Harder-hitting viruses like Epstein Barr Virus (Glandular Fever) and bacterial infections like Borrelia (Lyme Disease) can cause an inflammatory response, and one of the first signs can be pallor as well as fatigue. This is because they can both potentially lead to a state of anaemia.
• Excess bleeding: if you have a heavy menstrual flow, you have given birth recently or you have had heavy bleeding due to an injury then it will take time to rebuild your blood with enough iron and B vitamins.
• Low blood glucose: if the pallor comes and goes during the day and improves after eating, this could be a sign of hypoglycaemia or low blood glucose. Eating more protein and well-balanced meals can help prevent these more dramatic blood glucose highs and lows.
• Breathing problems: asthma, wheezing and difficulty breathing may lead to pallor in some people.
• Chronic inflammatory or autoimmune disease: some painful and systemic inflammatory conditions such as Juvenile Idiopathic Arthritis and Rheumatoid Arthritis as well an inflammatory bowel or iron and B vitamin malabsorption due to Coeliac disease (an autoimmune response to eating gluten) can also lead to pallor.
• Shock: a massive physical shock to the system like an allergic reaction, frost bite (or simply getting too cold), a surgical operation or accident, can cause the skin to go pale. This can remediate itself as the body heals and is a good sign that you are feeling much better.
• Emotional reactions: Things such as fright, fear and other intense emotions might manifest physically as pallor, making someone look “pale as a ghost.” This pallor can be seen in some people over the longer term who have more complex emotional and mental health issues as well as post-traumatic stress disorder (PTSD).

Nutritional factors – deficiencies and how to overcome them

• Low levels of iron: skin that is paler than usual in areas like the face, lower inner eyelids or nails may indicate a lack of iron. Iron levels and iron stores (ferritin) can be tested through a blood test via your medical doctor. Iron helps to pump oxygen and red blood cells around the body and brain which help you to feel energised and to support immunity. Increase your food sources of iron by eating  liver, beef, lamb, venison, eggs, pulses, green veg and apricots and top up with an iron supplement if you are not getting enough through your diet.
• B vitamin deficiency: vitamin B12 and B9 (folate) are also important blood builders alongside iron and are key for a glowing complexion as well as for energy, immunity and the nervous system. B12 is found in animal products such as meat, fish and eggs; and folate is from foliage such as salad leaves and green vegetables as well as pulses. B vitamin complex supplements should ideally be in the methylated bioavailable form if you need to top up your diet.
• Insufficient zinc and B6: if the skin doesn’t tan that easily and resembles that of a porcelain doll, it may be due to low levels of zinc and vitamin B6. Once these are at sufficient levels you may see some colour coming back into the cheeks during the summer months. Zinc is found in meats, fish and shellfish as well as dairy, nuts and seeds. Vitamin B6 is in poultry, fish, peanuts, bananas and oats. Again, you can top up with supplements if you are unable to consume enough of these nutrients.
• Not enough vitamin D: a lack of vitamin D might cause pale skin and dark circles under the eyes. It is important to keep vitamin D levels optimal to help support immunity and to dial down inflammation. Most people feel so much better overall once their vitamin D levels are supported optimally and this can come from sunshine exposure, eating foods rich in vitamin D like oily fish and grass-fed meat, as well as food supplements.

Round Up

While pale skin is often a natural and genetic trait, a sudden change or a steady decline to a paler complexion might indicate underlying health or emotional issues. Understanding the difference between natural pale skin and pallor is essential for recognising potential problems and seeking medical advice if needed. Eating a well-balanced diet rich in essential vitamins and minerals can also play a vital role in maintaining a healthy complexion.

If you would like to investigate any nutrient shortfalls or other reasons behind your or your child’s pallor then be in contact with our NatureDoc Clinical Team for support.

References

• Pallor
• The brightness dimension as a marker of gender across cultures and age
• Iron deficiency anemia: An updated review
• Anemia Screening
• Diagnostic dilemma of celiac disease presenting with weight loss and secondary amenorrhea: A case report  
• Skin findings associated with nutritional deficiencies
• The Relation of Conjunctival Pallor to the Presence of Anemia
• Accuracy and Reliability of Pallor for Detecting Anaemia: A Hospital-Based Diagnostic Accuracy Study
• Accuracy of clinical pallor in the diagnosis of anaemia in children: a meta-analysis 
• Vitamin B12 Deficiency
• Vitamin B12 and Vitamin D Deficiencies: An Unusual Cause of Fever, Severe Hemolytic Anemia and Thrombocytopenia
• Unusual manifestations of Epstein-Barr virus infection in an 8-month-old male infant
• Congenital Babesiosis After Maternal Infection With Borrelia burgdorferi and Babesia microti