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Paleness: causes and treatment

by Josephine Andrews
Published: Last Updated on 264 views

Pallor is defined as pale, sallow or pale skin. Pallor of the skin is often caused by a lack of oxygen in the blood. However, it occurs naturally in people with light skin. In some cases, pale skin and mucous membranes (e.g. pale gums) are also signs of diseases (e.g. anemia, iron deficiency). Find out here what causes paleness, when you need to see a doctor and what helps against pale skin.

quick overview

  • Causes of paleness: lack of oxygen in the blood, diseases (e.g. anemia, iron deficiency), natural skin coloration of a person
  • When to the doctor? If those affected feel well, no treatment is necessary at first. Paleness that cannot be explained and occurs with other symptoms must be clarified by the doctor.
  • Treatment : The treatment depends on the cause of the pallor. Among other things, medication, lifestyle adjustments, home remedies (e.g. contrast showers) are possible.
  • Signs: Skin is lighter than usual, sallowness of the face, pale mucous membranes (e.g. pale gums, pale tongue)
  • Diagnosis: discussion with the doctor, physical examination: visual diagnosis, blood pressure measurement, electrocardiogram ( ECG ), ultrasound , magnetic resonance imaging (MRI)

What causes pale skin?

The causes of pallor are varied. Both diseases and the natural pigmentation (coloration) of a person’s skin lead to pale skin. For example, someone who consistently avoids the sun is usually naturally paler than someone who spends a lot of time in the sun.

Pale skin is completely normal in people with a light skin type and does not automatically mean that someone is ill. However, if the skin appears paler than usual, consult your doctor.

Skin pallor occurs with:


In most cases, pallor occurs when the skin does not have enough blood supply. A possible reason for this is a lack of red blood pigment ( hemoglobin ) and red blood cells. In this case, doctors speak of anemia or anemia. As a result, the organs receive too little oxygen. This manifests itself, among other things, in the fact that those affected are pale in the face and/or the mucous membranes (e.g. pale gums or a pale tongue) appear light.

There are various causes for anemia. Many of these are harmless, such as an iron deficiency or vitamin deficiency caused by an unbalanced diet. But anemia is also possible due to bleeding (e.g. open wound, bleeding stomach ulcer ). Other causes include congenital genetic defects and diseases (e.g. chronic renal insufficiency, cirrhosis of the liver ). It is important that the doctor diagnoses and treats the cause of the anemia.

iron deficiency

One form of anemia is iron deficiency anemia. Iron deficiency is a common cause of pale skin, especially pale lips. Iron is important for oxygen uptake and storage as well as blood formation in the body. If there is too little iron in the blood, cells and organs receive too little oxygen. The lack of oxygen often makes those affected feel tired. Their skin is often pale and dry, and in some cases there are also dark circles under the eyes and red eyes (the inside of the lower eyelids have a reddish tinge).

Iron deficiency usually occurs either because those affected take in too little iron through food (e.g. too little meat, fish or legumes). Or they lose too much blood due to an injury or internal bleeding. Certain medications, such as drugs that inhibit gastric acid production (e.g. antacids, proton pump inhibitors) also impede the absorption of iron. In some cases, heavy monthly menstrual bleeding in women leads to iron deficiency.


Excessive blood loss is a possible cause of anemia (hemorrhagic anemia) and hence pale skin. This happens, for example, when someone is injured as a result of an accident and loses a lot of blood as a result. However, persistent minor internal bleeding (e.g. a bleeding stomach ulcer, intestinal polyps or haemorrhoids ) also cause chronic blood loss, which over time develops into anemia. People who lose a lot of blood acutely or over a longer period of time therefore usually look pale.

skin diseases

Pale skin is sometimes visible in a circle around the mouth. This is the so-called perioral pallor, colloquially known as “milk beard”. In the case of perioral pallor, the entire face does not turn pale, only the area around the mouth (mouth-chin triangle) appears lighter. Perioral pallor is, among other things, a typical accompanying symptom of skin diseases such as neurodermatitis or scarlet fever .

Vitiligo , also known as white spot disease, is a skin lesion in which white, sharply defined patches appear on the skin. However, the skin is not pale in the classic sense, but lighter in some areas due to a lack of the skin pigment melanin.

Raynaud’s Syndrome

In the so-called Raynaud’s syndrome (also Morbus Raynaud), attack-like circulatory disorders occur in the body. It is typical for the fingers (but not the thumb) or the toes to become whitish-pale and later blue in attacks. Those affected often report a feeling of numbness or pain in the relevant areas. Sudden constriction of the vessels (vasospasm) is caused by disturbances in the blood vessels , disturbed nerve activity or a disturbance in the hormonal balance. The exact causes for this are so far largely unknown.

If your fingers or toes suddenly turn pale or white, get them checked out by a doctor as a precaution. Most of the time, the symptoms are harmless. In rare cases, however, there is a disease (e.g. arteriosclerosis) behind it.

Congenital pigment deficiency (albinism)

Albinism (Latin “albus” for white) is an inherited and genetically determined metabolic disorder. It causes those affected to produce too little or no melanin at all. This pigment is responsible for the color of a person’s skin, hair and eyes. The more melanin there is in the skin, the darker its coloration. People with albinism therefore have whitish-pale skin and light blond to white hair. Their eyes appear pink or pale blue to light gray.

Other diseases

Pale skin also occurs with the following diseases or signs of a disease, among others:

  • acute nausea
  • emotional reactions such as fear
  • Cardiovascular problems such as low blood pressure (hypotension) or peripheral arterial disease (PAD for short; this is when the blood vessels that supply the legs and arms with oxygen are narrowed)
  • Shock (e.g. suddenly pale face from severe blood or fluid loss or an allergic reaction)
  • panic attacks
  • fainting (syncope)
  • Low blood sugar in diabetes mellitus
  • Infections (e.g. flu )
  • poisoning
  • hypothermia, frostbite
  • Cancers such as leukemia (blood cancer)

If an illness is the cause, skin pallor often occurs at the same time as other symptoms such as tiredness, lack of drive, dizziness or shortness of breath.

How dangerous is pallor?

Pallor is a very non-specific symptom and occurs in different situations. If you’re fine, there’s no reason to worry about pale skin at first. If there are other symptoms in addition to pallor, please consult a doctor:

  • If you have been looking noticeably pale for several days or if a certain area of ​​your body suddenly becomes pale and/or swollen.
  • If, in addition to pale skin, you have additional symptoms such as shortness of breath, dizziness, pain, gastrointestinal problems, abdominal pain, extreme tiredness, chills or fever.
  • If your periods are much heavier than usual, last unusually long, or come back even though you have been through menopause for some time.
  • If you notice blood in your stools or your stools are black in color.
  • If your urine changes color (e.g. due to blood) and/or the amount of urine, or if you urinate unusually frequently.
  • If you cough up blood or if your sputum looks bloody.
  • If you vomit blood.
  • If you have recently lost several pounds for no apparent reason.

If your baby or child is pale but fit and has no other ailments, this is nothing to worry about at first. If you are unsure, ask your pediatrician or family doctor for advice.

What helps against pale skin?

If the doctor has found the cause of the skin pallor and it is actually based on a disease, he treats it specifically. The treatment of pallor always depends on the cause. The following therapies are possible:

  • If there is an iron deficiency or a vitamin deficiency, you can first try to change your diet. If this is not enough, the doctor prescribes suitable preparations (e.g. capsules, tablets, infusions).
  • If you have low blood pressure (arterial hypotension), try to stimulate your circulation by exercising more, exercising and drinking enough water.
  • The doctor treats infections with drugs that fight the pathogen (e.g. antibiotics for bacterial infections).
  • If circulatory disorders due to constricted blood vessels in the legs (e.g. PAD) are the reason for the pale skin, walking training can help (e.g. walking at walking pace for at least 30 minutes at least three times a week). If the symptoms are severe, medication and, if necessary, vascular surgery may be necessary. If you smoke, please try to quit.
  • If blood loss from stomach or intestinal ulcers is responsible for the pallor, the doctor usually removes it as part of a gastroscopy or colonoscopy . Bleeding vessels, eg in the esophagus (varicose veins) or haemorrhoids, can also be sclerosed ( sclerotherapy ) or pinched off (ligature).
  • If the person concerned is pale due to heavy blood loss or severe anemia, blood transfusions may be necessary at short notice.
  • If other serious diseases are the reason for the pallor (e.g. cancer, kidney failure), the doctor treats them accordingly.

Only take iron or vitamin supplements and other medications after consulting your doctor. He will monitor the intake and check it regularly (e.g. by means of a blood test)!

home remedies

You can try some home remedies to help with your pale skin. However, these do not replace the diagnosis and treatment of pallor by your doctor. Examples of home remedies for paleness include:

  • Exfoliators: Use exfoliators once or twice a week for a rosier, more vibrant complexion.
  • Skin care: Sufficient moisture is important for a rosy complexion and healthy skin. Therefore, especially in the cold season, rely on products that contain urea or hyaluronic acid.
  • Alternating hot and cold showers (Kneipp treatments): those who alternately take hot and cold showers stimulate blood circulation through the difference in temperature. This invigorates the skin and makes it rosy.
  • Sauna sessions: Go to the sauna regularly. The heat dilates the blood vessels. This will restore your sallow and pale skin to a rosy colour.
  • Skin brushing: In the morning, massage your facial skin with a gentle skin brush. This gives you a healthy blush in seconds.

Home remedies have their limits. If the symptoms persist over a longer period of time, do not get better or even get worse, you should always consult a doctor.

Healthy lifestyle

Adjust your lifestyle if your pallor may be caused by an unhealthy lifestyle. Eat a healthy and balanced diet (lots of fruit and vegetables, little fat and sugar). Exercise regularly (about 30 minutes a day, but at least 2.5 hours a week). Make sure you drink enough (about 1.5 to 2 liters per day), preferably tap water, mineral water, tea and diluted fruit juices. Do not drink alcohol or only drink small amounts. Get enough sleep (about seven to eight hours a night). Avoid stress and quit smoking if you can.

What is pale skin?

Pallor on the face (pale complexion) is usually recognizable at first glance. The skin appears sallow and has a very fair complexion. People with fair skin type have naturally pale skin. That’s nothing to worry about. If the paleness is pathological, other areas of the body are often also very pale, for example the oral mucosa, gums, tongue, inside of the lower eyelids, hands, fingers, toes, arms and/or legs. Depending on the cause, pale skin also occurs with other symptoms such as fatigue, nausea, tremors and/or fever.

How does the doctor examine paleness?

The first point of contact for pale skin is the general practitioner. The doctor first conducts a detailed discussion (anamnesis) with the person concerned in order to find out the cause of the pallor. If there are further questions about the patient’s state of health or if further examinations are necessary, the family doctor will refer you to a specialist if necessary.

conversation with the doctor

During the interview, the doctor asks the person concerned, among other things, whether they have any previous illnesses, what their lifestyle is like (do you eat healthily? Do you smoke?) and whether they are taking any medication. In addition, the doctor asks whether there are any other physical characteristics or complaints apart from the pallor.

Physical examination

During the physical examination, the doctor looks closely at the skin color in visible areas such as the hands, the nail bed, the lips and the mucous membranes (eg the conjunctiva of the eyes or the lining of the mouth). In addition, the doctor measures the blood pressure and pulse of the person concerned to check the blood flow and function of the heart. If necessary, he performs an electrocardiogram (ECG), which provides information about the activity of the heart muscle.

In some cases, the doctor does the so-called fist test. The affected person raises one arm and clenches his hand into a fist up to 60 times within two minutes. Meanwhile, the doctor presses on the artery of the wrist. After the time has elapsed, the doctor releases the wrist . Normally, the hand is supplied with blood again quickly and the skin turns pink to reddish. If the blood circulation is disturbed, the skin of the hand initially remains pale and the patient complains of pain.

The doctor usually also takes blood to rule out possible diseases (e.g. anemia, iron deficiency, kidney disease, infection). Ultrasound (sonography) or magnetic resonance imaging (also: magnetic resonance imaging, MRI) are sometimes used to further examine the blood flow in the affected body area. If the person concerned has pain in the stomach or intestines, the doctor will carry out a gastroscopy (gastroscopy) or colonoscopy (colonoscopy). Depending on the findings, further examinations follow to diagnose the cause of the pallor.

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