The appearance of an orange hue on the skin, particularly visible on the hands, is a phenomenon that often prompts concern. This color change, known scientifically as carotenoderma, is frequently noticed on the palms and soles of the feet. While this symptom is usually harmless, it can occasionally signal an underlying health issue that requires attention. Understanding the reasons behind this skin discoloration is the first step toward determining its significance.
Carotenemia: The Most Common Cause
Carotenemia is the most frequent reason for orange palms, resulting from elevated levels of carotene in the bloodstream. Carotene is a natural pigment found in many fruits and vegetables, such as carrots, sweet potatoes, and dark leafy greens. When consumed excessively, the body cannot convert this pigment into Vitamin A quickly enough. The unconverted, fat-soluble carotene then circulates in the blood and deposits into the skin’s outer layer, accumulating most noticeably in areas where the skin is thickest. This is why the pigment becomes highly visible in the palms and soles of the feet.
The pigment accumulation is particularly noticeable because the palms and soles possess a thick layer known as the stratum corneum. This dense layer of skin traps the carotene, making the discoloration pronounced in these specific areas. Although the condition is startling to observe, carotenemia caused by diet is considered medically harmless and requires no treatment beyond dietary adjustment.
How to Differentiate Benign Carotenemia
Distinguishing between benign carotenemia and a more serious condition relies on a single visual check: the color of the eyes. Carotenemia never causes discoloration of the sclera, which are the whites of the eyes. If the skin is orange but the sclera remain clear, the cause is almost certainly a harmless, diet-related excess of carotene.
This is the key difference that separates carotenemia from jaundice, a condition that also causes yellowing of the skin. Jaundice results from an excess of bilirubin, a different pigment created by the breakdown of red blood cells. When bilirubin levels are too high, it deposits in the skin and causes the whites of the eyes to turn yellow.
The reason for the difference lies in the skin structure of the eyes and the palms. The sclera and mucous membranes lack the thick stratum corneum that traps carotene. Therefore, if the orange hue is present on the palms but the sclera are unaffected, the body is dealing with excess carotene, not excess bilirubin.
Underlying Health Conditions That Cause Discoloration
While diet is the most common cause, orange or yellow skin discoloration can sometimes signal systemic medical issues that impair the body’s ability to process pigments. In these cases, the body struggles to break down carotene or eliminate bilirubin, even with a normal diet.
One metabolic condition linked to discoloration is hypothyroidism, where an underactive thyroid gland slows down the body’s processes. The thyroid hormone plays a role in the metabolic conversion of carotene into Vitamin A. When thyroid hormone levels are low, this conversion process decelerates, allowing carotene to build up in the blood and skin.
Discoloration can also be associated with diabetes mellitus, which may impair carotene conversion, resulting in elevated serum levels. Though the exact mechanism is not fully understood, the condition alters the metabolic pathway, leading to carotene buildup in the skin.
More concerning causes involve organs responsible for waste processing, such as the liver and kidneys. Liver disease can cause jaundice by failing to process bilirubin, leading to its accumulation throughout the body, including the eyes. Similarly, certain forms of kidney dysfunction, such as chronic glomerulonephritis, can lead to hypercarotenemia, as the kidneys play a role in eliminating compounds from the bloodstream.
When to Consult a Doctor and Treatment
If you notice a sudden orange discoloration of your palms, consult a healthcare provider to confirm the cause. A doctor will perform a physical exam, paying close attention to the sclera to rule out jaundice, and take a detailed dietary history to assess carotene intake.
If the cause is not clear, blood tests may be ordered, including a serum carotene level, a thyroid panel, and liver function tests. These laboratory results can help distinguish diet-related carotenemia from discoloration linked to an underlying condition.
For simple dietary carotenemia, treatment is a straightforward reduction in high-carotene foods. The skin color gradually fades as the body eliminates the stored pigment, a process that takes several weeks to a few months. Medical attention is recommended if the whites of the eyes are yellow, if the discoloration appears suddenly without a dietary change, or if it is accompanied by systemic symptoms like fatigue, unexplained weight loss, or abdominal pain.