Skin Discolorations

WHEN TO SEE YOUR DOCTOR

* Your skin or large portions of it turns any unusual shade.

* Your natural skin pigment disappears.

What Your Symptom Is Telling You

Candice always wears long sleeves, opaque stockings, a scarf around her throat, gloves and a broad-brimmed hat to shade her face. And she despises her image. She'd just love to ditch her wardrobe and join a bikini team. But a few minutes in the sun bring out her true colors: Large, lily-white patches of skin that glare starkly against the few pigmented areas that remain.

Candice has vitiligo—a common, physically harmless condition that is caused by the body's immune system "eating away" the skin's pigment. Occasionally it affects the entire body, says Leonard Swinyer, M.D., clinical professor of dermatology at the University of Utah in Salt lake City.

Not all skin color changes are quite so dramatic. A fairly common color switch is to yellow. There are several possible reasons for turning yellow. One is age. "Elderly people can develop a yellowish cast to the skin as it thins and lets the underlying fat layer show through," says Joseph G. Morelli, M.D., associate professor in the departments of dermatology and pediatrics at the University of Colorado Health Sciences Center in Denver.

If you have a package-a-day carrot habit or eat lots of foods rich in the nutrient beta-carotene, your skin might become yellowish. "Little kids often get this from eating lots of vegetable baby food," explains Robert E. Clark, M.D., Ph.D., director of the Dermatologic Surgery and Cutaneous Oncology Unit at Duke University Medical Center in Durham, North Carolina.

When an overall yellow color (jaundice) follows flulike symptoms, it can signal a serious problem, such as hepatitis, gallbladder trouble or cirrhosis of the liver. Jaundice occurs when bilirubin—a natural waste product of the body that is normally processed by the liver and excreted—backs up into the bloodstream, explains Francisco Averhoff, M.D., epidemiologist for the Hepatitis Branch of the Centers for Disease Control and Prevention in Atlanta. The toxin can give a fair-skinned person a sallow look, but it first turns the whites of the eyes yellow, regardless of skin tone.

Less commonly, reactions to certain heart medications can darken the skin or turn it a bluish shade. And on very rare occasions, a skin cancer on the surface of the body can become internalized and produce an overall color change to brown or black, says Dr. Swinyer.

Symptom Relief

If your skin turns red from overexposure to the sun, you know you've overdone your time in the outdoors. Any other color change deserves investigation and sometimes treatment.

Light up your life; darken your skin. "A possible treatment for vitiligo is PUVA," says Martin A. Weinstock, M.D., Ph.D., director of photomedicine at Roger Williams Medical Hospital and chief of dermatology at the Veterans Affairs Medical Center in Providence, Rhode Island. A drug called psoralen (the P in PUVA) and exposure to ultraviolet-A (UVA) light, are combined in an effort to generate pigment, he explains.

Quit the rabbit food. It's the obvious solution to a beta-carotene complexion. Beta-carotene is not toxic like vitamin A (to which it converts once it's in the body). Simply taking in less beta-carotene will get rid of the yellow hue.

See a doctor. "If you have jaundice," says Dr. Averhoff, "the underlying conditions must be diagnosed and treated by a physician."

You'll also need to see your doctor to get at the root of any other color change. If a heart medication is causing a bluish color, he may be able to alter your dosage or prescribe an alternate medication.

See also Jaundice