Carotenemia is a condition in which yellow- or orange-colored skin develops due to high levels of beta-carotene in the blood. It is often caused by eating excessive amounts of foods or supplements high in the nutrient carotene. It can be resolved by reducing carotene intake and should not result in complications.
This article explains carotenemia symptoms, causes, diagnosis, and treatment.
Carotenemia Symptoms
The hallmark symptom of carotenemia is yellow- or orange-hued skin called carotenoderma. It tends to appear in thick areas of the skin, such as the palms of the hands and soles of the feet.
Carotenoderma across the whole body is rare. A telltale sign of carotenoderma is its enhanced appearance under artificial light.
Other symptoms, which may be due to specific rare causes of carotenemia, include:
- Pruritus (itchy skin)
- Fatigue
- Abdominal pain
- Weight loss
Carotenemia vs. Jaundice
Jaundice is a condition in which the skin also appears yellowish. It is caused by too much bilirubin (a byproduct of breaking down red blood cells) in the blood. However, one important difference between jaundice and carotenemia is that while both conditions may result in yellow skin, only jaundice leads to yellow sclera (whites of the eyes).
Causes
In carotenemia, there are high levels of beta-carotene in the blood. Carotene is the main nutrient converted into vitamin A in the body. However, because the body only converts a limited amount of carotene to vitamin A daily, high vitamin A levels do not occur with excessive carotene intake.
The most common cause of carotenemia is an excessive intake of carotene-rich foods over months.
Foods high in carotene include red, yellow, orange, and dark leafy green fruits and vegetables. These include carrots, sweet potatoes, papaya, cantaloupe, winter squash, broccoli, spinach, kale, red and yellow bell peppers, and tomatoes.
Infants and toddlers eating large amounts of orange and green pureed vegetables may develop carotenemia. This might, at first, be confused with jaundice.
Additional causes of carotenemia include other conditions, such as:
- Hypothyroidism (an underactive thyroid gland
- Diabetes (chronic condition affecting how the body uses blood sugar)
- Pregnancy
- Anorexia nervosa (an eating disorder with fear of weight gain and difficulty maintaining body weight)
- Familial (genetic) carotenemia
- Kidney conditions, such as nephrotic syndrome or glomerulonephritis
Diagnosis
To diagnose carotenemia, a healthcare provider will perform a physical exam to look at the areas of skin with yellow or orange pigmentation (the coloring of a person's skin).
They will also take a detailed dietary history, focusing on high-carotene foods and nutritional supplements. They may also ask you to estimate the amounts consumed and how long you've eaten the foods or taken the supplements.
Carotenemia resulting from the diet does not usually require laboratory confirmation. However, a healthcare provider may order blood tests to validate the diagnosis. Carotenemia can be confirmed by a high beta-carotene level, a normal or slightly elevated vitamin A level, and normal liver function test results.
If the cause of carotenemia is unclear, screening for other conditions that can occur with carotenemia should be performed.
Treatment
The main treatment for carotenemia is reducing the amount of carotene-rich foods and supplements in the diet. However, it’s important to not completely avoid carotene-containing foods, as they provide many essential health-promoting nutrients.
If the cause of carotenemia is not a result of diet, then treatment will involve addressing the underlying condition.
For example, suppose it is determined that diabetes or high blood sugar (glucose) levels are causing carotenemia. In that case, reducing blood sugar levels through diet, lifestyle changes, or medication may resolve the condition.
Prognosis
After reducing the amount of high-carotene foods in the diet, skin pigmentation is expected to slowly improve over time. Diet-induced carotenemia is nonprogressive and is unlikely to lead to any serious consequences.
Summary
Carotenemia is yellow or orange-hued skin due to high carotene levels in the blood. It is most often caused by eating excessive amounts of carotene-rich foods, such as dark leafy greens and orange, yellow, and red fruits and vegetables. Rarer causes of carotenemia include hypothyroidism, diabetes, anorexia nervosa, and pregnancy.
A healthcare provider can diagnose carotenemia based on a diet history and physical exam. Carotenemia is usually not serious and does not progress to other body systems. The main treatment is reducing the amount of carotene-rich foods in the diet, which will slowly resolve the carotenemia over time.
5 Sources
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By Brittany Poulson, MDA, RDN, CD, CDCES
Poulson is a registered dietician and certified diabetes care and education specialist. She is based in Utah.
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