Having pale skin is normal for some people and simply describes the color of their complexions. However, when skin suddenly turns pale, it is often a sign of an underlying health condition. Unhealthy pale skin is called pallor.
The sudden or unusual lightening of one’s skin tone can occur in all skin tones.
This article will discuss conditions that have pale skin as a symptom. It will also cover how each condition is treated, and when sudden paleness may signal a medical emergency.
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What Paleness Looks Like
Sudden or unusual paleness can affect people with any skin tone and make the skin appear lighter than usual, or "ashy" in people with dark skin tones.
Paleness can often be confused with pigment loss, but the two are not one and the same. Paleness in this context does not have any connection to melanin, the pigment that gives the skin color.
Paleness is often most evident in (and limited to) the face, but it can also result in whitening of the nail bed, palms, mucous membranes in the mouth and eyes, lips, gums, and tongue.
What Causes Pale Skin?
Physiologically, sudden paleness is caused by lack of adequate blood supply to the skin or because there are a lower number of red blood cells than normal. A number of different conditions can result in this happening.
Common causes of sudden and unusual paleness include:
Vasovagal Syncope
Vasovagal syncope can occur when your body reacts strongly to a trigger—such as fear, heat exposure, or emotional distress— that your heart rate and blood pressure plummet, causing you tofaint. Sudden pale skin is a common symptom of vasovagal syncope.
Things that can trigger vasovagal syncope in some people include:
- Emotional distress
- Anxiety
- Fear
- Dehydration
- Excessive heat exposure
- Intense coughing
- The sight of blood or needles
Symptoms of vasovagal syncope include:
- Fainting
- Nausea
- Feeling warm
- Sweaty palms
- Feeling lightheaded or dizzy
- Blurry vision
Treatment for vasovagal syncope varies depending on the severity and the underlying cause. Some people rarely experience an episode, whereas others may be prone to fainting spells. Immediate treatment typically involves lying down with your feet elevated to help restore blood flow to the brain.
Possible treatments for vasovagal syncope include:
- Discontinuing medications that may lower blood pressure
- Wearing compression socks or abdominal binders
- Selective serotonin reuptake inhibitors (SSRIs) to help moderate the response of the nervous system
- Medications to increase blood pressure
- Corticosteroids to keep fluid and sodium levels up
Hypoglycemia
Hypoglycemia refers to low blood sugar. The symptoms of low blood sugar vary from person to person, and often affect people with diabetes. Symptoms can be mild to moderate or severe, typically come on suddenly.
Other than paleness, symptoms can include:
- Shakiness
- Excessive sweating
- Hunger
- Headaches
- Blurred vision
- Feeling dizzy, lightheaded, confused, or disoriented
- Nervousness or irritability
- Weakness
- Difficulty concentrating
- A fast or irregular heartbeat (arrhythmia)
- Inability to eat or drink
- Seizures
- Loss of consciousness
The first-line treatment for hypoglycemia is to follow the 15-15 rule, which involves eating at least 15 grams of carbohydrates, waiting 15 minutes, and checking your blood sugar again. If your blood sugar remains below 70 mg/dL, repeat the steps until your blood sugar is above that level.
The 15 grams of carbohydrates can come in the form of glucose tablets or gel, fruit juice or soda, a tablespoon of sugar or honey, or two tablespoons of raisins.
Anemia
Anemia is a condition that develops when the body does not have enough red blood cells to carry oxygen where it needs to go. There are many causes of anemia:
- Malnutrition: Not having enough iron, vitamin B12, or folic acid can lead to anemia.
- Blood disorders: Some inherited blood disorders can cause anemia, such as sickle cell anemia or thalassemia.
- Chronic conditions: Some chronic conditions such as hyperthyroidism, hypothyroidism, advanced kidney disease, and lupus can all lead to anemia.
- Blood loss: In some cases, losing blood due to an ulcer, heavy menstrual bleeding (previously called menorrhagia), hemorrhoids, or gastritis can cause anemia.
Aside from pale skin, the symptoms of anemia can include:
- Fatigue
- Shortness of breath
- Heart palpitations
The treatment for anemia depends on the cause. If a lack of nutrients is to blame, your doctor will treat the deficiency through oral or intravenous infusion of the missing nutrient. In some serious cases, a blood transfusion may be needed to restore healthy red blood cells in the body.
For anemia caused by a condition, it’s likely that the disorder needs to be treated. In the event that internal bleeding is the cause, surgery may be required to repair the injury that is causing the bleeding.
Sepsis
When a bacterial infection (such as a urinary tract infection or a surgical wound infection) spreads to the bloodstream, it can cause a systemic reaction known as sepsis. This can sometimes progress to septic shock, which is a life-threatening emergency.
In addition to pallor, symptoms of sepsis can include:
- Low blood pressure
- Weakness
- Confusion
- Fever
Intravenous antibiotic medications, given in a hospital, are often necessary to stop a serious bloodstream infection. IV fluids may also be administered, as well as medications that raise blood pressure.
What Is Sepsis?
Frostbite
Frostbite is an injury that occurs when a person’s skin is exposed to cold temperatures for a long period of time. It occurs because the tissues underneath the skin and the top layer of the skin become frozen. It is most commonly found in the feet, hands, ears, and nose.
The symptoms of frostbite will vary depending on how severe it is. In the early stages, symptoms will include paleness, throbbing and aching in the affected area, and a pins and needles sensation. If the tissue damage is more severe, the area will become hard and frozen.
Once the affected area has thawed, the skin will become blistered and red. The most severe form of frostbite will cause the skin to turn white, blue, or blotchy. Damage could extend to the bone in this case, and blisters full of blood will become black and scabbed.
To treat frostbite, the affected area will first be warmed in a bath of water mixed with an antiseptic solution at 38 degrees Celsius. If blisters form, they will likely be drained of any fluid and left alone to heal. The tissue that is affected may also be treated with a topical ointment and covered with a bandage.
Use These Pictures to Identify Frostbite
Shock
Shock occurs when the tissues in your body are deprived of oxygen, blood, and nutrients. When this happens, the body reacts quickly to keep itself alive.
A person can experience several types of shock. Cardiogenic shock occurs when there is a decrease in blood flow in the body, typically caused by damage to the heart. Hemorrhagic shock occurs when oxygen cannot be delivered throughout the body because fluid cannot be passed throughout the body normally.
Other types of shock include:
- Hypovolemic shock: This occurs when there is not enough blood volume in the body. It can cause internal bleeding.
- Neurogenic shock: This can happen when someone’s spine becomes injured, damaging the nerves that control the width of blood vessels. The blood vessels below the injury relax and open too much, causing a significant drop in blood pressure.
- Septic shock: This occurs when an infection causes dilated (expanded) blood vessels and a drop in blood pressure.
- Anaphylactic shock: When a person has a severe allergic reaction, their blood vessels dilate, causing low blood pressure.
- Obstructive shock: Obstructive shock causes a stop in blood flow.
- Endocrine shock: If someone is suffering from a critical illness, it may lead to damage to the heart functions and a drop in blood pressure that could be life threatening.
When a person goes into shock, they will experience many symptoms along with pale skin, including:
- Changes in pulse
- Irregular heartbeat
- Shallow and rapid breathing
- Lightheadedness
- Clammy skin that feels cool
- Dilated pupils
- Pain in the chest
- Nausea
- Confusion and anxiety
- Low blood sugar
- Extreme thirst
- A decrease in urination
- Unconsciousness
Since shock can be life-threatening, call 911 at the first signs of the condition. Once in the hospital, shock will be treated depending on the cause. Some treatments include heart surgery, blood transfusions, or antibiotics.
If you’re with someone experiencing shock, the first thing you should do is call 911. While waiting for medical help to arrive, if the person is not breathing or lacks a heartbeat, perform CPR.
Blood Pressure Changes
Changes in blood pressure can lead to pale skin. Blood pressure is the rate of force at which your heart is pumping blood throughout your circulatory system. Changes in blood pressure can happen throughout the day without causing problems. However, when blood pressure rises or drops significantly, this can indicate a health issue.
Many things can cause changes in blood pressure, including:
- Stress and anxiety
- Medications
- Physical activity
- Certain types of foods such as fermented foods and caffeinated beverages
- Adrenal insufficiency
What Is Abnormal Blood Pressure?
When blood pressure changes, it can either go too high or too low. High blood pressure is known as hypertension, whereas low blood pressure is known as hypotension.
In most cases, symptoms of high blood pressure are nonexistent. However, those with low blood pressure will often present with symptoms such as:
- Pale skin
- Dizziness or lightheadedness
- Nausea
- Fainting
- Dehydration and extreme thirst
- Blurry vision
- Cold and clammy skin
- Fatigue
- Shallow and quick breathing
In the event that blood pressure spikes to high levels, treatment will involve medications and lifestyle changes, including eating healthy, avoiding salty foods, managing stress, and exercising more.
For low blood pressure, treatment involves eating more salt and drinking more water, reducing or changing medications that may be causing a drop in blood pressure, and starting a new medication that can help to manage the drops.
Vitamin Deficiency
A vitamin deficiency occurs when the body doesn’t get enough of one or more vitamins or minerals that it needs because of a poor diet or an absorption issue. When this occurs, it can lead to health issues, such as digestion problems, skin diseases, bone health issues, and degenerative neurological disorders such as dementia.
Aside from pale skin, malnutrition can cause other symptoms, such as:
- Easy bruising
- Rashes
- Skin pigmentation changes
- Thin hair
- Achy joints
- Soft bones
- Gums that are easy to bleed
- Night blindness
- Swollen, cracked, or shriveled tongue
- Increased sensitivity to light
- Depression and anxiety
Changing one's diet or taking dietary supplements can often remedy a vitamin deficiency. In those who cannot eat or are not digesting their food properly, nutrients may need to be given through an IV or tube into the gastrointestinal tract. In some cases, long-term tube feeding may be recommended and the tube will be put directly into the stomach or small intestine and kept there.
Diagnosing Sudden Pale Skin
To get to the bottom of what is causing pale skin, your healthcare provider will start by asking you when the paleness started, what triggered it, and any other symptoms you have. They will also ask you about your medical history and any medications you take.
Diagnostic tests may include a complete blood count (CBC), blood pressure check, and a colonoscopy (if intestinal bleeding is suspected).
When to Seek Help for Pale Skin
In some cases, the sudden onset of pale skin can be a medical emergency. Seek emergency help if paleness presents with other symptoms such as fainting, fever, vomiting blood, rectal bleeding, or abdominal pain, or sepsis.
If you have pale skin accompanied by shortness of breath, pain, a feeling of coldness in any of your limbs, or chest pain, seek immediate medical attention.
Summary
Pale skin refers to the sudden loss of color from your skin. Unlike natural paleness, pale skin is usually a result of a health condition, such as anemia, low blood pressure, or frostbite. Some causes are not serious, while others require immediate medical attention. If you have pale skin and other concerning symptoms, see your doctor right away for a diagnosis.
