What is carotenemia?

Carotenemia is a benign condition characterized by yellowing of the palms, soles of the feet, face, and other areas of the skin. The condition occurs when too much carotene, a yellow pigment found in food, builds up in the bloodstream. It is most often seen in infants whose diets consist of carotene-rich foods such as carrots, green and yellow vegetables, and milk. Carotenemia does not normally require medical treatment, and the physical signs usually go away on their own with minor changes in diet. However, a baby who develops yellow skin should be evaluated by a pediatrician to rule out other possible causes.

Carotene, found in many plants and dairy products, is an important source of vitamin A in the diet. It is absorbed by the gastrointestinal tract and is converted to usable vitamin A over time. When excess carotene overwhelms the small intestine, the pigment saturates the blood and skin. As a result, the skin exhibits a light yellow to orange hue.

Carotenemia is almost always associated with diet, but it can occasionally be a sign of a more serious condition. Diabetes, hypothyroidism, and liver and kidney disease can alter carotene levels in the body and cause physical symptoms. In addition, a genetic metabolic disorder that inhibits vitamin A-carotene conversion can produce chronic symptoms. People who notice signs of carotenemia in themselves or their children should see a doctor to make sure there are no underlying health problems.

A doctor can usually diagnose carotenemia by evaluating the physical appearance of the skin and asking about eating habits. Carotenemia can be differentiated from more serious skin conditions, such as jaundice, by its manifestation: it tends to affect only small areas of the skin and never affects the eyes. If a patient has symptoms of fatigue, abdominal pain, or weight loss, blood tests are usually needed to check for other medical problems.

In most cases, doctors do not recommend treating carotenemia. Since the condition is the result of what is generally considered a healthy diet, a doctor simply assures the patient that it is harmless. If a person is concerned about the physical appearance of himself or her child, the doctor may suggest moderating carotene-rich foods such as carrots, cucumbers, broccoli, sweet potatoes, and squash. The yellowish color begins to fade within the first two weeks after limiting such foods, and the skin usually returns to normal in about three months. If making dietary changes doesn't help, a follow-up visit with a doctor is needed.

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