Skin Color Changes

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Introduction

What are skin color changes?

Skin color changes include any discoloration of the skin in a patchy or uniform pattern. Skin color changes can include red, yellow, purple, blue, brown (bronze or tan), white, green, and black coloring or tint to the skin. Skin can also become lighter or darker than normal.

Types of skin color changes

Possible skin color changes include:

  • Blotchy red spots

  • Bruising or bleeding under the skin

  • Change in appearance of a mole or other birthmark

  • Darkening (hyperpigmentation), such as darkening of the facial skin

  • Flushing (redness)

  • Jaundice (yellowing of skin and eyes)

  • Mottled or marbled appearance

  • Pale bluish or grayish skin tone (cyanosis), which can also affect the lips and nails

  • Patchy skin color changes, such as patches of white skin (vitiligo)

  • Tiny red or purple spots (petechiae)

  • Unusually light skin color (hypopigmentation)

Pigment-producing cells in the skin called melanocytes give skin its color. Melanocytes produce a pigment called melanin. Lighter skin, or hypopigmented skin, produces less melanin, while darker areas of skin, or hyperpigmented skin, produce more melanin. Your skin may be naturally light or dark depending on how much melanin your skin produces. Changes in melanin production can be caused by changing hormone levels and medications.

Although melanin pigment is brown, its appearance changes hue the deeper it rests in the skin. This is due to an optical phenomenon called the Tyndall effect. Deep patches of melanin may look green, grey, even blue.

Changes in skin color can also accompany a variety of disorders, diseases and conditions, including inflammation, malignancy (cancer), organ failure, allergies, and infections. Changes in skin color can occur suddenly or gradually. The color can be blotchy and affect only a small area of the skin, such as a rash on your chest, or you may have a uniform change over the entire body, such as redness or jaundice (yellowing of the skin and eyes).

Skin color changes can be caused by a serious, potentially life-threatening condition, such as an allergic reaction, infection, or cancer. A rash of tiny purple spots on the skin can be due to meningitis or allergic purpura, both of which can be life threatening. Seek immediate medical care (call 911) if you, or someone you are with, have these symptoms or other serious symptoms, such as a change in consciousness, or hives or a rash accompanied by wheezing, shortness of breath, or swelling of the face, mouth or throat.

Symptoms

What other symptoms might occur with skin color changes?

In addition to skin color changes, you may experience other skin symptoms, such as itching, a change in texture, dryness, temperature changes, blisters, or pain. Other symptoms can affect the digestive tract, respiratory system, nervous system, cardiovascular system, endocrine system, or immune system.

For example, some serious cardiovascular conditions, such as acute congestive heart failure or heart attack, can be associated with skin color changes (pallor or cyanosis) as well as chest pain, dizziness, and shortness of breath. Contact your licensed health care provider regarding any type of persistent skin condition or skin color changes that cause you concern.

Other skin symptoms that may occur along with skin color changes

Skin color changes may occur with other symptoms affecting the skin including:

  • Blistering
  • Changes in skin texture
  • Increase or loss of hair
  • Inflammation or irritation
  • Itching
  • Pain
  • Photosensitivity (abnormal sensitivity to sunlight)
  • Scaling or peeling
  • Swelling
  • Temperature changes
  • Thickening or thinning

    Other symptoms that may occur along with skin color changes

    Skin color changes may occur with other symptoms related to other body systems including:

    • Changes in color of urine (deep orange or brown)
    • Numbness or burning sensation
    • Pale-colored stool

    Serious symptoms that might indicate a life-threatening condition

    In some cases, skin color changes may occur with other symptoms that might indicate a serious or life-threatening condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) for skin color changes accompanied by any of the following symptoms:

    • Bleeding symptoms including blood in vomit, stools or urine

    • Change in level of consciousness (fainting), confusion or alertness

    • Chest pain, tightness or pressure, or heart palpitations

    • Cold, clammy skin

    • High fever (higher than 101 degrees Fahrenheit)

    • Hot and dry or hot and moist skin with change in consciousness

    • Rapid heart rate (tachycardia)

    • Respiratory or breathing problems, such as shortness of breath, difficulty breathing, labored breathing, wheezing, not breathing, or choking

    • Severe headache

    • Sudden dizziness

    • Swelling of the mouth, lips, tongue or throat

    Causes

    What causes skin color changes?

    Your skin may be naturally light or dark depending on how much melanin your skin produces. Changes in melanin production can be due to a variety of conditions and some medications. Skin darkening can be due to changing hormone levels or medications, but it can also occur from exposure to ionizing radiation (such as the sun) or heavy metals. Radiation therapy can also cause an increase in skin pigmentation.

    Skin color changes can also be caused by a wide variety of other diseases, disorders and conditions, including genetic disorders, inflammation, malignancy (cancer), organ failure, allergies, and infections.

    Infectious causes of skin color changes include rashes and bacterial or fungal infections, as well as viral infections, such as roseola. Autoimmune and inflammatory causes of skin color changes include systemic lupus erythematosus, rheumatoid arthritis, psoriasis, and rosacea. In some cases, skin color changes can be due to very serious or life-threatening illnesses, including melanoma (a type of skin cancer), viral hepatitis, or poor blood flow due to peripheral artery disease (PAD).

    Infectious causes of skin color changes

    Skin color changes may be caused by a variety of infectious diseases including:

    • Bacterial skin infection, such as impetigo or cellulitis

    • Hepatitis (viral liver infection)

    • Tinea (yeast infection of the skin)
    • Viral infections

    Allergic causes of skin color changes

    Skin color changes may be caused by an allergic reaction including:

    • Allergic or irritant contact dermatitis, such as poison ivy, poison oak, or poison sumac
    • Drug reaction

    Autoimmune and inflammatory causes of skin color changes

    Skin color changes may be caused by autoimmune and inflammatory disorders including:

    • Erythema multiforme
    • Psoriasis (chronic skin disorder involving overproduction of skin cells)
    • Rosacea (chronic inflammatory skin disorder)
    • Systemic lupus erythematosus (disorder in which the body attacks its own healthy cells and tissues)
    • Vitiligo (possibly an autoimmune disorder that leads to loss of melanin-producing cells)

      Other causes of skin color changes

      Skin color changes can be caused by other underlying conditions or diseases including:

      • Adrenal gland dysfunction, such as Addison’s disease
      • Congenital (hemangioma, Mongolian spot, junctional nevus)
      • Exposure to toxic substances or poisons
      • Heat or high temperatures
      • Melasma (patchy skin darkening that is often seen in pregnant women)
      • Raynaud’s phenomenon (spasms of small blood vessels of the fingers and toes, reducing blood circulation. Raynaud’s phenomenon is secondary to many autoimmune disorders such as lupus)
      • Skin disorders, including rashes, that cause a temporary or permanent color changeSun exposure
      • Tumor growth

        Medications that cause changes in skin color

        Skin color changes can be caused by medications including:

        Life-threatening causes of skin color changes

        In some cases, skin color changes may accompany a serious or life-threatening condition, including an allergic reaction called anaphylaxis. Life-threatening conditions include:

        • Acute or severe cardiovascular or respiratory conditions, such as respiratory failure, heart attack, acute asthma, and congestive heart failure
        • Allergic purpura (severe allergic reaction)
        • Anaphylaxis (severe allergic reaction)
        • Blood circulation problems, such as peripheral artery disease (PAD)
        • Heavy metal poisoning
        • Hemachromatosis
        • Organ disease or failure of major organs, such as the heart, liver, pancreas, gallbladder or kidney
        • Septic shock and other forms of shock

        Questions for diagnosing the cause of skin color changes

        To diagnose the underlying cause of skin color changes, your doctor or licensed health care practitioner will ask you several questions about your symptoms. Providing complete answers to these questions will help your provider in diagnosing the cause of your skin color changes:

        • When did the skin color changes first appear and in what area of the skin?

        • What do the skin color changes look like?

        • Have you had simliar symptoms before?

        • Do you have any other symptoms?

        • Have you been in recent contact with any unusual substances or environments, such as exposure to allergens, chemicals or unusual plants, taking new medications or supplements, or traveling to a foreign country?

        • Describe all diseases and conditions in your medical history and list all of the medications, supplements, and herbal drugs you are taking.

        • Do you smoke? How much do you drink?

        What are the potential complications of skin color changes?

        Complications associated with skin color changes can be progressive and vary depending on the underlying cause. Because skin color changes can be due to serious diseases, failure to seek treatment can result in complications and permanent damage. It is important to visit your health care provider when you experience any kind of sudden, persistent or recurrent change in skin color. Once the underlying cause is diagnosed, following the treatment plan outlined by your doctor can lower your risk of potential complications of skin color changes and underlying causes including:

        • Growth or spread of skin cancer or infections and gangrene

        • Permanent organ damage, organ failure, and other life-threatening complications

        • Permanent skin discoloration

        • Poor quality of life, or psychological stress due to unsightly skin color changes
        • Progression

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        Medical Reviewer: William C. Lloyd III, MD, FACS
        Last Review Date: 2019 Jan 4
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