What is Carotenemia?

Carotenemia is a benign condition characterized by yellowing of the palms, soles of the feet, face, and other areas of skin. The condition occurs when an excess of carotene, a yellow pigment found in foods, builds up in the bloodstream. It is most commonly 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 dietary changes. A baby who develops yellow-shaded skin should still be evaluated by a pediatrician, however, to rule out other possible causes.
Carotene, which is found in many plants and milk products, is a major source of dietary vitamin A. It is absorbed by the gastrointestinal tract and converted to usable vitamin A over time. When excess carotene overwhelms the small intestine, the pigment saturates the blood and skin. As a result, 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 may alter carotene levels in the body and lead to physical symptoms. In addition, a genetic metabolic disorder that inhibits carotene-vitamin A conversion can produce chronic symptoms. People who notice signs of carotenemia on themselves or their children should consult with a doctor to make sure there are no underlying health problems.
A physician can usually diagnose carotenemia by evaluating the physical appearance of the skin and asking about dietary habits. Carotenemia can be differentiated from more serious skin conditions such as jaundice by its manifestation: it tends to affect only small areas of skin and never involves the eyes. If a patient has symptoms of fatigue, abdominal pain, or weight loss, blood tests are typically needed to check for other medical problems.
In most cases, doctors do not recommend treatment for carotenemia. Since the condition is a result of what is usually considered a healthy diet, a physician simply reassures the patient that it is harmless. If an individual is concerned about the physical appearance of herself or her child, the doctor can suggest moderating carotene-rich foods such as carrots, cucumbers, broccoli, sweet potatoes, and squash. Yellowing starts to disappear within the first two weeks of limiting such foods, and the skin typically returns to normal within about three months. If making dietary changes does not help, a follow-up visit with a doctor is needed.

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