Paleness

Alternative names
Skin pale or gray; Pallor

Definition

Paleness is characterized by an abnormal loss of normal skin or mucous membrane color which develops suddenly or gradually.

Considerations
Unless pale skin is accompanied by pale lips, tongue, palms of the hands, inside of the mouth, and lining of the eyes, it is probably not clinically significant, and does not require treatment.

Pale-looking skin does not necessarily indicate disease—lack of sunlight or inherited paleness may be the reason.

Although generalized pallor affects the entire body, it is most apparent on the face, lining of the eyes, inner mouth, and nails. Localized pallor usually affects a single limb.

How easily pallor is diagnosed varies with skin color and the thickness and vascularity of the subcutaneous tissue. Sometimes it is only a subtle lightening of skin color. It may be very difficult to detect in a dark-skinned person; sometimes it is apparent only on the eye and mouth lining.

Paleness may be the result of decreased blood supply to the skin (cold, fainting, shock, hypoglycemia) or decreased number of red blood cells (anemia).

Common Causes

• normal fair complexion
  
• lack of exposure to the sun (it is healthier to be pale than tanned)
  
• anemia (blood loss, poor nutrition, or underlying disease)
  
• shock
  
• frostbite
  
• chronic diseases including infection and cancer

• a person suddenly develops generalized pallor. Emergency interventions should be taken, if necessary, to maintain adequate circulation.
  
• paleness is accompanied by Shortness of breath, blood in the stool, or other unexplained symptoms.

Medical history questions documenting your pallor in detail may include:

• time pattern
  o Did it develop suddenly?
  o Did it develop in response to reminders of a traumatic event?
  
• location
  o Is it all over (generalized)?
  o Is it only in one location?
  + What location?
  
• other
  o What other symptoms are also present?
  o Is there pain in an affected body part?
  o Is there Shortness of breath?
  o Is there blood in the stool?
  o Are you Vomiting blood?
  o Is there a pale arm or hand, or leg or foot, and the pulse cannot be felt in the area?

• extremity arteriography (if pallor is localized)
  
• blood studies (CBC or blood differential)

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