Carotenemia

Carotenemia is a benign condition in which the skin takes on a yellow-orange coloration due to elevated levels of carotenoids in the blood, most often beta-carotene. It typically appears on the palms, soles, and nasolabial folds and spares the sclera, which helps distinguish it from jaundice.

Common causes are excessive intake of carotene-rich foods such as carrots, sweet potatoes, pumpkin, and leafy greens, or the use of high-dose beta-carotene or other carotenoid supplements. Less commonly, disorders that affect metabolism or clearance of carotenoids such as hypothyroidism or certain liver diseases can predispose to higher carotene levels, but these conditions are not required for diagnosis.

Patients may notice a gradual color change; itching is not typical and there is no systemic illness associated.

Diagnosis is clinical; if there is concern for jaundice, liver tests and bilirubin measurements help differentiate, and serum carotene levels can be measured but are rarely needed.

Management consists of reducing dietary intake of carotene-containing foods or stopping supplements. Discoloration generally fades within weeks to months after intake is decreased, provided there is no ongoing excessive consumption. The condition does not indicate vitamin A toxicity; in fact, high vitamin A levels are not the same as carotenemia.