What Is Pallor?

Pallor is a term that describes an abnormally pale appearance. It occurs when there is a decrease in the amount of blood flowing to your tissues. Red blood cells (RBCs) contain hemoglobin, a molecule that gives blood its red color. Hemoglobin binds with oxygen on your RBCs and travels through the vessels to be delivered to your body's tissues, displaying a red pigment as it moves under the skin.

If many cases, pallor is a normal response that occurs in a person with healthy hemoglobin levels and good blood flow, such as if you go outside when it's cold.

However, many conditions can be the cause for experiencing pallor, and it's typically not a concerning sign unless seen in certain areas of your body. Diagnosing the cause of your pallor will consist of a review of your medical history and other symptoms you are experiencing. Treatment begins with addressing the underlying cause and preventing complications from lack of blood flow to tissues.

Types of Pallor

Pallor can result from a disease process that causes the blood to leave the less important areas of the body and divert to the more critical organs. It can also result from a reduced amount of certain blood cells, which can occur due to various conditions. The type of pallor will vary based on what is causing it. Some causes of pallor are more common and less severe than others.

Anemia

Anemia is when your body doesn't have enough red blood cells and oxygen-carrying hemoglobin, and it can have many different causes. Anemia usually results from:

• Bleeding excessively, such as during your period or due to an ulcer
• Insufficient red blood cell production
• Excessive breakdown of red blood cells

Hypoglycemia

Glucose (sugar) is important because it helps your body create energy to power your organs. When you don't have enough sugar in your system, it can cause many unwelcome symptoms. Also known as low blood sugar, hypoglycemia causes your body to release the "flight-or-flight" hormone epinephrine, which causes your body to respond to this critical drop in blood sugar by triggering symptoms of hypoglycemia like a racing heart, sweating, and pallor.

Peripheral Artery Disease

Peripheral artery disease (PAD) is caused by hardening in the walls of the arteries (the part of your circulatory system that carries blood throughout your body) from atherosclerosis (thickening of the arteries) or plaque build-up. When plaque builds up in the arteries, your blood cannot flow as easily because the inside of the arteries are narrower.

Other conditions can cause pallor, but they are considered more serious. For example, shock and frostbite can cause paleness as the body works to shift blood supply to more critical organs. 

Raynaud's Phenomenon

Raynaud's phenomenon (sometimes called Raynaud's syndrome) is a condition where certain body parts, often fingers and toes, experience reduced blood flow in response to cold or stress. Having this conditions causes affected areas to turn white or blue due to narrowed blood vessels (vasospasm), leading to temporary pallor. As blood flow returns, the skin may turn red and become warm. This condition can be primary or secondary to other diseases.

Symptoms

Because pallor is a symptom, it's essential to find out what is causing pallor and if any other symptoms accompany it. When you experience pallor, it isn't always a serious problem. When there is paleness of the lips, tongue, palms of your hands, inside your mouth, and the lining of your eyes, it is considered more serious.

Symptoms of Anemia

In addition to pallor, the initial signs of anemia include:

• Chest pain
• Shortness of breath
• Light-headedness and headaches
• Irritability
• Feeling tired
• Loss of appetite
• Difficulty concentrating
• Numbness or tingling in the extremities

As anemia continues and worsens, you may notice other symptoms such as brittle nails, craving non-food items, shortness of breath, and paleness.

Symptoms of Hypoglycemia

Signs of low blood sugar usually happen quickly and can be different for each person. Some symptoms of hypoglycemia include:

• Anxiety and irritability
• Nausea
• Dizziness and confusion
• Feeling weak
• Fast heart rate
• Sweating or chills
• Feeling shaky or jittery

More severe signs of low blood sugar include tingling and numbness of the lips and tongue, coordination problems, and seizures.

Symptoms of Peripheral Arterial Disease

The signs of peripheral arterial disease (PAD) usually occur when you are walking or exercising and tend to go away with rest. As the disease continues, you may notice symptoms happen quicker and with less intense exercise. When resting, your legs and feet might be numb and feel cool to the touch with some paleness. Other symptoms of PAD in your legs are:

• Achiness
• Leg fatigue and cramping
• Burning
• Pain

Raynaud's Phenomenon

Raynaud's phenomenon, which affects blood flow to certain parts of the body, more often affects the fingers and toes. The symptoms can vary in severity and may be idiopathic (occurring independently from another conditions) or associated with a condition. Symptoms may include:

• Numbness or tingling
• Color changes to the skin, which most commonly causes affected areas to turn white or blue
• A throbbing or stinging feeling
• Sensitivity to temperature changes

What Causes Pallor?

When there is a decrease in the amount of blood sent to the skin or reduced hemoglobin in the blood, you can notice an abnormal paleness in your skin color. If blood vessels become blocked (such as by plaque build-up) the amount of blood flowing is limited.

Sometimes, people experience pallor because of the body's built-in automatic protection system. When your body detects organs like the brain or heart are critically low on oxygen, it will activate the sympathetic nervous system. The sympathetic nervous system is best known for responding to what your body believes is a dangerous situation. Blood vessels in parts like the arms and legs constrict or get smaller, redirecting blood flow to those most critical body parts for survival.

Diagnosis

When determining the cause of your pallor, your healthcare provider will review your medical history and ask about your symptoms. They will ask you questions about when the paleness developed and any events that may have occurred before it started. They will examine your skin to check where your paleness is on your body and check your pulse in various areas to feel for adequate blood flow.

The following tests may be ordered:

• Complete blood count (CBC): A CBC can help to detect other health conditions. It also includes a test to help measure the amount of hemoglobin in RBCs.
• Blood differential: This test measures the percentage of white blood cells and can help determine how many cells are abnormal.
• Thyroid function tests: Thyroid tests can be helpful to ensure your thyroid is working correctly or if it is the cause of your pallor. Thyroid function tests will measure your free T4, TSH, and total T3 levels.
• Colonoscopy: Colonoscopies can help locate bleeding in the large intestine by using a small camera attached to a flexible tube that is inserted into your intestine via your rectum.
• Extremity angiography: This is a test that allows your healthcare provider to see the arteries in your extremities. It can be used to assess pallor, but is not commonly ordered.

Treatments for Pallor

The lack of oxygen-rich blood being routed to your tissues can become problematic if it goes on too long. The goals of treating a symptom like pallor include improving the amount of oxygen that is available and delivered to your tissues and vital organs. Treatment will depend on what is causing the paleness.

Treatment for Anemia

Treating anemia starts by addressing the underlying cause, which can involve stopping bleeding or replacing vitamins needed to create RBCs. People with severe anemia may need blood transfusions.

Treatment for Hypolgycemia

Treating low blood sugar involves consuming 15 grams of carbohydrates and rechecking your blood glucose levels after 15 minutes until levels equal 70mg/dl. Increasing blood glucose levels can be done usually by:

• Glucose tablets or gel
• Four ounces of juice or regular soda
• One tablespoon of sugar or honey
• Consuming hard candies

Treatment for Peripheral Arterial Disease

Medications like aspirin or Plavix (clopidogrel) prevent your blood from over-coagulating and forming clots. Your healthcare provider might also prescribe medicine to decrease vessel plaque build-up, thereby lowering your cholesterol.

Some lifestyle changes can also help. Make sure to have periods of rest when exercising to relieve pain, maintain a well-controlled blood pressure, and do not smoke. Surgery may be necessary if severe symptoms interfere with daily living activities.

Treatment for Raynaud's Phenomenon

The goals of treatment for Raynaud's phenomenon includes managing symptoms, preventing complications, and improving blood flow to the affected areas. The approach to treatment may depend on whether the condition is associated with other medical conditions or not. General strategies for managing Raynaud's phenomenon include:

• Avoiding exposure to the cold: Wear warm clothing, gloves, and socks or use hand and foot warmers.
• Managing stress: Stress can trigger Raynaud's, so techniques like relaxation exercises, meditation, or yoga may be beneficial.
• Taking medications: Your healthcare provider may prescribe medications like calcium channel blockers, vasodilators, or, in more severe cases, endothelin receptor antagonists.
• Exercising: Regular exercise can improve circulation and help manage symptoms. A physical therapist may provide specific exercises tailored to individual needs.

If Raynaud's is being caused by another condition, managing that condition is important for reducing your symptoms.

Prevention

It is impossible to completely prevent all conditions that lead to pallor, as your genetics contribute to your overall health and disease development. However, certain daily practices and lifestyle choices can help with prevention. Ways to help prevent some causes of pallor include:

• Eat the right foods: Iron-rich foods can help prevent the common uses of anemia. Include red meats, poultry, and fish in your diet. Green leafy vegetables like spinach, peas, lentils, and beans are also a great source of iron. 
• Check your glucose levels: If you have diabetes and have a blood glucose monitor, check your blood sugar levels often, including before and after meals and exercise. Treating low sugar levels before they begin to drop can prevent most episodes.
• Lifestyle modifications: Avoid smoking and decrease the amount of alcohol you consume, if you drink alcohol. Increase your daily exercise to at least 30 minutes every day.

Complications

Pallor is usually a short-term symptom that does not result in any problems. If the condition causing it goes untreated, it's possible to develop further issues for some tissues in the body due to a lack of blood flow. Without blood flow, the organs of your body will be deprived of the nutrients they need to keep functioning.

Tissues require oxygen to create energy; without this element, it can lead to problems like heart failure. A lack of blood supply to the extremities can cause open sores (ulcers), among other complications.

A Quick Review

When there is a decrease in blood flow to tissues, pallor can develop from the lack of red pigment normally created by the hemoglobin in your blood. In most cases, pallor is a symptom of an underlying condition that your healthcare provider can help you treat and manage. It is important to treat any underlying conditions you have to ensure you don't experience long-term complications.