Yellow Skin (Jaundice)

The medical term 'jaundice' refers to the yellowing of the skin and eyes. Jaundice is a symptom of several potential underlying disorders but is not a disease itself. When the body absorbs an excess amount of bilirubin, jaundice occurs. Bilirubin is a yellow pigment produced in the liver when dead red blood cells are broken down. Normally, the liver eliminates bilirubin along with the already present red blood cells. Jaundice can indicate a major issue with red blood cells, liver, gallbladder, or pancreatic function. The likelihood of developing jaundice is higher in infants and the elderly.

What is Yellow Skin (Jaundice)?

Jaundice is a medical condition that results in yellowing of the skin, mucous membranes, and sclera (the whites of the eyes). This yellow colouration is caused by an excess of bilirubin, a yellow-orange bile pigment. The liver produces a fluid called bile, and bilirubin is formed through the breakdown of red blood cells. While jaundice is not a disease itself, it can serve as an indicator of various underlying conditions.

Types of Jaundice

Jaundice is a condition characterized by the yellowing of the skin and the whites of the eyes due to an excess of bilirubin in the bloodstream. There are three main types of jaundice:

1. Pre-hepatic (hemolytic) jaundice: This type of jaundice occurs when there is an increased breakdown of red blood cells (hemolysis), leading to an overload of bilirubin in the bloodstream. Causes include conditions such as hemolytic anemia, sickle cell disease, or certain genetic disorders.
2. Hepatocellular (hepatic) jaundice: Hepatocellular jaundice results from liver damage or dysfunction, which impairs the liver's ability to process and excrete bilirubin effectively. Causes may include liver infections (such as hepatitis), liver cirrhosis, alcoholic liver disease, or drug-induced liver injury.
3. Post-hepatic (obstructive) jaundice: This type of jaundice occurs when there is a blockage in the bile ducts, preventing the normal flow of bile from the liver to the intestine. As a result, bilirubin accumulates in the bloodstream and causes jaundice. Common causes of post-hepatic jaundice include gallstones, pancreatic cancer, strictures (narrowing) of the bile ducts, or tumors blocking the bile ducts.

What causes Yellow Skin?

Yellow skin, medically known as jaundice, is typically caused by an excess of bilirubin in the bloodstream. Bilirubin is a yellowish pigment produced during the breakdown of red blood cells and is normally processed by the liver and excreted in bile. When bilirubin levels become elevated, it can lead to the yellowing of the skin and eyes. Several factors can contribute to elevated bilirubin levels and jaundice, including:

• Liver diseases: Conditions such as hepatitis (inflammation of the liver), liver cirrhosis (scarring of the liver tissue), alcoholic liver disease, or liver cancer can impair the liver's ability to process bilirubin effectively.
• Bile duct obstruction: Blockages in the bile ducts can prevent the normal flow of bile from the liver to the intestine, leading to the accumulation of bilirubin in the bloodstream. Causes of bile duct obstruction include gallstones, tumors, strictures (narrowing) of the bile ducts, or pancreatic disorders.
• Hemolytic disorders: Conditions that cause an increased breakdown of red blood cells (hemolysis) can result in elevated bilirubin levels. Examples include hemolytic anemia, sickle cell disease, or certain genetic disorders affecting red blood cell metabolism.
• Medications: Some medications can cause liver damage or interfere with bilirubin metabolism, leading to jaundice as a side effect.
• Infections: Certain infections, such as viral hepatitis or malaria, can cause liver inflammation and dysfunction, resulting in jaundice.
• Newborn jaundice: Jaundice is common in newborn babies due to the immaturity of their liver function. In most cases, newborn jaundice resolves on its own without treatment.
• Other factors: Other factors that can contribute to jaundice include excessive alcohol consumption, certain autoimmune diseases, and rare inherited disorders affecting bilirubin metabolism.

Symptoms of Yellow Skin (Jaundice)

Jaundice, characterized by yellowing of the skin, occurs when there's a buildup of bilirubin in the body. Symptoms of jaundice include:

• Yellowing of the Skin: The most noticeable symptom is yellow discoloration of the skin, starting from the face and spreading to other parts of the body.
• Yellowing of the Eyes: The whites of the eyes (sclera) may also turn yellow.
• Yellowing of Mucous Membranes: Yellowing may extend to the gums, inside the mouth, and the undersides of the tongue.
• Dark Urine: Urine may appear dark or brownish due to the presence of excess bilirubin.
• Pale Stools: Stools may appear pale or clay-colored due to a lack of bilirubin reaching the intestines.
• Itchy Skin: Some individuals with jaundice may experience itching (pruritus) due to the accumulation of bile salts in the skin.
• Fatigue: Jaundice can be associated with feelings of fatigue and weakness.
• Abdominal Pain: In some cases, individuals may experience abdominal pain, especially if jaundice is caused by gallstones or other liver or bile duct issues.
• Nausea and Vomiting: Jaundice may be accompanied by symptoms such as nausea, vomiting, and loss of appetite, particularly if it's related to liver disease or obstruction of the bile ducts.
• Weight Loss: Rapid weight loss may occur in some cases, particularly if jaundice is caused by a serious underlying condition such as liver cirrhosis or cancer.

Risk factors of Yellow Skin

• Acute liver inflammation: This can interfere with the liver's capacity to conjugate and produce bilirubin, leading to a buildup of bilirubin.
• Bile duct inflammation: This condition can impede the secretion of bile and the excretion of bilirubin, both of which contribute to jaundice.
• Blockage of the bile duct: This obstruction makes it difficult for the liver to eliminate bilirubin.
• Hemolytic anaemia: When a significant number of red blood cells are broken down, bilirubin production increases.
• Gilbert's syndrome: This hereditary disease compromises the ability of enzymes to handle bile discharge.
• Cholestasis: This condition disrupts the flow of bile in the liver, causing conjugated bilirubin-containing bile to not pass through the kidneys and instead remain in the liver.

Hereditary conditions, including thalassemia and hereditary spherocytosis, as well as certain skin problems such as pyoderma gangrenosum and inflammatory joint diseases, may put adults at risk of developing jaundice.

Prevention

Preventing jaundice can be challenging due to its various causes. However, some general guidelines to follow include:

• Minimize the risk of hepatitis infection.
• Adhere to recommended alcohol consumption limits.
• Maintain a healthy body weight.
• Keep your cholesterol levels under control.

Diagnosis of Yellow Skin

Doctors will likely check the patient's medical records and perform a physical examination to look for jaundice. They will carefully examine the abdomen, search for tumours, and determine the firmness of the liver. Cirrhosis, or liver scarring, indicates a hardened liver.

Jaundice can be confirmed through several tests. A liver function test is the initial step in determining whether the liver is functioning correctly. If the cause cannot be identified, doctors may recommend blood tests to assess bilirubin levels and the composition of the blood. These tests include the following:

• Bilirubin tests: High levels of unconjugated bilirubin compared to conjugated bilirubin indicate hemolytic jaundice.
• Complete blood count (CBC): Tests for hepatitis A, B, and C to detect various liver conditions.
• Imaging tests: If a blockage is suspected, the doctor will examine the liver's structure using imaging tests such as MRIs, CT scans, and ultrasounds.
• ERCP (Endoscopic Retrograde Cholangiopancreatography): In certain cases, the doctor may perform an ERCP, which combines endoscopy with x-rays.

A urine test or urine analysis can indicate conjugated jaundice through a positive bilirubin result. Serum tests should be used to corroborate the results of the urinalysis.

Treatment for Yellow Skin

Jaundice is not a problem in and of itself; it is merely one of several potential underlying medical conditions. The doctor's recommendation for treating jaundice will depend on the underlying cause.

Rather than treating the symptoms of jaundice, the focus of treatment is on addressing the cause. The following types of treatments may be implemented:

• Anaemia-related jaundice can be cured by increasing the amount of iron in the blood, either through iron supplements or by consuming iron-rich foods.
• Hepatitis-related jaundice may require antiviral or steroid drugs for treatment.
• Jaundice caused by obstructions can be treated through surgery to remove the blockage.
• Jaundice resulting from drug usage may involve switching to a different medication.
• Treating jaundice due to liver disease caused by alcohol consumption necessitates abstaining from alcohol.
• Jaundice caused by gallstones may require treatment, often involving the removal of the gallbladder.
• In the case of cirrhosis, the final stage of chronic liver disease caused by various factors, the treatment for cirrhosis-related jaundice may involve corticosteroids or diuretics, depending on the type of liver disease present.

When to visit a Doctor?

The primary reason for seeing a doctor for jaundice is to determine the cause. Among the possible causes are:

• Inflammation of the liver
• Bile duct obstruction
• Congenital conditions
• Pancreatic cancer

Home Remedies for Jaundice

While jaundice treatment typically requires medical intervention, there are some home remedies that may help alleviate symptoms and support liver health. 

• Stay Hydrated: Drink plenty of water to help flush out toxins from the body and prevent dehydration, which can worsen jaundice symptoms.
• Healthy Diet: Consume a well-balanced diet rich in fruits, vegetables, whole grains, and lean proteins. Avoid fatty, processed, and fried foods, and limit your intake of alcohol and sugary beverages.
• Herbal Teas: Some herbal teas, such as dandelion root tea, may help support liver health and improve bile flow. Consult a healthcare provider before incorporating herbal remedies into your routine, especially if you have underlying health conditions or are taking medications.
• Frequent Meals: Instead of large meals, opt for smaller, more frequent meals throughout the day to reduce the burden on the liver and aid digestion.
• Avoid Alcohol and Smoking: Both alcohol and smoking can further damage the liver and exacerbate jaundice symptoms. Avoid alcohol entirely and quit smoking to support liver function and overall health.
• Rest: Get plenty of rest to allow your body to recover and heal. Avoid strenuous activities and prioritize relaxation to reduce stress on the liver.
• Foods Rich in Vitamin C: Incorporate foods high in vitamin C, such as oranges, lemons, kiwis, and berries, into your diet. Vitamin C is an antioxidant that may help protect the liver from damage caused by free radicals.
• Milk Thistle: Milk thistle is a popular herbal supplement that is believed to support liver health and aid in detoxification. However, scientific evidence supporting its effectiveness in treating jaundice is limited. Consult a healthcare provider before taking any supplements.
• Turmeric: Turmeric contains curcumin, a compound with anti-inflammatory and antioxidant properties that may benefit liver health. Add turmeric to your cooking or consume it as a supplement after consulting with a healthcare provider.
• Monitor Symptoms: Keep track of your symptoms and seek medical attention if they worsen or if you experience severe abdominal pain, fever, vomiting, or other concerning symptoms.

Conclusion

When the underlying cause is treated, jaundice often disappears. Mild cases of jaundice typically resolve on their own without medical intervention and do not have any long-term effects on the liver. Jaundice can be a symptom of a serious disease, so it is recommended to visit a doctor immediately.

FAQs

1: Can jaundice be prevented? 

Since jaundice can be caused by several factors, there is no definitive strategy to prevent it. However, it is possible to prevent underlying medical conditions.

2: What deficiency causes yellow skin? 

Yellow skin can result from inadequate amounts of healthy red blood cells caused by a deficiency of vitamin B12.

3: Is jaundice curable in adults? 

Jaundice itself is typically not treated in adults. However, the doctor will address the underlying cause.

4: Does yellow skin indicate liver failure? 

A dysfunctional liver is unable to eliminate bilirubin, which leads to jaundice, causing yellowing of the skin and eyes.

5. Can Jaundice spread?

Jaundice itself isn't contagious. It's a symptom of an underlying condition, like liver disease or bile duct obstruction. However, some conditions causing jaundice, like hepatitis, can be spread through blood or bodily fluids.

6. What should a jaundice patient eat?

A jaundice patient should focus on a healthy, balanced diet. This includes fruits, vegetables, whole grains, and lean proteins. Avoid fatty or fried foods and limit alcohol intake. Stay hydrated by drinking plenty of water.

7. Does jaundice cause itching?

Yes, jaundice can cause itching in some cases. Itching occurs when bilirubin, a substance responsible for jaundice, builds up in the skin. This can irritate nerve endings and lead to itching, especially on the hands and feet.

8. Are jaundice and hepatitis the same?

No, jaundice and hepatitis are not the same. Jaundice refers to the yellowing of the skin and eyes due to high levels of bilirubin in the blood. Hepatitis is inflammation of the liver, often caused by viruses, excessive alcohol consumption, or other factors. Hepatitis can lead to jaundice, but they are separate conditions.

9. What causes yellow skin?

Yellow skin, known as jaundice, is caused by high levels of bilirubin in the blood. Bilirubin is a yellow pigment formed when red blood cells break down. Elevated bilirubin levels can occur due to liver disease, bile duct obstruction, hemolytic anemia, or other conditions.

References:

https://my.clevelandclinic.org/health/diseases/15367-adult-jaundice

CARE Medical Team

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