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Jaundice - yellow skin Health Article

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Definition

Jaundice is a yellow color in the skin, the mucous membranes, or the eyes. The yellow pigment is from bilirubin, a byproduct of old red blood cells.

Alternative Names

Yellow skin and eyes; Skin - yellow; Icterus; Eyes - yellow; Jaundice

Considerations

If you’ve ever had a bruise, you may have noticed that the skin went through a series of color changes as it healed. When you saw yellow in the bruise, you were seeing bilirubin.

Normally, about 1% of our red blood cells retire every day, to be replaced by fresh red blood cells. The old ones are processed in the liver and disposed of. Much of the resulting bilirubin leaves the body in the stool.

If there are too many red blood cells retiring for the liver to handle, yellow pigment builds up in the body. When there is enough to be visible, jaundice results.

Jaundice can be caused by too many red blood cells retiring, by the liver being overloaded or damaged, or by the inability to move processed bilirubin from the liver through the biliary tract to the gut.

Most babies have some jaundice during the first week of life. The ordeal of birth can send many red blood cells to an early retirement (especially if a vacuum is used!), and babies’ livers are often unprepared for the load. Before mom’s milk comes in and stooling begins in earnest, bilirubin accumulates more easily. Jaundice is even more common in premature babies.

Physiologic jaundice is the name for normal jaundice commonly seen in healthy babies.

Pathologic jaundice is the name given when jaundice presents a health risk, either because of its degree or its cause. Pathologic jaundice can occur in children or adults. It arises for many reasons, including blood incompatibilities, blood diseases, genetic syndromes, hepatitis, cirrhosis, bile duct blockage, other liver diseases, infections, or medications. The term also applies to physiologic jaundice exaggerated by dehydration, prematurity, difficult delivery, or other reason.

Another condition called Gilbert syndrome is a benign, hereditary condition in which mild jaundice develops. It is caused by low levels of some bilirubin-processing enzymes in the liver. This condition, once recognized, requires no further treatment or evaluation. There are other more rare hereditary causes of elevated bilirubin levels.

A yellow-to-orange color may be imparted to the skin by consuming too much beta carotene, the orange pigment seen in carrots. In this condition, the whites of the eyes remain white, while people with true jaundice often have a yellowish tinge to the eyes.

This condition is called hypercarotenemia or just carotenemia.
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Review Info

Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc. , 05/08/2008

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