Skin And Eating Disorders: Why You Have Dry, Blotchy Skin That Has An Unhealthy Gray Or Yellow Cast

Eating disorders are serious, potentially deadly diseases that affect every aspect of health. One of the disturbances that drives most individual cases of eating disorders is dissatisfaction with personal appearance. Making the condition all the more difficult to overcome is the reality that anorexia, bulimia, and binge-eating disorders all take their toll on the skin.

Yellow skin

People who live with anorexia nervosa sometimes develop hypercarotenemia, an accumulation of yellow-orange pigment in the skin of the soles of the feet, palms of the hands, and under the nose. Hypercarotenemia is caused by the accumulation of beta-carotene in the skin. This accumulation occurs when the diet is overly rich in beta-carotene from “healthy” foods such as carrots and other yellow and orange vegetables. When there is hypercarotenemia in someone who has anorexia or bulimia, usually there is also hypothyroidism or dysfunctional fat metabolism.

Acrocyanosis, also known as pernio

In acrocyanosis the skin turns cold and pale with a bluish tint. The underlying problem in this skin condition is the dilation of blood vessels just beneath the skin. The body attempts to maintain the temperature of its core by shutting off circulation to the skin. A pin-prick to get a drop of blood for blood sugar testing will show a low blood sugar level suggestive of hypoglycemia, but inside the body, and in blood drawn from a vein, blood sugar levels will be normal. Acrocyanosis is most common in teenage girls who live with anorexia nervosa.

Body hair

Fine, lightly pigmented hair called lanugo sometimes appears in people who have anorexia. These hairs will be most noticeable on the face, back, forearms, and abdomen. Lanugo appears in both females and males who have anorexia, but it is more common in females. One explanation for the appearance of fine, downy hair in anorexia is that the body is attempting to conserve heat.

Dry skin (also known as asteatosis or xerosis)

Dry skin results from the reduced production of the skin’s natural lubricating oil called sebum. It can be caused by compulsive washing, hypothyroidism, poor circulation, or low levels of thyroid hormone. Dry skin occurs as soon as the fifth day of severely reduced food intake. Some skin care products help relieve dry skin in anorexia, but the product needs to include cholesterol (which is not absorbed into the rest of the body through the skin), triglycerides, and waxes. Dry skin products that are based on squalene are not helpful.

Acne

Between 47 and 59 percent of anorexia patients develop acne as they recover. This is due to the body’s resumption of production of sebum and sex hormones. It is not caused by a fundamental hormonal imbalance.

Baldness and fragile hair

Hair loss and easily broken hair are common in anorexia. They occur after crash diets and in vitamin A deficiency.

Skin symptoms of polycystic ovarian syndrome

Women who live with bulimia tend to have the outward manifestations of polycystic ovarian syndrome (PCOS). These are dark facial hair, patches of rough skin, and acne. Researchers don’t know whether PCOS causes increased risk of bulimia or bulimia causes increased risk of PCOS. Treating  PCOS resolves these symptoms.

Itching

In anorexia, the lower the weight, the greater the problem with itchy skin. Regaining weight reduces the itching. In some cases, itching is related to thyroid dysfunction or zinc deficiency. Treating those problems reduces the itching.

Stretch marks (striae distensae)

Stretch marks are common in men who have anorexia, but not in women who have anorexia.

Angular cheilitis (irritation at the corners of the mouth)

Exposure to acid causes angular cheilitis, irritation at the corners of the mouth. Sometimes this is due to an anorectic person’s preference for “slimming” foods that have naturally high acid content, such as grapefruit and lemons, and sometimes it is due to contact with stomach acid after purging.

Clubbed knuckles

People who have anorexia or bulimia who purge by inducing themselves to vomit tend to develop clubbed knuckles on the hand they use to force themselves to vomit.

Fingernail and toenail abnormalities

Among people who live with anorexia, up to 9 percent have broken nails, from 15 to 33 percent have fragile nails, 15 percent have lines up and down their nails, and up to 48 percent have pitted nails. These problems are due to nutrient deficiencies.

Pili torti

Twisted hairs, or pili torti, are hairs that rotate around their root. This condition is most common people who live with anorexia who have naturally stiff, thick, curly hair.

Scars from cutting and burning

Up to 13 percent of adults who live with eating disorders and up to 30 percent of adolescents who live with eating disorders mutilate their skin by cutting and burning.

Skin problems associated with binge-eating disorder

Although most of the skin problems associated with eating disorders occur in people who live with anorexia or bulimia, people who have binge-eating disorders are not exempt from skin problems. They tend to have skin conditions that are found in people who don’t have eating disorders, such as dermatitis, psoriasis, and eczema. However, they have these “normal” skin problems at a rate up to nine times higher than the general population.