Why are the bottom of my feet yellow or orange?[ Yellow soles of feet]

Jaundice:

• After the breakdown of red blood cells in the body, a yellowish waste substance called ‘bilirubin’ is produced. It goes into the liver and is secreted in urine and stool, thus removing it from the body. This cycle is naturally going on in the body.
• When there’s liver damage or excess breakdown of Red blood cells in the body, bilirubin accumulates in the blood, imparting a yellow discoloration to the skin and sclera(white part of the eye).

• Signs and symptoms of liver damage can be:
  • Anorexia(decreased appetite)
• Nausea
• Vomiting
• Fever
• Abdominal pain
• Bruises etc

• Causes of jaundice can be:
  • Hepatitis
  • Gall bladder stones
  • Obstruction of bile duct
  • Liver failure
  • Cirrhosis
  • Medications such as steroids, contraceptives, penicillin, etc
  • Herbal medications

Cause of jaundice in newborns:

• Physiological Jaundice: If the baby turns yellow immediately after birth and color changes to normal within a period of 2 weeks, it is normal/ physiological and nothing to worry about. The discoloration is usually mild and limited to the eyes and upper half of the body.
• Pathological Jaundice: If yellowish discoloration of baby’s skin appears 24 hours after birth and does not settle in 14 days with clay/white-colored stools and urine stains, the clothes are yellow. The most common areas of yellow discoloration are cheeks, eyes, palms, and feet. It is pathological as there are increased bilirubin levels in the blood due to hemolysis (red blood cells breakdown). It requires medical treatment because high levels of bilirubin can cross the blood-brain barrier and lead to permanent damage of the brain called ‘kernicterus’ in medical terms.

Treatment:

• In newborns, Phototherapy or specific light treatment to get rid of excess bilirubin.
• In adults, the cause is treated, e.g., if acute viral hepatitis is the underlying factor, then anti-viral treatment is started.
• The doctor may prescribe iron supplements to increases oxygenation of body tissues.
• If there’s an obstruction to the bile duct, surgery is recommended
• Treatment of jaundice upon the cause and needs to be treated immediately by a healthcare professional.

Anemia:

• Lack of healthy red blood cells to carry adequate oxygen to body tissues is called anemia. More oxygen is supplied to vital organs instead of peripheries as a compensatory mechanism, resulting in a pale/ yellow discoloration of eyes, face, hands, and feet.
• Signs and symptoms of anemia include:
  • Lethargy
  • Weakness
  • Nausea
  • hair loss
  • brittle nails
  • headaches
  • clay or rice cravings
  • Chest pain or palpitations on exertion
• Causes of Anemia can be:
  • Decreased RBC(red blood cells) production: Iron deficiency anemia, Bone marrow failure, kidney diseases (due to lack of hormone: erythropoietin), etc
  • Increased blood loss: due to Haemorrhage, Gastrointestinal bleed, Gynaecological disorders, worm infestation, cancers, etc
  • Increased RBC destruction: hemolytic diseases, Thalassemia, Sickle cell anemia, drug-induced hemolysis, etc
• Treatment includes:
  • Dietary change including increase intake of leafy green vegetables, fish, liver, beef, etc
  • Intravenous iron therapy in severe iron deficiency
  • Blood transfusion in severe anemia
  • In children, Specific Treatment is required if the underlying cause is malabsorption.
  • Correction of the underlying cause of blood loss
• Prevention can be done by:
  • Eating a healthy diet such as fruits and vegetables
  • An eating a diet rich in iron, such as green leafy vegetables
  • An eating a diet rich in Vitamin B12, such as beef

Carotenemia:

• High levels of carotenoids in the blood, usually above 30mg per day, are called carotenemia.
• Carotenoids are a normal part of a healthy diet and contribute to natural skin color.
• Carotenoids are present in many bright-colored fruits and vegetables. Carotenes leave the body through urine, stool, sweat, and sebum.
  • Foods rich in carotenoids include:
    • Orange vegetables, such as carrots, sweet potatoes, squash, pumpkin, etc
    • Green vegetables such as Spinach, broccoli, kale, peas, cucumber, lettuce, parsley, etc
    • Fruits such as apricot, mangoes, papaya, cantaloupe, peaches, prunes, etc
    • Citrus fruits
    • Food items with high carotene are milk, eggs, butter, and palm oil.

.

It occurs due to excessive or prolonged consumption of carotene-rich foods or If there’s under-secretion of carotenoids from the body, causing their accumulation in the body leading to yellowish discoloration of the skin, most of the palms and soles of feet.

• Causes of carotenoids under-secretion  are:
  • Yellow feet diabetes.
  • High cholesterol.
  • Hypothyroidism:

There’s decreased conversion of carotene to vitamin A in hypothyroidism and associated hyperlipidemia and hypercholesterolemia, leading to carotenoids build-up in the blood.

• Kidney problem:

In diseases affecting kidneys, such as glomerulonephritis and nephrotic syndrome, serum carotene levels may become markedly raised.

• Liver problem:

There’s decreased conversion of carotene to Vitamin A in liver disease or liver injury, leading to carotenemia and yellowish discoloration.

Less common causes of carotenemia are:

• Inborn errors of metabolism:

Carotenemia can sometimes occur due to an inborn error of metabolism failing to convert carotene to vitamin A thus causing carotenoid accumulation in the body.

• Anorexia nervosa:

There’s a defect in the conversion of carotene to vitamin A associated with hypercholesterolemia

OR

it may result from a normal intake of dietary carotene in the presence of a decreased bodily requirement.

• Systemic amyloidosis:

Systemic amyloidosis may be associated with hyper-carotenemia with prominent carotenoderma

• Treatment:

It isn’t a severe disease and can be corrected by cutting down foods in a diet rich in carotene. If the underlying cause is a systemic condition, seek medical help.

• Yellow toenails:
  • Yellowish discoloration involving only toenails and is worsening without treatment usually indicates a fungal infection.

• Signs and symptoms include:
  • Nail thickening or cracks
  • Nail discoloration
  • Brittle, crumbly, or ragged
  • distorted shape
  • Smelling slightly foul
  • pain from shoe pressure due to the thickened nail.
• Treatment includes:
  • Topical and oral antifungal medications such as terbinafine or itraconazole
  • Laser fungal toenail removal
  • Surgery

Diet:

 Following fruits and vegetables also cause yellowish discoloration of the skin if eaten in large quantities for a long time, and discoloration disappears after eating.

• Turmeric
• nutritional supplements
• pumpkin
• Pepper
• Squash
• sweet potatoes
• green vegetables
• citrus fruits

Lycopenemia:

• A condition with high lycopene levels in the blood.
• In older children/kids, Another possible reason for the yellowish discoloration is lycopenemia. It is a condition similar to carotenemia because it is also related to dietary intake. If children excessively and long consume foods rich in lycopene, yellowish discoloration may develop on the palms and soles of feet.
• Foods rich in lycopene are:
• Tomatoes
• Beets
• Chilli beans
• Berries
• pink grapefruits
• watermelon
• apricots
•  

• Treatment:

This condition is harmless, and Lycopenemia settles one’s dietary consumption of lycopene-rich foods is stopped, and the discoloration is reversed.

Raynaud’s phenomena:

• It is a genetic disorder of blood vessels in which exposure to cold or emotional stress constricts the blood vessels, mostly affecting the toes and fingers.
• When blood flow to the skin is restricted, it may become yellow and pale and forms patches of discoloration at the top and bottom of the feet and hands.

• Signs and symptoms can be:
  • Color changes on exposure to cold: first pale, then blue(cyanosis), and then red.
  • Numbness
  • Tingling(paresthesia)
  • Brittle nails

• Treatment includes:
  • Medical; Vasodilators/drugs that dilate the blood vessels to regulate normal blood flow
  • Surgical; Nerve surgery/sympathectomy

in severe cases to avoid blood vessels constriction(vasoconstriction)

• Complications include:
  • Ulcers
  • Gangrene
  • Amputation

• Prevention includes:
  • Maintain body warmth
  • Reduce exposure to cold by wearing gloves
  • Avoid stress
  • Avoid tobacco, alcohol, caffeine, and cocaine
  • Meditation techniques such as yoga and exercises to relieve stress
  • Avoid medications such as beta-blockers, ergotamine, stimulants such as amphetamines, etc

Too much turmeric:

Some research has shown that high doses of turmeric can cause yellow discoloration of the soles.

This is considered to be a more rare cause:

Yellow feet secondary to Tumeric are generally non-dangerous, but this can lead to some associated yellow in the hands and feet.

Turmeric is a mild spice that people often use medicinally for its antioxidant and anti-inflammatory properties. The most active compound in turmeric, curcumin, is a bright yellow pigment.

Trinitrotoluene Poisoning:

 It is an explosive chemical called Trinitrotoluene(TNT). TNT contains volatile nitro-groups, which, when reacting with melanin(the natural pigment that gives color to the skin), cause yellow discoloration.

• Handlers of this explosive material may experience yellowish discoloration of hands or soles of feet.

• Signs and symptoms of TNT poisoning:
  • Yellow or orange discoloration of the skin
  • Dermatitis
  • Irritation of eye, nose, throat, and skin

High exposure can cause:

• Weakness
• Headache
• Anemia
• Liver damage
• Central nervous system damage

• Treatment includes:
  • Removal from the source to avoid further exposure
  • Removal of clothes
  • Washing the skin with soap and mild exfoliation as this poison can also absorb slowly through the skin.
  • No specific antidote is yet available
  • The doctor may treat the patient symptomatically

When to see a podiatrist?

The yellow discoloration is sometimes mild and settles with time, but if it is:

• associated with a systemic condition
• isn’t improving. Rather worsening with time. Seek medical help immediately to avoid possible complications.

Signs and symptoms pointing to a systemic condition can be:

• Fever
• Abdominal pain
• Chest pain
• Headache
• Fatigue
• Dizziness
• Shortness of breath
• Pale stools and dark urine
• Dark stools/blood in stools
• Altered sleep-wake cycle
• Sensitivity to cold
• Weight gain
• Increased sleep
• Decreased appetite.
• Blood in vomiting.
• Bleeding from nose, mouth, or rectum
• Easy bruising to the body
• Confusion or drowsiness

Whom to see?

If there’s a yellow discoloration of the feet, you can visit a doctor or a podiatrist. But podiatrist is the one who is uniquely qualified among all healthcare professionals and specifically trained in treating all foot conditions.

How is it diagnosed?

The doctor will take a careful history to determine the causative factor and perform a physical examination to reach a diagnosis at the hospital. The doctor may order some investigations to confirm the diagnosis.

History:

• Age of patient
• Duration
• History of foot trauma
• Occupation
• Diet history
• History of Fatigue, lethargy, or weakness
• Types of shoes you wear daily
• Any previous history of a systemic disorder

Physical Examination:

The doctor will perform a detailed physical examination to check the areas of discoloration and any other physical findings to reach a diagnosis.

Investigations:

To confirm the diagnosis, the doctor may order the following investigations :

1. Complete blood count
2. Serum bilirubin levels
3. Liver function tests
4. Blood glucose test
5. Thyroid function test
6. Beta carotene levels
7. Lipid profile/Cholesterol levels
8. Ct-scan
9. MRI

How to get rid of yellow feet?

At home:

Following home remedies may prove beneficial in treating yellowish discoloration of feet:

• Limit consumption of carotene-rich fruits and vegetables
• Consume fruits and vegetables rich in iron and Vitamin 12, such as green leafy vegetables, liver, beef, fish, etc
• Drink excess water and juices such as cranberry juice to help flush out the toxins circulating in the body.
• Eat a fiber-rich diet to regulate digestion. It also aids in lowering blood sugar and cholesterol levels.
• Apply topical zinc or Vitamin E on areas of discoloration.
• In fungal infections of toenails, apply diluted tea tree oil.
• If the cause of discoloration is Corns or calluses:

• Epsom salt soaks: Soak feet in warm water with some Epsom salt for 15-20 mins twice daily. It will soften the skin, then Scrub with a pumice stone. After scrubbing, wash your feet with soap, dry thoroughly and apply moisturizer. Avoid excess scrubbing as it can cause skin damage and infections. This remedy will remove calluses if done regularly.
• Baking soda: It is used as a natural exfoliating agent. In a tub of warm water, add 5 tablespoons of baking for 15 mins twice daily and then scrub with a pumice stone. Wash feet with a mild soap, dry well, and moisturize.
• Garlic: Garlic has antibacterial and antifungal properties. Take a clove of garlic and cut it into two. Rub one piece on soles of feet daily at night. Wait for it to dry, and wrap the area with a bandage. Wash this area in the morning. Repeat application until the discoloration disappears
• Chocolate Weed Leaves and Turmeric: Turmeric is an antiseptic, and Chocolate weed leaves are tropical plants found in wasteland regions. It is found in soybeans, cotton, and rice plantations. Take a handful of chocolate weed leaves and a spoonful of turmeric powder, combine well and grind. Apply the mixture to the bottom of the feet. Repeat daily for 7 days. They both may help in treating yellowish discoloration of the feet.

At hospital treatment:

See a healthcare professional if the condition:

• doesn’t improve with home remedies
• there are associated systemic disease
• if it is worsening with time.

• If discoloration is due to corns and calluses which are too thick to remove by home -remedies doctor may perform:
• salicylic acid treatment
• Electro-cauterisation
• Laser removal
• Surgery

• Anemia:

• a diet rich in iron( green leafy vegetables)
• vitamin b12 (beef, liver) is advised to treat yellow discoloration.
• If anemia is severe Intravenous injections of RBC substrates or blood transfusions may be advised.

• For jaundice:
  • underlying cause such as hepatitis needs to be treated by antivirals
  • Calamine lotion for itching
  • Surgery if bile tract is obstructed
  • In cirrhosis, specific medical treatment is required by a healthcare specialist.

• Fungal infections: If the cause of discoloration is a fungal infection, the doctor may prescribe:
  • topical or oral antifungals such as terbinafine or itraconazole etc

• Respiratory diseases such as lymphedema need to be treated by a pulmonologist.

• Trinitrotoluene poisoning: If the cause of discoloration is TNT poisoning: there are no home remedies, and treatment is done at the hospital.

• Removal from the source
• Removal of clothes
• Skin is washed with soap and water
• The doctor may give symptomatic treatment
• There’s no Specific anti-dote yet available to treat TNT poisoning.

How to prevent Yellow discoloration of Feet?

Dietary and lifestyles changes are required to prevent feet yellowing:

• Maintain good foot hygiene: Wash feet regularly with a mild soap, dry well and then moisturize.
• Keep toenails clean, dry, and trim straight across. Avoid curving the edges.
• Wear properly fitting footwear. Avoid tight shoes, socks, and high-heeled shoes.
• Avoid going out or in the sun barefoot.
• Eat a healthy diet enriched with iron and Vitamin B12
• Avoid excessive intake of fruits and vegetables rich in beta carotene
• Eat healthy and low-cholesterol foods
• Avoid exposure to poisonous substances and irritants
• Examine feet daily for injuries and skin changes, cuts, redness, swelling, corns, calluses, or nail changes such as thickening, discoloration, cracks, brittleness, etc
• If you have diabetes, then regularly monitor your blood sugar levels and get your feet examined by a doctor for ulcers or any signs of nerve damage.
• If you’re suffering from any associated systemic condition, regularly visit your doctor to avoid possible complications.