What is the treatment for carotenemia?

Treatment for Carotenemia

The primary treatment for carotenemia is dietary modification by reducing the intake of carotene-rich foods, which typically leads to resolution of the yellow skin discoloration within a few weeks to months. 1, 2

Understanding Carotenemia

Carotenemia is characterized by:

• Yellow-orange discoloration of the skin, most prominently seen on the palms and soles 3
• Normal sclera (unlike jaundice, which affects the sclera) 4
• Elevated blood carotene levels 1
• Benign condition that doesn't require extensive diagnostic testing 4

Causes of Carotenemia

Primary Causes:

• Excessive consumption of carotene-rich foods such as:
  • Carrots, winter squash, and other orange vegetables 2
  • Green vegetables (including green beans) 2, 5
  • Orange and yellow fruits (papaya, mango) 4
  • Commercial nutrient supplements containing carotene 3

Secondary Causes:

• Metabolic carotenemia due to genetic defects of the enzyme 15-15'-carotenoid dioxygenase 1
• Medical conditions that may predispose to carotenemia:
  • Hypothyroidism 1
  • Diabetes mellitus 1
  • Anorexia nervosa 1
  • Liver disease 2
  • Kidney disease 2

Treatment Approach

1. Dietary Modification:

   • Reduce intake of carotene-rich foods 1, 2
   • Discontinue carotene supplements if applicable 3
   • No specific upper limit is required, but moderation is key 6

2. Address Underlying Conditions:

   • Evaluate and treat any underlying medical conditions that may contribute to carotenemia, such as hypothyroidism or diabetes 1

3. Patient Education:

   • Reassure patients about the benign nature of the condition 4
   • Explain that skin discoloration will gradually resolve with dietary changes 2
   • Distinguish from jaundice (which affects sclera and indicates liver dysfunction) 4

4. Monitoring:

   • Clinical follow-up to observe resolution of skin discoloration 2
   • No need for laboratory monitoring unless underlying condition is suspected 4

Expected Outcomes

• Skin discoloration typically resolves within weeks to months after reducing carotene intake 2
• No long-term health consequences from carotenemia itself 1
• Normal carotene intake is beneficial for health, as carotenoids exhibit important protective mechanisms 1

Special Considerations

• While excessive carotene intake should be avoided, adequate intake of fruits and vegetables remains important for overall health 6
• The Chinese Nutrition Society suggests an upper limit of 50 mg/day for lycopene and 60 mg/day for lutein, though specific upper limits for β-carotene are not clearly established 6
• High-dose β-carotene supplementation (20-30 mg/day) has been associated with increased risk of lung cancer in smokers and should be avoided 6