What causes yellowing of the skin on the lower leg?

Generally, yellowing of the skin on the lower leg may be caused by factors such as skin pigmentation, aging, hemolytic anemia, cholestasis, or cirrhosis. It is recommended to seek medical attention promptly, identify the underlying cause, and receive symptomatic treatment under the guidance of a qualified physician. Specific analyses are as follows:

1. Skin Pigmentation

Skin pigmentation occurs due to uneven distribution of melanin in the skin. Under the influence of sun exposure, friction, or genetic factors, melanin content in the skin of the lower legs may be relatively high, resulting in a yellowish or darker appearance. This condition typically does not involve other symptoms. Skin-lightening products containing vitamin C derivatives, arbutin, or niacinamide (such as whitening creams or gels) may help achieve a more even skin tone.

2. Aging

With advancing age, skin blood circulation slows down and metabolic rate decreases, weakening the skin’s ability to repair and renew itself. This may lead to pigment deposition, causing the skin on the lower legs to appear yellow. Maintaining healthy lifestyle habits—such as balanced nutrition and adequate sleep—can promote skin health.

3. Hemolytic Anemia

Hemolytic anemia may result from intrinsic defects in red blood cells. When large numbers of red blood cells are destroyed, hemoglobin is released and broken down into bilirubin, increasing bilirubin levels in the blood and causing skin yellowing. This may be accompanied by symptoms such as chills, fever, headache, and vomiting. Treatment may include medications such as sodium salicylate tablets, methylprednisolone tablets, or compound cyclophosphamide tablets, taken as directed by a physician.

4. Cholestasis

Cholestasis may be caused by viral hepatitis. Impaired bile flow prevents bile from entering the intestines normally, causing bilirubin from bile to reflux into the bloodstream, elevating serum bilirubin levels and leading to skin yellowing—including on the lower legs. Symptoms may also include itching, darkened urine, and pale stools. Medications such as phenobarbital tablets, ursodeoxycholic acid tablets, or ademetionine 1,4-butanedisulfonate for injection may be prescribed to alleviate symptoms.

5. Cirrhosis

Cirrhosis may be triggered by factors such as medication use or immune system disorders. It severely impairs liver function, reducing the liver's ability to metabolize and excrete bilirubin, thereby increasing blood bilirubin levels and causing generalized skin yellowing, including on the lower legs. Patients may also develop complications such as ascites, portal hypertension, and splenomegaly. Treatment under medical supervision may include medications such as compound vitamin B tablets, polyene phosphatidylcholine capsules, or entecavir capsules.

Routinely exfoliating helps remove dead skin cells and promotes metabolism. Additionally, try to avoid prolonged standing or sitting; engage in appropriate physical activity to improve blood circulation.