Black people experience yellow skin as a symptom of jaundice, but it may be difficult to see at first, depending on your skin tone. It’s easier to spot the whites of your eyes turning yellow, but that could also be due to a benign cause.

Jaundice is the yellowing of your skin and eyes. It’s usually due to a problem with your liver or another underlying condition.

Jaundice occurs when you have too much bilirubin, a yellow pigment, in your blood. The layer of fat under your skin absorbs this excess bilirubin, causing a yellow appearance. This also occurs in the whites of your eyes.

It might be difficult to detect a yellowish skin appearance depending on a person’s skin tone. Black people have a variety of skin tones, and if you have a darker skin tone, jaundice may be more challenging to see. You’re more likely to first notice signs of jaundice in your eyes.

But people with dark skin often experience other causes of yellow eyes. Read on to learn more about how to recognize jaundice if you have black or brown skin and how to distinguish it from other conditions.

Regardless of your skin tone, the primary symptoms of jaundice are the yellowing of:

  • your skin
  • the whites of your eyes (sclera)
  • your bodily fluids

If you have a darker skin tone, it may be difficult to notice any yellowing. You may first notice yellowing of the sclera or bodily fluids.

Jaundice is a symptom of several underlying conditions. You may experience other symptoms related to the underlying condition. Symptoms common to some of these conditions include:

Yellow eyes do not always mean jaundice

The white part of your eye (sclera) has a thin protective layer called the conjunctiva. When the conjunctiva degenerates (due to exposure or age), it can cause the sclera to appear more yellow or even brown. This is more common in people with melanin-rich skin, like people of African or Asian descent.

This is a benign condition, meaning it does not negatively affect your health. Consider seeing a doctor or ophthalmologist if you are concerned about yellow eyes with other symptoms.

The American Academy of Family Physicians recommends that adults see a doctor right away if they notice yellow skin.

A doctor can order a blood or urine test to check your bilirubin levels. They may also order imaging tests like a CT scan or ultrasound to view your liver.

Jaundice in newborns is common, as their livers may not be developed enough to filter bilirubin properly.

According to the Centers for Disease Control and Prevention (CDC), about 3 in 5 babies get jaundice. If it does not resolve itself in 2 to 3 weeks, it may be a sign of an underlying condition.

It’s important to see a doctor the same day if you notice any of these additional symptoms occurring in your baby:

  • fussiness
  • difficulty sleeping or waking
  • difficulty feeding
  • not pooping or peeing enough

The CDC also notes that it may be challenging to see jaundice in babies with darker skin. But you can check their gums and upper lips for discoloration. You can also press gently on their skin to look for yellowing.

Older research suggests that Black babies are less likely to experience jaundice. But newer studies suggest that this causes health professionals to sometime miss signs of jaundice in this population.

As a result, Black babies with an increased risk of highly elevated bilirubin levels often do not receive a diagnosis soon enough. This causes them to be more likely to experience complications like kernicterus. Experts do not quite understand the reason for this, but genetics likely play a role.

Black babies with an increased risk of elevated bilirubin may have a genetic condition that’s not always screened for at birth. (More on that below.) More research is needed to understand the incidence of highly elevated bilirubin levels in Black babies and to develop best practices for screening.

Emergency jaundice symptoms in babies

Seek emergency medical care if you notice any of the following symptoms in your baby:

  • persistent high-pitched crying
  • arched body, with head and neck bent backward
  • stiff or limp body
  • unusual eye movements

Anyone can get jaundice, regardless of skin tone. The conditions that cause jaundice can affect people of all races. But Black people may have a greater risk for some of these diseases than people from other racial groups in part due to social and environmental factors.

Some of these conditions include:

Fatty liver disease

About one-quarter of U.S. adults have nonalcoholic fatty liver disease (NAFLD). NAFLD often has no symptoms, but you may experience jaundice if it progresses to cirrhosis, which is severe liver scarring.

Black U.S. adults have lower rates of chronic liver disease than people of all other racial groups. But they have higher rates of overweight and obesity, which are risk factors for NAFLD.

Hepatitis

Hepatitis is inflammation of your liver, usually due to a virus. Not everyone with hepatitis will develop jaundice, but it may show up as a symptom later in the disease progression.

Despite making up only 12% of the U.S. population, African American people account for 31% of chronic hepatitis B cases and 23% of hepatitis C infections.

Sickle cell anemia

Bilirubin is a byproduct when red blood cells break down. People with sickle cell anemia have red blood cells that do not live as long and break down more easily. This causes a buildup of bilirubin, which leads to jaundice.

According to the American Red Cross, 98% of the U.S. population with some form of sickle cell disease are African American.

Gallstones

Gallstones are hard deposits of cholesterol or bilirubin. Sometimes they can enter your bile duct and block the flow of bile. This causes bile to build up in your liver, leading to jaundice.

Although Black people appear to be at lower risk overall for gallstones than other racial groups, they do have higher rates of certain risk factors. You’re more likely to develop gallstones if you have obesity, type 2 diabetes, or sickle cell anemia.

Liver, bile duct, or pancreatic cancer

Liver, bile duct, or pancreatic cancer can cause a bile buildup. It may be because of reduced liver function or a tumor blocking the bile duct.

According to the Office of Minority Health, people who identify as Black or African American are more likely than non-Hispanic white people to develop cancer in these organs.

Glucose-6-phosphate dehydrogenase (G6PD) deficiency

G6PD deficiency is a genetic condition that lowers your G6PD blood levels. Without this important enzyme, red blood cells break down sooner than they should, resulting in a buildup of bilirubin.

The condition is more common in Africa, affecting 15% to 26% of people in some regions. According to the National Library of Medicine, it affects about 1 in 10 African American males in the United States.

Despite the disease prevalence, newborn screening often does not include screening for G6PD deficiency.

In 2022, New York became only the third state or district (behind Pennslvania and D.C.) to require G6PD deficiency screening for newborns.

More research is needed to look into this nutrient deficiency.

Other causes

Underlying conditions are not the only cause of jaundice. You can also develop jaundice from drinking too much alcohol or from taking certain medications like:

Because jaundice is a symptom of several possible illnesses, treating jaundice requires treating the underlying condition.

Jaundice will usually go away when you treat the underlying condition. But if you have chronic liver disease, your jaundice may not improve.

A doctor may recommend phototherapy to help with newborn jaundice. This special kind of light breaks down excess bilirubin to help your baby’s liver remove it from their blood.

Will jaundice go away on its own?

Jaundice in babies should go away within 2 weeks. Contact a doctor if it persists for longer.

Adult jaundice will usually require treating the underlying condition before symptoms go away.

Jaundice in adults is often a sign of a serious underlying condition. It may be more challenging for people with darker skin tones to detect a yellowing of their skin.

It may be easier to detect jaundice by spotting a yellow tint to the whites of your eyes. But be aware that people with melanin-rich skin may also have yellowish eyes due to aging. It’s important to consult a doctor to confirm what might be causing your eyes to look yellow.

Jaundice in babies is very common. Though Black babies seem to develop jaundice at lower rates, they may be at greater risk of extremely high bilirubin levels and complications like kernicterus.

Your baby’s pediatrician will usually monitor them for signs of jaundice for a few days.