If you’ve recently wondered why your skin looks dull, dry, or tired, your algorithm has likely produced an alliterative answer to your question: “ferritin face.” The viral phrase refers to how low iron can cause changes to your facial appearance, but is it even a real medical condition?
“Ferritin face” is not a recognized medical term, but low iron really can affect your skin and nails, explains Anna Komorowski, M.D., division chief of hematology and medical oncology at Northwell Health’s Northern Westchester Hospital.
As a hematologist, Dr. Komorowski specializes in blood conditions, including iron deficiency. “I actually love that people are talking about it because it's a very unpublicized nutrient deficiency that we don't hear about much about,” she says.
Iron is a mineral that our bodies use to transport oxygen and make red blood cells. Ferritin is the protein that stores iron in your cells, and it controls the release of iron into the body. When your body needs more iron, ferritin releases it. But if your ferritin level is depleted too, your body may not be able to access enough iron to keep making red blood cells and carrying oxygen efficiently.
That’s why low iron is linked to more than just facial changes, Dr. Komorowski explains. Iron deficiency can also cause fatigue, chills, restless legs syndrome, chest pain, and a variety of other symptoms.
Since iron deficiency impairs your body’s ability to produce red blood cells, some people with low iron may notice that their skin looks pale or dull. But “ferritin face” symptoms, especially pallor, will vary depending on a person’s skin type. “In deeper skin tones, you may not necessarily see an obvious loss of color across the entire face. Instead, pallor can sometimes be more noticeable on the lips, nail beds, palms, or inside the lower eyelids,” says Brianna Olamiju, M.D., a New York City-based dermatologist.
On top of that, not everyone who notices symptoms of “ferritin face” has iron deficiency, as there are a number of reasons, such as genetics, allergies, sleep issues, and dehydration, that could explain facial changes, according to Dr. Olamiju. “I would be cautious of viral claims suggesting that dark circles, facial puffiness, pale lips, prominent veins, dull skin, or even changes in facial structure automatically mean your ferritin is low. Dark circles do not always equal iron deficiency, and neither does looking tired,” she says.
Essentially, low iron can affect how you look, but it doesn’t always—and there may be other things at play. “Low ferritin, particularly when it reflects iron deficiency, can be associated with things like pallor, increased hair shedding, brittle nails, and sometimes dry or lackluster-looking skin,” says Dr. Olamiju. “But there isn’t a specific facial appearance that tells me, as a dermatologist, ‘this person has low ferritin.’ A tired, pale, or dull-looking complexion can have many different causes. Your face can give us clues about your health, but it cannot tell us your ferritin level—a blood test can.”
When Dr. Komorowski thinks that one of her patients may have iron deficiency, she orders an iron test, a ferritin test, and a total iron-binding capacity test (TIBC); she explains that a complete blood count (CBC) test can also provide more information, though some people with iron deficiency can still have normal CBC results. Blood tests can provide more answers beyond what skin changes may indicate, she emphasizes.
Meanwhile, Dr. Olamiju warns against self-medicating by starting to take an iron supplement if you think you may have “ferritin face.” “More iron is not always better, and taking iron when you don’t need it can cause side effects and potentially be harmful. It is important to test your iron and ferritin levels to know exactly where you stand, rather than guessing,” she says.
Skin and hair changes can be a window into what’s going on inside your body, including potentially low iron. “Ferritin face” may not be officially recognized medically, but low iron is particularly common in menstruating women, and it is a real reason why you may notice changes in your skin. If you think you might have “ferritin face,” talk to your doctor about getting bloodwork done to check your iron and ferritin levels.
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