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Background: Carotenoderma is a benign yellow-orange discoloration of the skin caused by carotenoid accumulation within the stratum corneum. It is classically associated with excessive ingestion of carotene-rich foods or supplements and is most prominent on the palms and soles, where the stratum corneum is thickest. Although conventional carotenoids such as beta-carotene and lycopene are well recognized causes, supplement-associated carotenoderma remains underreported, particularly in relation to commercially available “skin brightening” products marketed as containing so-called colorless carotenoids. Case Presentation: We report the case of a 35-year-old woman with no significant past medical history who developed asymptomatic orange-yellow discoloration of both palms and soles after taking an over-the-counter anti-tanning supplement, over the counter colourless carotenoid pills, for one month. She denied excessive intake of carotene-rich foods, carrots, vegetable juices, or additional nutritional supplements apart from occasional melatonin. Examination demonstrated marked orange-yellow pigmentation of the palms and soles with sparing of the sclerae, face, and tendons. She was otherwise systemically well, with no jaundice, pallor, or abdominal findings. The patient also described bilateral eye floaters and dry eyes of one month’s duration after commencing the supplement. Her visual acuity and visual fields were normal at presentation, although retinal examination had not yet been performed. A diagnosis of supplement-associated carotenoderma was made clinically. The supplement was discontinued, liver function tests were arranged, the case was planned for reporting to the Hong Kong Poison Information Centre, and ophthalmology referral was made to exclude retinal toxicity. Conclusions: This case highlights that even products marketed as containing “colorless carotenoids” and promoted as unlikely to cause visible skin pigmentation may still be temporally associated with clinically apparent carotenoderma. It also underlines the importance of careful supplement history taking in patients presenting with yellow-orange discoloration of the skin, as well as the need to distinguish carotenoderma from jaundice and other systemic disorders. Ophthalmic symptoms in the setting of carotenoid-containing cosmetic supplements warrant specialist evaluation, particularly because tanning-related carotenoid agents such as canthaxanthin have been associated with retinopathy. Further pharmacovigilance and case reporting are needed to clarify the safety profile of oral skin-whitening supplements.

Keywords: carotenoids; dietary supplements; skin pigmentation; retinal diseases; drug-related side effects and adverse reactions; poison control centers