Can ‘Ferritin Face’ Reveal That You Have Anemia?

“Shoutout to the person who commented on one of my videos several years ago, ‘You should get your ferritin checked because your lips are very pale,’” one woman shared in a TikTok video. “The amount of low ferritin faces and low thyroid eyes I see on a daily basis is crazy,” someone wrote in the comments.

Another woman who regularly posts about having low iron levels wrote in one video, “Low iron is looking like this even after 10 hours of sleep and being asked if you’re okay 24/7.”

While TikTok often promotes questionable medical advice, doctors say ferritin face is based in fact. “These visual clues can certainly prompt concern,” says Anna Komorowski, MD, the division chief of hematology and medical oncology at Northwell Northern Westchester Hospital in Mount Kisco, New York. But doctors say there’s more to the story.

What Is ‘Ferritin Face’?

“The idea that insufficient iron can impact one’s appearance is medically well established, even if ‘ferritin face’ is a newer, informal term,” Dr. Komorowski says.

According to TikTok posts, visual symptoms of ferritin face are:

• Pale lips
• Dull skin
• Dark circles under the eyes
• Brittle hair and nails

Why Ferritin Face May Suggest Anemia

Doctors agree that the signs of ferritin face parallel the outward signs of anemia.

“Anemia is a condition when the body lacks enough red blood cells, resulting in your body’s essential organs not receiving enough oxygen,” says Raffi Karagozian, MD, a hepatologist and gastroenterologist at Tufts Medical Center in Boston. “One of the most common causes of anemia is low iron.”

“Anemia can show several manifestations on the skin,” says Gary Goldenberg, MD, an assistant clinical professor of dermatology at Icahn School of Medicine at Mount Sinai Hospital in New York City.

“Skin can lose its warm appearance and can look pale or gray-ish, depending on baseline skin tone,” he says. The dark under-eye circles happen because skin in this area is usually thinner than in other areas of the body, Dr. Goldenberg explains. Coupled with lower levels of hemoglobin, an iron-rich protein in red blood cells that gives blood its color, this can lead to the appearance of dark circles.

A dull skin complexion is the result of reduced oxygen being delivered to the skin, coupled with slower skin cell turnover, he adds. Brittle nails, thinning hair, and painful cracks at the corners of the mouth can signal anemia, too, Dr. Karagozian says.

Blood Testing Is Still Needed to Confirm an Anemia Diagnosis

While they may share certain physical symptoms, “ferritin face” cannot diagnose anemia. “These visual symptoms can occur with a variety of medical conditions,” Karagozian says. “It is important to confirm anemia by blood test.”

• Serum iron test, which measures the amount of iron in the blood;
• Transferrin test, which measures a protein that moves iron through the body;
• Total iron-binding capacity, which measures how well iron attaches to certain proteins in the blood;
• Ferritin blood test, which measures how much iron is stored in the body

Anemia Could Indicate a More Serious Underlying Condition

How to Treat Low Iron, According to Doctors

• Dietary Changes Healthcare providers recommend increasing the amount of iron-rich foods in your diet, as well as foods that contain vitamin B12, which supports iron’s role in building healthy blood cells.
• Oral Supplements Doctors may prescribe iron supplements to increase iron levels in the body or vitamin B12 supplements to treat vitamin B12–deficiency anemia.
• IV Iron This is used in “more severe cases” of anemia, Karagozian says

“My strongest recommendation if you observe any of these visual signs is to promptly see a healthcare provider for a thorough evaluation, including a blood test,” Komorowski says.