Visual Signs of Physical Health: An Overview

Generally, when you visit your doctor for consultation, it is common to expect a brief discussion and check-up followed by a suggested treatment plan. Although this holds true, a physician with a good eye for detail can figure out internal illnesses just by looking at the visible signs in the body. Not all diseases are completely manifested internally; some conditions may manifest with external signs in the physical body that can come across as a telltale sign to your doctor. This article aims to discuss a few common signs that may indicate underlying disease conditions.

Generally, the appearance of your skin, face and nails, or even the way you walk can indicate the possibility of certain underlying conditions. Any visible changes that are a deviation from what is considered normal can serve as important cues to your health provider.

Skin

Changes in color, texture, moisture level or any visible marks/spots on the skin may signify existing medical conditions, allergies , treatment drug side effects, and clues about lifestyle.

Pale skin may usually be indicative of iron deficiency anemia, and it is mostly spotted along with paleness in the inner part of lower eyelid. An abnormal yellow color of the skin is due to increase in a pigment called ‘bilirubin’ which is seen in jaundice as a result of destroyed hemoglobin cells or due to an underlying liver disease.

In some circumstances, when a person eats a lot of colored vegetables or fruits (yellow, orange, red), the skin develops a yellowish color due to the presence of increased carotenoids, a naturally occurring pigment in these foods. This condition is called ‘hypercarotenemia’ which can be mistaken for jaundice.

Normal causes for reddish or pink appearance of the skin may be due to increased blood flow, exercise, and heat. Abnormal causes include hormonal disturbances, fever, certain foods or drugs. It may also indicate elevated levels of hemoglobin in the blood, a condition where there is abnormally increased production of red blood cells (polycythemia).

Bluish tinge in the skin called cyanosis can signify conditions associated with lower oxygen levels as in cardiac/respiratory diseases or due to the intake of certain drugs. However, this may not be easily evident on dark skinned individuals of Black or Asian origin.

Dark hyperpigmented skin is seen as a result of a spike in melanin (normal skin pigment) production and there may be a variety of factors contributing to this. These include hormonal hyperpigmentation as seen in pregnancy, inherited disorders, or simply prolonged exposure to the sun.

Hormonal disorders related to thyroid and pituitary glands can also show changes in the texture and moisture of the skin. Decrease in pituitary hormones can make the skin appear pale and wrinkle free with loss of hair. Lower levels of thyroid hormone can result in dry, waxy skin whereas increased levels make the hands feel hot and sweaty.

Face

Not only the changes in eyes, lips, nose, and facial skin signal disease conditions, but the very shape and structure of the face can reveal typical genetic disorders. Down’s syndrome is characterized by a small nose, underdeveloped nasal bridge, an overall flat facial profile with ears developing in a slightly lower position than normal.

A reddish patch in the shape of a butterfly on the face is a characteristic feature of an autoimmune disorder called ‘Systemic lupus erythematosus.’ However, other signs and symptoms may need to be evaluated by your doctor for a confirmatory diagnosis. Appearance of skin rash can generally include causes like allergies, gastrointestinal symptoms, or infections.

In the eyes, protruding eyeballs may suggest hyperthyroidism (elevated levels of thyroid hormone) and sunken, puffy eyes may indicate lower thyroid hormone levels. Bluish tinge in the whiter parts of the eye is commonly seen as a sign of an inherited bone disorder (osteogenesis imperfecta) whereas yellow color may denote jaundice.

Nasal septum, which is the separating tissue between the two nostrils, can appear deviated in persons with a past history of trauma to the nose or in persons suffering from sinus and headache issues. Pale lips can generally indicate poor health, and the presence of rashes or blisters may indicate viral infections. Also, severe allergies due to a drug or food substance can induce swelling of the lips and face. A smooth and reddish tongue can also serve as an indicator of iron deficiency anemia, in addition to visible skin cracks in the corners of the mouth.

Fig 1. Gap in between the two fingernails (Schamroth’s Window) disappears in Clubbing

Nails

Similar to the face and skin, changes in the texture and appearance of nails can sometimes point out serious underlying disorders. A phenomenon called ‘clubbing’ appears in the fingernails, where the nail plates appear flat and the end of the fingers appear more swollen than normal. To check for this sign, one may place together the same fingers from each hand and make them touch each other with their nails as shown in Fig 1. If no gap (Schamroth’s Window) appears in between them, it indicates clubbing, implying serious health conditions like liver cirrhosis, cardiac disorders, tuberculosis, pulmonary or gastrointestinal diseases.

Spoon shaped nails are a sign of anemia, and a pitted nail may denote skin disorders like psoriasis, eczema, and lichen planus.

Conclusion

Visible clues to health are most often overlooked as small, insignificant changes as far as these signs don’t cause any pain or trouble. Every individual can choose to be mindful of even the minor changes that they experience or notice in their body, to identify any potential health problems well in advance. Some common signs have been described in this article and there are many other signs and symptoms which require clinical reasoning to confirm the diagnosis. It is always advisable to consult with a healthcare provider if you experience any new signs that seem unusual or abnormal before inferring the cause on your own.

References

1.       Innes, J. A., Dover, A. R., & Fairhurst, K. (2018). MacLeod’s clinical examination. Elsevier Health Sciences.

2.       Cramer, I. C., Cox, E. G. M., De Kok, J. W. T. M., Koeze, J., Visser, M., Bouma, H. R., De Bie Dekker, A., Van Der Horst, I. C. C., Bouwman, R. A., & Van Bussel, B. C. T. (2025). Quantification of facial cues for acute illness: a systematic scoping review. Intensive Care Medicine Experimental, 13(1), 17. https://doi.org/10.1186/s40635-025-00719-x

3.       Alghamdi, F. S., Albogami, D., Alsurayhi, A. S., Alshibely, A. Y., Alkaabi, T. H., Alqurashi, L. M., Alahdal, A. A., Saber, A. A., & Almansouri, O. S. (2022). Nasal septal Deviation: A Comprehensive Narrative Review. Cureus, 14(11), e31317. https://doi.org/10.7759/cureus.31317

Assessed and Endorsed by the MedReport Medical Review Board