Jaundice: symptoms, causes and when to get help

The main sign is yellow skin and yellow whites of the eyes. The NHS says it may be less noticeable on brown or black skin, but the whites of the eyes will still look yellow, so looking at the eyes is the most reliable check.

The NHS says you may also have itchy skin, darker pee and paler poo than usual.

If you have yellow skin or eyes, the NHS says to ask for an urgent GP appointment or get help from NHS 111. Do not wait to see whether it settles by itself.

NICE Clinical Knowledge Summaries describes jaundice as a clinical sign, not a disease in itself: yellow pigmentation of the skin, the whites of the eyes and the mucous membranes due to raised bilirubin in the blood. It can be caused by many disorders, from benign to life-threatening.

The NHS describes bilirubin as a waste product that is usually removed from the body by the liver. It says that in newborns jaundice usually happens because the baby's liver is not yet able to work properly and clear bilirubin. In adults, the liver or the bile ducts or the blood itself may be the source of the problem, which is why a cause needs to be found.

The NHS lists alcohol-related liver disease, gallstones, hepatitis, pancreatitis and sickle cell disease among serious causes. Treatment depends on what is causing it.

NICE CKS groups the causes of jaundice in adults by where in the body the problem lies.

NICE CKS says assessment includes asking about how long the jaundice has been present, changes in urine and stools, itching, pain, fever, weight loss, travel abroad, injecting drug use, blood transfusion, medicines and alcohol. The doctor will examine you and test a urine sample for bilirubin. If you are not acutely unwell, blood tests including liver function tests, clotting and hepatitis screening when indicated are done, along with an ultrasound scan.

Treatment depends on the cause. NICE CKS says most adults with jaundice in primary care should be admitted or referred to hospital. It lists reasons for same-day assessment, including being acutely unwell or dehydrated, having a fever, bruising or signs of sepsis or bleeding, marked abdominal pain or vomiting, very high bilirubin, abnormal clotting, being frail, suspected paracetamol overdose and being pregnant. People who are well and have hepatitis A or Gilbert's syndrome can be managed by the GP.

Where cancer is suspected, NICE CKS says referral should use the suspected cancer pathway, for an appointment within 2 weeks.

Jaundice is a sign, so it cannot itself be caught. Some of the conditions behind it can be infectious, though. The NHS explains that hepatitis A is a liver infection spread in the poo of an infected person, through unclean water or food, food handled by an infected person, or close physical contact including sex and sharing needles.

For hepatitis A, the NHS says you are usually infectious for 7 days after jaundice started, or 7 days after symptoms started if you have not had jaundice. During that time it advises limiting contact with others (adults staying off work and children off school or nursery), washing hands thoroughly after using the toilet, and not preparing food or drink for others.

Causes such as gallstones, Gilbert's syndrome, newborn jaundice and alcohol-related liver disease are not infections.

It depends entirely on the cause. The NHS says hepatitis A usually clears up on its own within 3 to 6 months, and that most people with it get better within a few months. Gilbert's syndrome causes mild jaundice that comes and goes, and the NHS says it does not usually need any treatment.

In newborn babies the NHS says the yellow is most noticeable at around 3 days old and usually takes around 2 weeks to go. Jaundice from gallstones or liver disease persists until the underlying problem is treated.

The NHS says newborn jaundice is a common condition that causes yellowing of the baby's skin and eyes, and that it is usually harmless and gets better without treatment. It usually starts on the face and head and can spread, and may be seen under the tongue or inside the cheeks. It can be easier to see in bright light, and pressing gently on the tip of the nose or forehead may help. It can be harder to see on black or brown skin.

Most babies get better without treatment, and the NHS says feeding regularly, around 8 to 12 times a day, can help them improve more quickly. If treatment is needed it is usually phototherapy, a special light shone on the skin, and most babies need around 48 hours of it. Rarely a blood transfusion or medicine into a vein is needed.

Other causes the NHS lists include Gilbert's syndrome, infections, a different blood type from the mother, and problems with how the liver works.

NICE CKS lists being pregnant among the reasons that an adult presenting with jaundice should be admitted for same-day assessment, so yellow skin or eyes during pregnancy should be assessed urgently.

The NHS says to ask for an urgent GP appointment or get help from NHS 111 if you think you might have hepatitis A and you are pregnant. Tell your midwife or maternity unit straight away if you notice yellowing or itching.

Any yellowing of the skin or whites of the eyes in an adult needs prompt assessment: ask for an urgent GP appointment or call NHS 111, as the NHS advises.

NICE CKS describes situations for same-day hospital assessment, including being acutely unwell, having a fever, being dehydrated, bruising, marked abdominal pain, vomiting, signs of bleeding or infection, being pregnant, or suspected paracetamol overdose. If you feel very unwell, are confused or are vomiting blood, call 999. For a baby, follow the table above.

On the NHS, jaundice in an adult is assessed urgently by a GP or NHS 111, with blood tests and an ultrasound scan, and referral to hospital if needed. Newborn jaundice is checked by the midwife and care team, and bilirubin levels are measured if signs appear.

Private gastroenterology and liver clinics offer the same blood tests and imaging. Because jaundice can signal serious illness, do not delay NHS assessment while arranging a private appointment, and ask that results are shared with your GP.