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"Do you have a ferritin face?" asks a young woman on TikTok, pointing out dark circles, pale skin and brittle hair, alongside before and after photos of her beauty treatments. The content creator attributes these traits to her low iron levels.
It is one of many videos and posts on TikTok and Instagram claiming that low levels of ferritin, a protein that stores iron in the body, can leave visible traces on the face.
Users mention pale or grayish skin, dark circles under their eyes, dry or cracked lips, hair loss and weak nails, while others share portraits showing stark visual differences.
The expression "ferritin face" has spread widely on social media, and the videos have racked up millions of views.
But doctors say that appearance alone does not diagnose iron deficiency.
"Ferritin-looking face is not a medical diagnosis," says Aziza Sesay, a GP in the West Midlands, UK. "However, it may be an indication that something is not right."
Paleness, hair loss or brittle nails can accompany iron deficiency, but they can also be signs of other conditions, he told BBC News.
What is ferritin?
Ferritin levels indicate the state of the body's iron stores, while hemoglobin is the protein in red blood cells that transports oxygen.
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When hemoglobin levels are low, the blood cannot carry enough oxygen, a condition known as anemia.
But iron stores can be depleted before that happens, meaning that a person can be iron deficient and have symptoms without developing anemia.
"You don't have iron stores, but you maintain your hemoglobin levels. That's where the big discrepancy lies," said hematologist Drew Provan.
Dr. Sue Pavord, also a hematologist, said iron deficiency is common and often underdiagnosed in women.
According to the British Society of Gastroenterology's British guidelines, a ferritin level below 15 micrograms per liter indicates no iron stores, while a level below 30 generally indicates low iron stores.
Lucy M., 32, who posts about hair loss as @marvluceskin on Instagram and TikTok, said the term "ferritin face" seemed to describe the changes she had noticed in herself.
In 2021 he developed palpitations, fatigue and hair loss. After receiving the news that her blood tests were normal and being diagnosed with generalized anxiety disorder, further analysis revealed that her ferritin level was 12 micrograms per liter.
Lucy said she looked "grey" and that her hair had become dull and brittle.
He shared photos with the BBC of when he had low ferritin levels, comparing them to when they had recovered, and said the difference between how he felt and how he looked was "abysmal".
Can iron deficiency alter your face?
"Ferritin face" videos often encourage viewers to look for a combination of physical signs - from dark circles and pale skin to dry lips, thin hair and brittle nails - and compare them to their own appearance.
"You're not ugly, you have low ferritin," says one creator, pointing to the camera.
Provan said it was "impossible" to determine a person's ferritin levels based on the appearance of their face.
People with severe anemia may appear pale, he explained, while fatigue can contribute to dark circles under the eyes, but these visual signs are "subjective and unreliable."
In people with darker skin, changes in skin color may be less obvious, Sesay added, meaning someone specifically looking for signs described on the Internet could miss iron deficiency.
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For doctors, symptoms and how a person feels are more useful than appearance.
According to Provan and Sesay, blood tests are important not only to confirm iron deficiency, but also to determine the cause and guide treatment.
Heavy menstruation, low dietary iron intake, gastrointestinal blood loss, and iron absorption problems in the intestine can influence this deficiency, which is commonly treated with oral iron intake.
Pavord said it's best to take iron tablets on an empty stomach, ideally first thing in the morning, and advised avoiding tea or coffee at this time, as they can inhibit absorption.
Iron can also be obtained naturally from foods such as meat, legumes, lentils, leafy green vegetables, and fortified cereals.
Taking iron supplements without a diagnosis can be harmful, while self-medication could delay investigation of an underlying problem.
Lucy said that despite this, social media has helped women take their symptoms more seriously and given some the confidence to ask questions when something doesn't feel right.
"There are so many women who say, 'Oh my God, this is me!'" she said, adding that she is not a doctor and presents her content as her own experience.
For her, doing so has been empowering, providing women with information with which they can advocate for themselves.
Sesay called social media a "double-edged sword": It can encourage people to seek help, but it can also lead them to misdiagnose themselves based on a short video.
For Lucy, what's helpful is not self-diagnosing by appearance, but knowing when something doesn't feel right and when to ask questions.
This article was originally written in English and we used an artificial intelligence tool to translate it. A BBC journalist reviewed the text before publication. Learn more about how we use AI.
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