Greyscale gets mentioned a lot of times, but at the back of my mind it seems like its some sort of leprosy. What's the nearest real world disease that comes close to GRRM's greyscale.

  • 8
    What are the symptoms? Aug 6, 2011 at 23:49

14 Answers 14


From what I recall of the disease:

  • Victims start to lose feeling in their limbs.
  • Disease spreads from extremities to the center of the body.
  • The affected portions are disfigured, covered with a grey scale. Very unpleasant to look at.
  • Can be extremely slow in progress.

This reminds me of leprosy, at least in the fashion it was described in the Thomas Covenant series.

  • 9
    As well as the social stigma attached to the disease. Aug 8, 2011 at 19:55
  • 3
    +1 Most types of leprosy produce patches of dead skin that's lighter than your normal pigment; in a caucasian "grey and scaly" would definitely fit: en.wikipedia.org/wiki/File:Leprosy.jpg
    – KutuluMike
    Jul 18, 2012 at 16:45
  • 1
    Another similarity with the real-world history of leprosy is how lepers were often sent off to live and die in leper colonies, typically in remote locations, out of fear they'd spread the disease Sep 6, 2016 at 14:24

The closest real world equivalent would be likely be Metatastic calcification or Calcinosis. Usually it is localized though it can occasionally be systemic in nature. Basically through some means not fully understood the body is unable to properly process calcium which then builds up throughout the body causing soft tissue calcification and in rare cases calcification of the internal organs, tissues, and arterial walls.


Let's see the symptoms first on AWOIAF page for the disease. The following symptoms are mentioned:

  1. The patient loses sense of feeling in the affected parts.
  2. The affected parts turn into a grey, hard to touch stone-like phenomenon.
  3. In final and severe stage, the disease turns inwards, affecting the internal organs.

It is also supposed to be contagious.

Other than leprosy which has been already suggested, The closest I have gotten is the following:


Effects are listed below:

  1. Raynaud's Phenomenon is shown by patients which means excessively reduced blood flow in response to cold or emotional stress, causing discoloration of the fingers, toes, and occasionally other areas.
  2. Reynaud's phenomenon can complicate into an ischemic Gangrene. In it, cells die and affected area turns into dry, shrunken and dark reddish-black. Therefore, the victim loses sense of touch or use of the affected parts.
  3. healed pitting ulcers on the fingertips
  4. In the more severe form, it also affects internal organs.
  5. Affected parts become discolored, ranging from red to grey. A mild example shown below:

enter image description here

The disease is described as following by American Chemical Society:

First described in the 18th century, scleroderma literally means “hard skin” and is characterized by thickened, stonelike skin that may become hyperpigmented. However, the real damage is being done under the surface of the skin. The immune system damages the small blood vessels and any area where collagen-producing cells are located. Initially, the excess collagen causes thick, tight skin, that burns and is very painful. More seriously, the lungs, heart, gastrointestinal tract, kidneys, muscles, and joints may be targets of excessive buildup of fibrous connective tissue that is primarily composed of collagen.

But a good point to notice here is, You can't catch Scleroderma as you might catch Grey scale.

There is another interesting disease called Fibrodysplasia ossificans progressiva in which literally bones start growing and your muscles gradually become rigid and frozen like a stone but not much matches other than that.


It's Leprosy, or something really close. Leprosy is named from the Greek word for scales "lepra", and patches of infected skin can look Grey. Nerves going numb was typically one of the first signs of the disease. (thus the poking of fingers in the book). There's two kinds of Leprosy, one that kills you eventually and one that leaves localized patches on you and you can recover from, just like Greyscale in the book.

It could be Leprosy complicated with Calcinosis, with the virus itself being responsible for the calcinosis part, by causing changes in the body's calcium absorption.


It's likely that there is no one real world equivalent to the disease in much the same way that characters, places and events can not be direct representations of one real world equivalent. George R. R. Martin likes to take inspiration from multiple sources and combine them together insisting that direct comparisons are boring.

I don't like to just take a character from history, whoever it is, and just change his name, kind of file off the serial number and present him as my own character. What I much prefer to do is perhaps take 2 or 3 characters from history and mix them up together or do juxtapositions that are original; I mean I don't want…I love historical fiction as a reader, but one of the problems with historical fiction, if you read a lot of history, you're always going to know how it's comes out. If you read a novel that’s actually set during the Wars of the Roses, you know what’s going to happen to those two little boys in the tower; you know who's going to win the Battle of Bosworth Fields. You know the ultimate fate of the mad King Henry VI. So I don't like that, I don’t want someone to just look at my book and know what happens because they're recognizing historical analogues, I like the stories to be unpredictable.

With that said there are likely many real world inspirations for the disease with none of them being true equivalents.


  • Cast out to live in a colony
  • Stigma and fear of it
  • Loss of feeling
  • Blindness
  • Discolouring on the skin


  • Thick, dry "fish scale" like skin
  • Impaired eyesight


  • Hard/thick skin
  • Internal organ problems

Fibrodysplasia ossificans progressiva (FOP)

  • Muscle to bone (stone men)


As you can see not one of the diseases contain all of the similar symptoms to greyscale but that all of them combined come to a form of it.

Potential real world examples were taken from the following article: International Business Times, Game of Thrones - greyscale and its real-life equivalents.


From the descriptions of the grey and cracking nature of the skin and, I believe, at one point the skin is described as breaking with diamond patterns, it would be akin to whatever causes a Harlequin fetus (article not for the faint of heart).

  • 3
    Maybe you should add a Not-Safe-For-Peaceful-Sleep tag to your link Oo_ The image behind it is rather gruesome (as is the phenomenon itself)
    – silvith
    Sep 17, 2012 at 9:55

It is called ichthyosis. I don't think there is a direct equivalent though as this is normally a symptom of genetic diseases.


Fibrodysplasia ossificans progressiva

It causes the body to replace muscle with bone. It is also known as the "Stone Man Syndrome".


Most likely it is Diabetes. Peripheral neuropathy and severly decrease circulation causes skin on the legs to discolor, weep, and eventually limbs have to be removed. As it progresses, kidney and other organs are affected. Some go blind and eventually you die of some diabetic related issue.

  • 3
    But diabetes is not contagious; in contrast, the people of Westeros suspect greyscale is. Of course, they might be mistaken...
    – Andres F.
    Sep 17, 2012 at 5:24
  • At the risk of being spoilery, later on in the A Dance With Dragons, a minor character contracts greyscale through exposure to an infected being. May 12, 2014 at 19:27
  • @AndresF. They don't appear to be wrong given how JonCon got it
    – Aegon
    Sep 5, 2016 at 9:15

It's not a disease but more like a physical effect. Ever seen a "krokodil addict"? That's a really fatal drug popular amongst poor Russian towns.

People call it krokodil because you end up losing your skin, organs and limbs and they turn greyish-greenish and it makes you look like a crocodile. Not contagious though. Sorry for the really disturbing image. Don't ever use this kind of drug.

enter image description here

The image was sourced from here.


Greyscale first reminded me of severe mange in dogs, the human version being scabies.

I think that's what greyscale physically resembles the most and the condition could probably cause psychological disorders but to my knowledge it does not calcify internal organs.

Due to the contagious nature of scabies I expect that it'd have about the same societal stigmas as leprosy or chicken pox.


I suspect it's real-life equivalent is the smallpox. The disease is contagious, often fatal and leaves survivors scarred. It doesn't turn a person into the image of a gargoyle but it's effects on people and their attitude towards the disease and its victims are similar.

@apoorv020 Leprosy is always contagious, but greyscale seems to lose its contagious properties. Else the daughter of Stannis would be in much greater pysical isolation, or her isolation would be referred to in the books.

  • 2
    "Leprosy is always contagious" - Strange claim. Technically it is contagious but practically it is one of the hardest diseases to catch. The bacteria can travel, of course, but requires oral or nasal fluid contact, and even then most people are naturally immune. Physical isolation of people with leprosy is driven by fear, not science.
    – user1030
    Oct 4, 2012 at 18:08
  • 1
    @JoeWreschnig not a strange claim, but it seems I did manage to screw up my facts based on things I thought I knew. After reading up, leprosy is indeed a pretty good candidate for real life greyscale
    – silvith
    Oct 5, 2012 at 11:34
  • From what I understand, leprosy is caused by a bacterial infection. If the bacteria is eliminated entirely, by the immune system alone or with help, the subject would no longer be contagious. (Which is what modern medicine does, albeit much faster and with a far greater success rate.) In which case, I'd disagree that "leprosy is always contagious."
    – arkon
    Mar 22, 2015 at 10:19

How about Oregon plague:




  • 1
    Those people had bubonic plague whose symptoms are completely different from the description of greyscale.
    – Niall C.
    Sep 18, 2012 at 0:19
  • @Hamid: The Oregon plague is actually the black death; it wiped great amounts of the human population in Europe. (middle-ages) My own country is thought to have lost 2/3 of the population. It is usually spread through rodents, though this is not a problem anymore. I read somewhere (cant remember where anymore) that it still presists in some forrested parts of mongolia, but is otherwise accounted for as extinct but for in laboratories. Now and then single cases will emerge, but we know how to stop it from spreading now. (body fluids) Perhaps a mix of several of the diseases purposed here?
    – user9151
    Oct 4, 2012 at 17:46

scleroderma possibly,but it's not contagious.

  • Oh wow. You suggested that years before I did. Pity you did not explain your reasoning
    – Aegon
    Sep 5, 2016 at 9:17

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