Itchy Skin and Liver Problem

Medically reviewed by | By

Update Date May 11, 2020
Share now

Our skin act as a window to our overall health with internal diseases may manifest as various skin changes. Itchy skin or pruritus can be an indication of underlying medical conditions including liver problem. In fact, skin changes may be the first sign of liver disease in patients.

The hepatobiliary system is made up of the biliary system and the liver. Pruritus is the commonest and at times the most distressing symptom of hepatobiliary diseases. It can be transient and mild or persistent and severe. The reason for generalized itching with liver disease is not well understood, other than the apparent link with obstructed bile flow.

Pruritis in liver problems is believed to be due to cholestasis, an increased level of bile in the bloodstream due to blockage of its pathway. Bile is produced in the liver cells, travels out of a network of bile ducts through the pancreas and empties into your small intestine. It helps the removal of wastes by the liver and helps your intestines absorb dietary fat.

The liver neutralizes toxins and filters bile salts. If its function is impaired, accumulation of bile salts, bile acids, and bilirubin occur. Deposition of these materials in the skin is believed to cause irritation and itching. Further research is still ongoing on understanding the exact chemicals that cause the cholestatic itching, which may eventually lead to new treatment options.

Characteristic of itching in liver diseases

Widespread, or generalized itching from liver disease can appear before other signs or symptoms of cholestasis develop. Pruritus in cholestasis has a number of unique features. It is predominantly most severe on limbs, particularly on the palms and soles. It is typically worse late in the evening and at night, thus affecting sleep. It is usually exacerbated by menstrual period, hormone replacement therapy, early pregnancy, contact with wool and heat such as hot baths.3,4

It does not get relieved by scratching and usually have no visible skin lesions other than scratching signs itself. Sometimes skin lesion as a skin patch or nodule can develop on the skin and may be mistaken as primary skin problems.

Managing itchy skin due to liver problems

Itching due to liver diseases is most improved after resolving the cause of bile flow obstruction. If treating the underlying cause is not possible, several medications such as Cholestyramine and Rifampicin can help relieve the itch. Cholestyramine works by binding bile salts in your intestines so they are excreted rather than reabsorbed back into the bloodstream. Rifampicin, an antibiotic, causes an increase in liver metabolism of bile and other chemicals.

Pruritus of liver diseases is quite resistant to treatment. It adversely affects the patient’s quality of life by frequently disrupting sleep, their daily activities, and personal relationships. It can also lead to depression and even suicidal intent in extreme cases. In a rare situation, intractable itch in patients of chronic liver disease can be an indication of a liver transplant even if there is no liver failure yet.

Hello Health Group does not provide medical advice, diagnosis or treatment.

msBahasa Malaysia

Read also:

    Was this article helpful for you ?
    happy unhappy"

    You might also like

    This is How Skin Cracks

    Before getting down to the concept behind cracked skin, we should first understand the concept of skin “brick and mortar”.

    Written by Aaron Joseph Sta Maria
    Skin Care, Beauty December 20, 2019

    Trivial Skin Diseases that Could Worsen without Care

    While not all skin conditions need urgent treatment, one should never take their supposed trivial skin diseases lightly as they can worsen over time. 

    Medically reviewed by Hello Doktor Medical Panel
    Written by Ahmad Wazir Aiman Mohd Abdul Wahab
    Skin Care, Beauty December 20, 2019

    Understanding Urticaria

    Urticaria, also known as wheal or hives, is a form of allergic rash. It can appear anywhere on the and can join together to form larger itchy areas.

    Medically reviewed by Panel Perubatan Hello Doktor
    Written by Nga Truong
    Skin Diseases, Health centers October 31, 2019

    Update On Current Management of Psoriasis

    Psoriasis is chronic condition that poses physical and emotional stress on the patient. Current management of Psoriasis is discussed in this article.

    Medically reviewed by Panel Perubatan Hello Doktor
    Written by Ahmad Wazir Aiman Mohd Abdul Wahab
    Balneum HD Desktop Right

    Recommended for you

    arthritis psoriasis

    Every 1 in 3 Psoriasis Patients Develops Arthritis

    Medically reviewed by Dr. Joseph Tan
    Written by Aaron Joseph Sta Maria
    Published on April 9, 2020

    Why You Should Not Be Worried About Biologic Treatment for Psoriasis

    Medically reviewed by Dr. Joseph Tan
    Written by Aaron Joseph Sta Maria
    Published on April 8, 2020
    lifestyle psoriasis

    Lifestyle Changes to Make in the Fight Against Psoriasis

    Medically reviewed by Dr. Joseph Tan
    Written by Aaron Joseph Sta Maria
    Published on April 8, 2020

    Chronic Diseases that Stem from Untreated Psoriasis

    Medically reviewed by Dr. Joseph Tan
    Written by Aaron Joseph Sta Maria
    Published on April 8, 2020