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
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