In this article, you can learn more about the causes of itching associated with liver disease, the symptoms to watch for, ways to find relief, and when to see a healthcare provider.
The Link Between Liver Disease and Itching
It’s not yet exactly clear why some liver diseases cause itching and others don’t. The link is said to involve pruritogens, which are substances associated with itchiness, and the nervous system.
The exact link between liver disease and itching remains unclear. Theories scientists are investigating include:
Bile salts: The accumulation of bile salts under the skin seen in liver disease may cause itching, although not all patients with elevated levels of bile salts experience itch. Opioid receptors: Activation of opioid receptors may cause itching due to interference with pain signaling. Elevated serotonin: Believed to cause itch by altering itch perception. Other conditions: Conditions that cause skin itching have been demonstrated in patients with liver cirrhosis or extreme liver scarring.
Causes
Liver diseases that cause itching cause the flow of bile to slow down or stop. The most common types of liver disease that cause itching include:
Primary biliary cholangitis (PBC) Primary sclerosing cholangitis (PSC) Intrahepatic cholestasis of pregnancy
Chronic hepatitis B and C and liver cirrhosis may also cause itching. Alagille syndrome (a genetic disorder characterized by a reduced number of bile ducts) also has itching as a symptom
Symptoms
The symptoms of itching associated with liver disease may be localized (contained in one area of the body) or generalized (all over the body). They can also be categorized as acute (sudden and temporary) or chronic (present for six or more weeks).
Additional symptoms may include skin irritation, redness, and infection due to excessive scratching. If itch is caused by liver disease, it often starts in the hands (the palms) and feet (the soles) and spreads to other parts of the body.
Treatment
Treatment will depend upon your symptoms and the type of liver disease you have, although not everyone may respond to treatments. Your healthcare provider will consider your entire medical history before discussing possible treatments.
Some treatment methods for itch associated with liver disease include:
Doing your best to avoid scratching the itch (which can make symptoms worse and increase the risk of infection) Limiting time spent in hot environments, such as direct sunshine and humidity Removing specific skin irritants from your daily routine, such as body wash, lotion, or soap Using creams such as aqueous cream with 1% menthol (for its cooling effect on the skin) or corticosteroid creams Trying an oral antipruritic medication, such as cholestyramine, which binds bile in the gastrointestinal tract to prevent reabsorption
When to See a Healthcare Provider
The sooner you can see a healthcare provider for the itch associated with liver disease, the better. Itchiness associated with liver disease is unlikely to improve on its own. It can get worse and start having an impact on your everyday life. It can interfere with your sleep, mood, anxiety levels, depression levels, fatigue, and general outlook.
Your healthcare provider can help you find the right treatment methods to reduce symptoms and limit the impact of itch on your life.
Summary
Some people with liver disease will experience itchy skin, and others will not. It’s not always clear why the itchiness is present, but it’s always important to talk to your healthcare provider about your symptoms. Treatment options for itch associated with liver disease include lifestyle adjustments, reducing exposure to potential irritants, and medications.
A Word From Verywell
Living with itchiness may not seem like a big deal, until it is. What can begin as a minor annoyance can develop into worsening symptoms without treatment. If you have itchiness that isn’t resolving on its own, consider talking to your healthcare provider (whether you have a liver disease diagnosis or not). Many treatment options can help reduce symptoms and prevent skin damage or infection from excessive scratching.
FatigueAbdominal painBruising easilyHaving dark-colored urine
Signs like yellowing of the whites of the eyes, indicating jaundice, are more severe and indicate the problem has been developing for some time.
