Itchy Skin in Liver Disease Progression: Early Sign You Shouldn’t Ignore

The liver is a vital organ in the human body that separates nutrients and waste as they pass through the digestive system. It also has the crucial role of producing bile, which delivers toxins out of the body and helps in proper digestion.

The term "liver disease" refers to many conditions that affect and damage the liver. If left untreated, liver disease can lead to more serious liver failure or liver cancer.

Itchy Skin as a Liver Disease Symptom

One of the symptoms of chronic liver disease is itching or pruritus. However, not everyone with liver disease developed this condition. Although a little itch should not be a cause for concern, continual itching can lead to other health problems.

Itching related to liver disease may get worse during the night. Some people experience itch in one area, like a limb, sole of the feet, or palm, while others may suffer from an all-over itch. This kind of itch does not generally involve skin lesions or rash, but a person may develop redness, visible irritation, and skin infection due to excessive scratching. Exposure to heat, stress, menstruation, and pregnancy can even worsen such conditions.

Various types of liver disease can be caused by inherited conditions, alcohol abuse, infection, and obesity. Itching is rare in liver diseases related to alcohol consumption and nonalcoholic fatty liver. It is usually associated with primary biliary cirrhosis (PBC), primary sclerosing cholangitis (PSC), and intrahepatic cholestasis of pregnancy. Some other types of liver disease that involve itching include chronic hepatitis B and C, familial intrahepatic cholestasis, Allagille syndrome, cancer of the head of the pancreas, and biliary obstructive disease.

Experts still cannot figure out precisely why itching occurs with liver disease. There are various possibilities that scientists are looking into, such as the accumulation of high levels of bile salts under the skin, raised histamine or serotonin levels, and the action of female sex hormones during pregnancy or hormone replacement therapy. People who suffer from itch associated with liver disease may also have elevated alkaline phosphatase (ALP) or lysophosphatidic acid (LPA).

Itching and Progression of Liver Disease

Some experts believe that the chemicals in the body may play a role in developing itch from liver disease. However, there is no apparent connection between the chemicals' levels and the itching's severity.

Although liver disease may be accompanied by itching, pruritis can develop early on, even before a person realizes that they have liver disease. It can even start at any point in liver disease.

These only mean that itching alone as a symptom does not say anything about liver disease's severity, progression, or prognosis. However, it does not mean that itching is not a serious problem. When it persists, it can still contribute to insomnia, fatigue, anxiety, depression, and impaired quality of life.

There are theories as to why the intensity of itching varies in cases of liver disease. One of these is the nature of the nerve pathways, which carry the perception of itching. A person's genetic makeup, diet, and other environmental factors may also play a role.