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What Can Your Skin Say About Your Liver Health?

Skin is the largest organ in our body and can often be an indicator of what´s happening inside of the body. In fact, skin manifestations are considered the most common extrahepatic (occurring outside the liver) signs of chronic liver disease*. In this article, we explore the most common skin symptoms of liver disease.

Dry & Itchy Skin Jaundice Skin Rash Terry´s Nails

Dry & Itchy Skin

Xerosis (dry skin) and pruritus (itchy skin) are the most common skin manifestations of liver disease and were observed in 95% and 50% of cases respectively, according to a study*. Pruritus often accompanied by skin dryness can be a very painful, exhausting, and difficult-to-manage symptom and have a very significant impact on one´s quality of life. Pruritis can occur at any stage of liver disease and is highly prevalent in autoimmune liver diseases, chronic viral hepatitis, drug-induced liver injury, and is much less prevalent in alcohol-related liver disease and non-alcoholic fatty liver disease.

Jaundice

Jaundice is one of the most well-known liver disease signs. Jaundice is a yellow discoloration of the skin and eyes that occurs when the liver is not able to remove enough bilirubin from the blood. The treatment of jaundice usually targets its primary causes rather than the symptoms of this condition.

Skin Rash

Skin rashes can be a sign of hepatitis C and should be taken seriously. Rashes that appear on your skin due to hepatitis C can show that your body is trying to fight the infection on its own. This rash is called urticaria and is the most common rash for those suffering from acute hepatitis C virus. This is a short-term infection, according to the National Digestive Diseases Information Clearinghouse, acute HCV typically lasts for six months or less. Urticaria can also cause the skin to swell, rashes on your face and often comes in rounds that can last for several hours. Urticaria can also develop as a result of certain allergic reactions.

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Terry´s Nails

The condition of one´s nails can also be an indicator of an underlying liver disease. Terry´s nails, which is a form of leukonychia, is one of the frequent liver disease manifestations characterized by the white discoloration on the nail plate. In 1954, Dr. Richard Terry was the first to identify the link between this nail condition and cirrhosis which he observed in more than 80% of cirrhosis patients. In Terry´s nails, the white discoloration usually affects the entire nail except for a 1-2mm distal band**. This condition is very prevalent in individuals with cirrhosis, heart failure, diabetes, or abnormal steroid metabolism.

Sources:

* Rudi Chandra, Irma Damayanti Roesyanto-Mahadi, Ariyati Yosi (2019); Profile of Cutaneous Manifestations in Chronic Liver Disease in H. Adam Malik General Hospital Medan; International Journal of Scientific and Research Publications (IJSRP) 9(2) (ISSN: 2250-3153), DOI: http://dx.doi.org/10.29322/IJSRP.9.02.2019.p8622.

** Tuzun Y, Karakus O. Leukonychia. J Turk Acad Dermatol 2009; 3 (1): 93101r.

***Bergasa NV. Frontiers in neuroscience pruritus of cholestasis. In: Carstens E, Akiyama T, editors. Itch: mechanisms and treatment. Boca Raton, FL: CRC Press/Taylor & Francis Group; 2014.

*** Hegade VS, Kendrick SF, Rehman J, Jones DE. Itch and liver: management in primary care. Br J Gen Pract. 2015;65(635):e418-e420. doi:10.3399/bjgp15X685477.