Liver Disease and Itchiness: What You Should Know

Liver disease refers to a range of diseases that can cause dysfunction and damage to the liver. There are over 100 types of liver disease. Some of these diseases may cause itching that can interfere with your quality of life. Itching as a symptom found in liver disease is referred to as pruritus. 

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.

person itching their arm

Oscar Wong / Getty Images

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:

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. 

Itching and Liver Disease Stages

Itching may or may not occur during any stage of liver disease. If you have been treated for an itch associated with liver disease and it returns, you’ll need to return to your healthcare provider to discuss the next steps. 

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. 

Frequently Asked Questions

  • Where does itching typically occur in people with liver disease?

    Itching associated with liver disease often starts on the palms and soles and spreads to other parts of the body. It can be acute (lasting less than six weeks) or chronic (lasting more than six weeks).

  • What are some common signs that your liver is not functioning properly?

    Itchy skin on the palms and soles is a sign your liver is not functioning properly, but it doesn’t necessarily mean you have liver disease. Other signs your liver is not functioning properly include:

    • Fatigue
    • Abdominal pain
    • Bruising easily
    • Having 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.

  • Is itchiness common in people with liver disease?

    Itchiness is common in people with certain types of liver disease. This does not mean everyone with liver disease will experience itch. It just means there is a link between liver disease and itch, although that link is not exactly clear.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Liver Foundation. The stages of liver disease.

  2. Bhalerao A, Mannu GS. Management of pruritus in chronic liver disease. Dermatology Research and Practice. 2015 Mar. 2015:e295891. doi:10.1155/2015/295891.

  3. Tajiri K and Shimizu Y. Recent advances in the management of pruritus in chronic liver diseases. World J Gastroenterol. 2017;23(19): 3418-3426. doi:10.3748/wjg.v23.i19.3418.

  4. American Academy of Dermatology. 10 reasons your skin itches uncontrollably and how to get relief

  5. Hegade VS, Kendrick SF, Rehman J, Jones DE. Itch and liver: Management in primary care. British Journal of General Practice. 2015;65(635), e418–e420. doi:10.3399/bjgp15X685477.

  6. Johns Hopkins Medicine. Common characteristics of liver disease.

By Michelle Pugle
Michelle Pugle, BA, MA, is an expert health writer with nearly a decade of contributing accurate and accessible health news and information to authority websites and print magazines. Her work focuses on lifestyle management, chronic illness, and mental health. Michelle is the author of Ana, Mia & Me: A Memoir From an Anorexic Teen Mind.