Skin Signs of Liver Damage
There are different signs and symptoms that show when you begins developing liver damage and liver disease. You may experience more fatigue and loss of appetite. You may also have issues with abdominal pain and easy bruising. But, beyond these typical symptoms of liver disease, you may also see your skin change. Skin conditions and skin manifestations are often clear signs of liver disease.
Pruritus (severe itching) tends to be one of the most obvious signs of liver damage.
But, before we step into discussing how liver disease manifests in the skin, let’s take a look at what causes liver disease and liver failure.
What Causes Liver Disease and Liver Failure?
Liver disease is a general term used to describe any condition that causes liver damage. There is a wide range of ways you can develop liver disease, ranges from viruses to autoimmune disorders to family history.
Typically, one of the key ways you can develop liver disease is by the disease already having been a part of your family. The disease’s having already been a part of your bloodline makes you more at-risk of also contracting liver disease.
The Four Stages of Liver Disease
There are four stages of liver disease: inflammation, fibrosis, cirrhosis, and liver failure.
Typically, many people do not show any symptoms of liver disease in the first stage, and don’t notice symptoms in the second stage either. It’s for this reason that many people do not receive treatment for liver disease until they’ve reached the third stage: cirrhosis.
But, to help people try to identify liver disease early on, all four stages are discussed below.
Stage 1: Inflammation
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During inflammation, the liver becomes inflamed or enlarged
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At the same time inflammation and/or enlargement is taking place, there may be an increase in liver enzymes
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Typically the only physical symptom is tenderness in the upper right area of the abdomen
Stage 2: Fibrosis
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During fibrosis, the liver starts to create scar tissue
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If the liver damage goes untreated, it’s very likely scarring will continue to worsen over time
Stage 3: Cirrhosis
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During cirrhosis, the liver is permanently damaged and severly scarred
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At this point, a person will typically experience symptoms. These symptoms include fatigue, appetite loss, pain, and fluid retention.
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Despite scarring, the liver may still function normally at this time.
Stage 4: Liver Failure
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During liver failure, the liver loses its ability to function
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The only treatment for liver failure is a liver transplant
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The primary symptoms of liver failure are weight loss, confusion, disorientation, and diarrhea.
Developing Liver Disease from Viral Hepatitis A, B, and C
Another one of the most common ways to develop liver disease is by contracting hepatitis, a virus that can be contracted in three different ways.
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Hepatitis A virus happens when a person eats or drinks food or water that's contaminated.
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Hepatitis B (HCB) virus is spread by coming into contact with contaminated blood, semen, or vaginal secretions
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Hepatitis C virus (HCV) occurs from direct blood to blood contact.
These three strains of hepatitis are not the only way strains that can cause you to develop liver disease.
You can also find yourself exposed to chronic hepatitis. This form of hepatitis can be caused by autoimmune disorders, metabolic disorders and unique circumstances. For instance, a person can contract hepatitis from a blood infusion or being the child of a pregnant mother with hepatitis.
Autoimmune Hepatitis and Other Conditions
You can also develop liver disease from autoimmune hepatitis (AIH). AIH occurs when the body’s immune system attacks and damages the body’s liver cells. The damage done to the cells eventually leads to inflammation and cirrhosis.
Wilson Disease is rare, but can cause liver disease. Wilson Disease causes for copper to buildup in the liver, which later leads to liver disease.
Primary Sclerosing Cholangitis is an autoimmune disease that leads the body’s bile becoming inflamed and scarred. It’s a chronic liver disease that can cause as little as liver damage and as much as liver failure.
Hemochromatosis is a blood disorder that can cause liver disease. Hemochromatosis occurs when too much iron builds up in the body.
Liver disease can also cause extrahepatic manifestations, which are conditions that occur outside the liver. An example of this would be dupuytren’s contracture, which effects connective tissue in the palm of the hands. The condition can cause fingers to permanently bend.
Liver Disease and Conditions Caused by Alcohol Abuse
Alcohol abuse is also known to increase a person’s likelihood of developing liver disease. Drinking too much and too frequently (more than one drink per day) can effect liver function and lead to chronic liver disease.
Skin Signs of Chronic Liver Failure and Liver Cirrhosis
Some skin signs of liver failure and cirrhosis are more general than others. For instance, you may simply experience itchy skin without visible symptoms. But, you may also develop jaundice (yellowing of the skin) .
How your skin responds to liver disease and cirrhosis depends on what parts of your liver are, and aren’t working correctly. It’s for this reason that dermatology studies liver disease very closely.
Cutaneous Signs of Liver Disease
Cutaneous (relating to the skin) signs of liver disease typically present in seven different ways.
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Spider angiomas occurs when a person has tiny red dots or visible blood vessels appear anywhere on their skin.
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Paper money skin is a condition that occurs more specifically for people who have developed alcohol-related cirrhosis.
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Petechiae occurs when tiny red dots on the skin
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If a person experiences easy bruising or bleeding, it can be a sign of liver disease.
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Palmar erythema occurs when someone starts to see rednesss in the palms of their hands.
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Xanthomas appear as small yellow bumps of fat deposits on the skin or eyelids
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Rosacea (red, flushed, blushing skin) and rhinophyma (advanced Rosacea that causes the nose to become enlarged.)
Other, less common ways that a person shows signs of liver disease is from terry’s nails, which are nails that are mostly white or opaque with a pink or brown band at the tip. Clubbing nails, when fingers or toes enlarge and the nails curve downward, is oftentimes a sign of cirrhosis.
Skin Findings in Liver Damage and Liver Disease
A variety of skin findings can be found depending on what type of liver disease a person is experiencing. Pruritus and pigment changes are common signs someone may have liver disease.
For instance, if someone shows signs of xanthelasma (Pale yellow, planar or slightly bulged, soft plaques around the eyelids), it most likely means they have Cholestatic liver disease. This form of liver disease reflects a slowing or stalling of bile flow.
Similar to Choleastic liver disease, a person can experience primary biliary cirrhosis , which is a chronic autoimmune liver disease that destroys the small bile ducts in the liver and leads to cirrhosis and liver failure.
When compared to the liver diseases listed above, Porphyria cutanea tarda (PCT) causes a different type of experience. Instead of the skin changing color, a person who has this condition will experience blistering skin lesions. These lesions will also develop on skin that has been sun-exposed.
Nonalcoholic Fatty Liver Disease is a condition where excess fat has collected in the liver, but there is no history of high alcohol consumption.
Hyperpigmentation is also a sign of chronic liver disease. It occurs when a person has gray blotches or dark pigmentation appear on their skin.
Skin Findings in Cirrhosis
One of the most common skin symptoms related to cirrhosis is jaundice. But, the skin condition can also be paired with other issues such as ascites, varices, and portal hypertension.
Ascites occurs when excess fluid accumulates in the abdomen. Varices, on the other hand, are abnormal enlarged veins that are twisted and can appear anywhere throughout the body.
Portal hypertension occurs when the portal vein — the vein responsible for transporting blood from the digestive organs to the liver — experiences high blood pressure. This increase in blood pressure is typically due to a blockage or damage to the liver.
A person can also have small bumps called papules appear on their skin.
How Liver Disease Effects Women
Women’s bodies respond to liver disease differently than men’s. This is because of the ways their bodies operate biologically. A woman is more prone to develop liver disease as she gets older because of the amount of estrogen in her body. When a women enters menopause, her level of estrogen drops, and causes for there to be less good bacteria in her body.
A woman’s sexual activity with a man can also leave her more susceptible to contracting liver disease. If she’s being sexually active with someone who has hepatitis, she runs a higher risk.
How Fatty Liver Disease Effects the Skin
Metabolic Disease
If a person is suspected of having liver disease, a doctor will also try to determine if they have a metabolic disease as well. The doctor will perform a lipid panel, which will show how the liver disease is effecting the metabolic system by measuring the amount of “good” and “bad” cholesterol found in the body.
High lipid levels can indicate liver disease, kidney disease, thyroid disease, or other conditions.
If high lipid levels are found in your system, then your doctor may require you to make lifestyle changes.
How do Doctors Diagnose Liver Disease Liver Failure?
Doctors and healthcare providers diagnose liver disease and liver failure by conducting a variety of tests. They’ll test for liver function and dysfunction by examining your blood cells to see if your liver is performing all of its essential tasks. The doctor will do this by performing different enzyme tests, measuring your bilirubin, analyzing your blood tests and measuring how effectively your blood flows.
While examining your liver’s function, your doctor will also examine different clotting factors. These tests will make sure your body is responding correctly after a blood test.
Because the liver performs so many different tasks, the doctor may also perform protein tests and imagining tests to check for malnutrition. The different tests will be able to measure your quality of life as well as if your body contains the correct level of bile salts. These salts are responsible for helping remove cholesterol from your body.
Treating Liver Disease
The treatment you receive for liver disease will depend on how advanced your disease is. Some people may be prescribed medications and supplements, while other people will need to receive a liver transplant.
The Complications of End-Stage Liver Disease
The end stages of liver disease occur when the liver moves from cirrhosis into liver failure. At this stage, a person may also develop portal hypertension. They also run the risk of developing primary liver cancer.
These two conditions typically lead to hospitalization and death. The person will need a liver transplant to live.
Ways to Help Prevent Liver Failure
Some of the best ways that you can help prevent liver failure is to maintain a healthy weight and healthy diet. Consuming too much red meat, alcohol, or sugary foods can contribute to your likelihood of developing liver disease. Obesity can contribute to a person’s ability to develop liver disease as the extra fat stored in the body can cause liver conditions and liver problems.
It’s also suggested that a person always wash their hands, wash the foods they eat, and avoid consuming alcohol and wild mushrooms. Practicing safe sex, getting vaccinated, and avoiding toxic chemicals will also help you avoid liver failure.
Key Takeaways
The liver performs a variety of functions and must be tested in many different ways.
Liver disease is able to cause different skin conditions.
The key causes of liver damage is hepatitis and prior family issues.
Liver damage can also be caused by obesity and alcohol abuse.
The first two stages of liver disease typically don’t have symptoms people recognize.
Women experience liver disease differently because of the amount of estrogen in their body. How their body responds differs both before and after menopause.
If you enter into liver failure, you’ll need to get a liver transplant to survive.
References
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Cutaneous Manifestations of Common Liver Diseases
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Liver Disease: Signs & Symptoms, Causes, Stages, Treatment
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Skin Changes in Cirrhosis
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The Stages of Liver Disease
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Recognizing and Treating Cutaneous Signs of Liver Disease
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Liver Disease: About Your Liver
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What Are the Cutaneous Stigmata (Skin Symptoms) of Cirrhosis?
