Feeling itchy may be a result of chronic liver disease. Luckily, there are many things you can try to help soothe the itch.
Living with chronic liver disease could encompass a wide range of health issues, especially if the liver has incurred any significant damage. Regardless of the cause of liver disease, skin itching that goes beyond the feeling of several mosquito bites can be one of the more frustrating manifestations of a struggling liver.
The technical term for itching, pruritus is a common symptom of advanced liver disease and liver cirrhosis. Pruritus can be:
- Localized to a specific area of the body
- Generalized to itching over the entire body
- Annoying, mild itching
- Severe itching that interferes with daily life
- Worse at night, interfering with sleep
- Most intense on the palms of the hands and soles of the feet
Some people have even described pruritus as a sensation that their internal organs feel itchy. Unfortunately, simple finger scratching rarely relieves pruritus. Thus, some people risk substantial injury and infection by attempting to scratch with sharp objects. The severity of pruritus does not always correlate with the degree of abnormality of liver function tests.
The Link Between Pruritus and the Liver
Although the exact connection between itching and liver disease is unconfirmed, experts believe it is due to the accumulation of toxins that have not been effectively filtered by a damaged liver. In healthy individuals, the liver acts as a filter, removing toxins and irritants from the bloodstream so they can be eliminated. However, a liver burdened by chronic disease may become injured – impeding the flow of bile through the liver.
- When bile flow is impeded, bile acids and bilirubin get backed up in the blood.
- A back up of bilirubin causes jaundice (yellowing of the skin and eyes) and can also cause pruritus.
Melissa Palmer, MD, internationally renowned hepatologist and author of Dr. Melissa Palmer’s Guide to Hepatitis and Liver Disease claims in her book that 20 to 50 percent of people with jaundice also have pruritus. In addition, certain medications used to treat chronic Hepatitis C may cause itching.
Physicians may prescribe one of the following for pruritus relief:
- Analgesics (pain-relievers) for neuropathic pain (gabapentin)
- Antihistamines (Benadryl, Atarax)
- Cholesterol-lowering agents (Questran, Colestid)
- Opiod antagonists (Narcan, Revia, Revex)
- Antidepressants (Zoloft)
Consulting with a physician to find relief from pruritus may yield one of the prescription medications above. However, many doctors forget to encourage their patients to try safer solutions before beginning a new drug that likely has side effects of its own.
Before adding to the pharmaceutical load your liver must process, consider one of these nine more natural itch-relief approaches first:
- Cold Packs – A cold pack on the skin will cool heat and relieve intense itching.
- Drink Water – Keeping hydrated will help maintain the skin’s suppleness which can reduce itching.
- Milk Thistle – This herbal supplement helps prevent toxins from backing up into the bloodstream.
- Shower in Tepid Water – Heat aggravates itching. Thus, make sure your bathing water’s temperature is not too hot.
- Wear Comfortable Clothing – Loose fitting clothing made from soft, smooth, natural fabrics will prevent excess heat from being trapped against the skin.
- Oatmeal Bath – Taking a tepid, colloidal oatmeal bath helps soothe irritated skin.
- Avoid Heat and Humidity – During hot and humid weather, seek a cool, air conditioned place to prevent pruritus flares.
- Topicals – Besides applying a moisturizer to prevent skin from getting too dry, some over-the-counter topical medications (like hydrocortisone cream and Benadryl lotion) can help reduce itching.
- Ice Rub – Instead of scratching, try gently rubbing the itchy area with an ice cube.
If you have chronic liver disease and find yourself struggling with itchiness, it is probably a consequence of your illness. If none of the natural approaches listed above offer relief from severe itching, consult your doctor. A medication used to thwart pruritus could prove valuable. Ultimately, liver transplantation may be required if pruritus becomes unbearable. While a liver transplant is the only cure for severe itching in people with advanced liver disease, the practical solutions just described and/or medications prescribed by a doctor are usually sufficient for less severe cases.
Pruritus can be very frustrating and is not a symptom to ignore. More severe than a mosquito bite or dry skin, itching from chronic liver disease deserves attention and prompt intervention.
http://iuhealth.org/riley/gastroenterology/liver-overview/symptoms-of-liver-disease/, Symptoms of Liver Disease, Retrieved May 18, 2014, Indiana University Health, 2014.
http://www.hcvadvocate.org/hepatitis/factsheets_pdf/pruritus.pdf, Pruritus (Itching), CD Mazoff, PhD, Retrieved May 18, 2014, Hepatitis C Support Project, 2015.
http://www.hepatitiscentral.com/mt/archives/2010/02/ten_tips_to_rel.html, Ten Tips to Relieve HCV-Related Itching, Nicole Cutler, L.Ac., Retrieved May 18, 2014, Hepatitis Central, 2014.
http://www.wisegeek.com/what-is-the-connection-between-liver-disease-and-itching.htm, What is the Connection Between Liver Disease and Itching?, Retrieved May 18, 2014, Conjecture Corporation, 2014.
Palmer, Melissa MD, Dr. Melissa Palmer’s Guide to Hepatitis and Liver Disease, Avery – Penguin Group, New York, NY, 2004; 319-321.