Liver disease can refer to either damage to the liver or a dysfunction that affects its performance. Although there are various ways to identify liver issues, constant itching is a symptom that may indicate a liver problem in many cases. This itching, also known as pruritus, can impact one’s mood and sleep, leading to depression, anxiety, and exhaustion. Therefore, it is essential to understand the warning signs, causes, and treatments of liver disease.

Symptoms
Itching in liver disease might affect one area, like the soles of one’s feet, a limb, or palms. One might also experience an itching sensation all over the body. Alternatively, one must keep the following points in mind too:

• The itch usually won’t be accompanied by skin lesions or a rash.
• One might notice redness, irritation, or infection due to continuous scratching.
• The itching might worsen during late evenings or at night.
• Stress, heat exposure, pregnancy, menstruation, and hormone replacement therapy might aggravate the itching.

Causes
Doctors have been unable to identify a specific cause behind itching in liver disease. Multiple factors are believed to cause this issue. Also, pruritus is commonly observed in cases of intrahepatic cholestasis of pregnancy, primary biliary cirrhosis, and primary sclerosing cholangitis. In these diseases, bile flow tends to slow down or stop altogether. However, nonalcoholic fatty liver itching is uncommon, and pruritus is usually absent in case of liver diseases associated with alcohol.

Listed here are a few factors that might be responsible for itching in liver disease:

• Large quantities of bile salts tend to collect under one’s skin in case of liver diseases, which might lead to itching.
• A spike in the serotonin level might change the perception of itch in some patients.
• High levels of histamine might cause pruritus in some people, though antihistamines don’t usually help.
• Itching might be caused by high levels of lysophosphatidic acid, which is known to impact the functions of cells.
• Elevated serum alkaline phosphatase levels might cause itching in liver disease.
• Chronic forms of hepatitis B and C might lead to pruritus as well.
• Itching is also a symptom in genetic disorders like Alagille syndrome, where the number of bile ducts decreases.

Treatment options
Usually, itching due to liver disease doesn’t subside on its own. However, treatment options are available, and one might need one or more. The common treatments are outlined here:

Avoid scratching incessantly
Scratching can worsen the condition and even cause one’s skin to break, allowing germs inside. Here are a few things one may try to avoid scratching.

• Keep fingernails trimmed and wear clothes that cover most of the skin.
• During baths, use cold or lukewarm water to avoid irritating the skin.
• Use soaps and moisturizers that are gentle on one’s skin and devoid of scents.
• When one feels the urge to itch, apply a wet and cool cloth over the concerned area.
• Wear clothes that let one breathe, are loose, and made from natural fabrics.
• Wear gloves to bed at night if the itch gets worse.
• Stay away from materials that irritate the skin.
• To combat winter dryness, invest in a humidifier.
• Avoid hot environments and direct sunlight as much as possible.

Use topical creams
If one is experiencing a mild itch in a specific area, using a cream with a cooling and soothing effect can be helpful. Typically, these creams are made with an aqueous base and are easy to apply. However, it is essential to remember that before using any new product, it is always a good idea to consult a doctor.

Take oral treatments
Some oral treatments inhibit the production of bile acids, while others may be able to remove bile salts from the body. In some cases, the doctor might recommend options that are effective in fighting depression and also help deal with chronic itching. However, remember to ask about the side effects of any of these treatments before getting started.

Try phototherapy
In light therapy, the skin will be exposed to certain kinds of light in a specific way. Multiple sessions might be needed before one starts feeling the effect.

Opt for anti-allergy treatments
These options might help one get a good night’s sleep even if they cannot treat the itch. This way, one can at least improve the overall quality of life.

Ignoring itching due to liver disease can interfere with daily life and impact overall wellness. So, seek medical advice immediately and discuss one’s distinct symptoms in detail. Also, remember that itching might be caused by other non-liver disorders, chemicals, cosmetics, fabrics, insect bites, or even certain plants. Hence, only a professional can suggest the necessary tests, diagnose the problem accurately, and treat it right and on time.