Some of the early signs of liver malfunctions could get manifested on your skin. These conditions are mainly triggered due to the inability of the liver to carry out its functions like blood detoxification and hormone regulation. Experts point out that sometimes these skin conditions could also serve as a warning sign of poor liver health.
Dr Rajiv Lochan J, lead consultant – HPB and Liver Transplantation Surgery, Manipal Hospital Bengaluru explains that the degree of liver dysfunction could be related to the severity of the skin manifestations. Some of the common skin conditions associated with liver disorders include yellow skin, small spider veins and redness of the skin, he adds.
“These changes can be seen irrespective of the cause of liver disease, and it becomes more prominent as the liver disease advances,” Dr Lochan says.
Cause of the skin manifestations
Liver is a multitasking organ involved in different physiological activities ranging from expulsion of toxins to digestion, hormone level regulation and even glucose metabolism. So, when it starts to dysfunction multiple aspects like protein synthesis, bilirubin regulation and removal of toxins from blood could get adversely affected.
“These adverse changes like unregulated estrogen levels, and accumulation of toxins in blood etc are the main factors causing these skin conditions,” explains Dr Chetan Kalal, program director, Liver, Pancreas and Intestine Transplantation, Nanavati Max super specialty Hospital Mumbai.
Hepatologists point out some of these skin manifestations:
1.Yellow skin and yellow eyes (jaundice)
Yellowing of skin, nails and the whites of the eyes are some of the most obvious and well-known signs of jaundice. Dr Kalal explains jaundice is indicative of liver dysfunction, possibly caused by hepatitis, cirrhosis, or bile duct obstruction.
Dr Lochan explains that the reason for jaundice is accumulation of yellow pigment called bilirubin in the blood. Bilirubin is the byproduct of hemoglobin metabolism in the liver, and when the liver doesn’t work properly the accumulation of this pigment causes jaundice.
The yellow coloration can also be seen in the floor of the mouth and sometimes when it is very striking the palm and skin can also become yellow.
2. Small thread veins
Also known as spider angiomas or spider veins, these are tiny blood vessels near the skin surface. “They can be a sign of liver disease due to increased pressure in the blood vessels connected to the liver,” explains Dr Kalal.
Dr Lochan says these can mostly be seen on the thighs, shoulder and abdomen of a person affected by a liver condition.
3. Rosacea (red, pus-filled bumps on face)
Rosacea is a skin condition, which makes your face appear red because of enlarged blood vessels or some pus-filled bumps. “While rosacea is primarily a skin condition, its occurrence may be linked to liver disease,” explains Dr Kalal. “Chronic liver disorders can affect blood vessel integrity and contribute to skin issues like rosacea,” he adds. While rosacea could be a skin manifestation of fatty liver, not everyone who has rosacea will have fatty liver.
4. Palmar erythema or paper-money skin
Palmar erythema is manifested through redness in the palms and could be an indicator of liver conditions, such as liver cirrhosis, hemochromatosis (when the body produces excess iron), and Wilson disease. Dr Kalal explains paper-money skin refers to a mottled appearance and can indicate liver condition, often associated with increased estrogen levels.
5. Leukonychia (white nails) and finger clubbing
Dr Kalal explains white nails (Leukonychia) and finger clubbing can be signs of chronic liver disease too, particularly in conditions like primary biliary cirrhosis (and autoimmune condition which attacks the bile ducts) and chronic active hepatitis (a long-lasting inflammation of the liver). Liver scarring in cirrhosis blocks the flow of oxygen and blood through the liver tissues resulting in white nails. In this condition there is a partial or full discoloration of fingernail. “Finger clubbing happens when the nails tend to become curved and become swollen on fingertips and nails,” he adds.
6. Red skin
Erythema, or redness of the skin, may result from increased blood flow or inflammation associated with liver disorders. Dr Kalal explains chronic liver diseases can contribute to this manifestation.
Other external manifestations
Some other external signs of liver condition may include itching (pruritus), dry skin, and changes in skin color and texture. “These can result from bile salt accumulation and impaired liver function,” explains Dr Kalal.
Skin and liver condition management and treatment
Experts say managing skin manifestations involves addressing the underlying liver condition. “Treatment may include medications, lifestyle changes and in severe cases a liver transplantation is required,” explains Dr Kalal.
“Always consult a healthcare professional for a proper diagnosis and get a personalized treatment plan tailored to the specific liver condition and its skin manifestations,” he adds.
Dr Lochan says it is important to consult specialists so that the link between the skin condition, and if there is any liver implication, can be examined carefully.
Takeaways
Most of the liver conditions also result in skin disorders. Some of the common skin conditions associated with liver damage include yellowing of skin, excess red pigmentation and formation of pus filled skin boils. The inability of the liver to detoxify the blood and also regulate some of the hormones like estrogen is often attributed as the main reasons for these skin anomalies.
