Liver disease and itching are closely connected; in fact, itching is a tell-tale sign of liver disease when it involves a generalized itch across the whole body, known as pruritus. Itching can also be associated with kidney failure and other systemic diseases, but when people experience this symptom, yellowing of the skin and eyes, and abdominal tenderness, liver disease is the likely culprit. There are medications available to manage the problem so patients with liver disease will feel more comfortable.
The precise mechanism behind the connection is not well understood. In healthy individuals, the liver acts as a filter, removing toxins and irritants from the bloodstream so they can be eliminated. People with liver disease cannot filter the blood efficiently, and some researchers have suggested that irritants can build up in the blood and deposit in the skin. Another sign of liver disease is blood vessel irritation leading to spidering veins just under the skin, an indicator that the vessels are inflamed because of something in the blood.
It is also possible that liver disease and itching are associated as a result of neuropathy. Irritants in the blood can damage the nerves, causing them to send confused or mixed signals to the brain. The nerves may read neutral or nonexistent sensations as itching, in which case the patient's skin is totally normal, but it still feels itchy.
The more advanced the liver disease, the more severe the itching can become. The organ becomes increasingly unable to filter effectively, and the toxins in the blood cannot be eliminated by other organs. People with liver disease can seriously injure themselves scratching as they attempt to cope with the pruritus. Some may try wearing gloves at night so they don't scratch themselves in their sleep.
Several things can be done to help manage itchy skin caused by liver disease. Medications can blunt the sensation, topical applications can soothe irritated skin, and patients can also try meditation and guided imagery. If the underlying liver disease can be managed, this should make the symptoms less severe, making the patient feel more comfortable and reducing the risk of complications, like infections caused by incessant scratching. Patients should be alert to changes in skin color and texture, as these may indicate a decline in liver function.