People with cirrhosis may experience skin symptoms such as rashes, changes in color, or paper money skin. It’s important to see a doctor if you’re experiencing these symptoms.

Symptoms affecting the skin, hair, and nails are common for people with liver diseases such as cirrhosis.

Skin symptoms, also known as cutaneous stigmata, may be the first indication of a liver problem.

However, cirrhosis often has no symptoms in its early stages. Skin and other symptoms may only develop after your liver is seriously damaged.

Cirrhosis develops when scar tissue replaces most of your liver’s healthy tissue. Liver damage leading to cirrhosis may occur due to conditions such as:

Although liver damage from cirrhosis is permanent, treatment and lifestyle changes may help prevent further damage.

The following are some skin symptoms of cirrhosis and how to treat them.

Many people with chronic liver disease experience pruritus, or itchy skin.

The itching may be limited to one part of your body or may affect your entire body. The irritated skin may be reddened or rough with bumps or cracks.

Scratching these areas may not relieve the itch. The itching often occurs at night and can disrupt your sleep.

Treatment options are available that may help relieve your itchy skin. These include:

It’s best to avoid scratching your itchy skin. It may help to wear comfortable clothing and reduce your exposure to high heat.

Jaundice is a serious condition that causes discoloration of your skin and the whites of your eyes. It occurs when there is too much of the yellowish substance bilirubin in your blood.

Bilirubin forms after red blood cells break down and move through your organs, including your liver. You excrete them from your body through your urine. Liver damage from cirrhosis can prevent the removal of bilirubin, so it builds up in your bloodstream.

One of the symptoms of jaundice is itching, which may be relieved as indicated above.

You may experience severe dry skin (xerosis) if you have cirrhosis. This may be due to your liver being unable to metabolize vitamin A, which is essential for healthy skin.

A 2021 study of 125 people with cirrhosis found that 93.5% of them had a vitamin A deficiency.

In addition to the above treatments for pruritis, you can try doing the following to relieve your dry skin:

  • Follow a diet of nutrient-rich foods, including fruits, vegetables, and lean meat.
  • Frequently apply an oil-based moisturizer.
  • Avoid overexposure to water by taking shorter baths or showers and spending less time in pools or hot tubs.
  • Drink plenty of water to help hydrate your skin.
  • Use a humidifier to prevent dry air in your home.

A spider angioma is a small skin lesion that has a red spot surrounded by smaller blood vessels that extend outward from it, giving the appearance of a spider.

About 33% of people with cirrhosis develop these painless lesions. You may have more than one of them.

Cirrhosis due to excessive alcohol use may lead to spider angiomas because ethanol increases the formation of new blood vessels.

In addition to cirrhosis, spider angioma is associated with these conditions:

For cosmetic reasons, you may have lesions removed via electrocauterization, but they may appear again later.

A xanthelasma is a discolored fatty deposit that forms under the skin around your eyes. It may appear in people with cirrhosis because of raised cholesterol levels.

People with diabetes or high blood pressure may also have xanthelasma. Women and people of Asian or Mediterranean descent are more likely to experience it.

Although xanthelasma is harmless, you may have it removed for cosmetic reasons.

You may develop thin capillaries on your upper body that look like the red and blue threads in dollar bills. For this reason, this condition is called paper money skin.

It’s similar to spider angiomas and may be caused by bleeding into your skin, which can occur with cirrhosis.

Skin symptoms specific to alcoholic liver cirrhosis

The following skin symptoms are specific to cirrhosis caused by the chronic use of alcohol:

  • spider angioma
  • paper money skin
  • Dupuytren’s contracture, a condition where the tissue beneath the skin of your palms and base of your fingers thickens and forms nodules that may cause one or more fingers to bend toward your palm
  • disseminated superficial porokeratosis, a disease that causes small, brownish dry patches on the skin of your arms and legs
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Cirrhosis may affect your hair and nails as follows:

  • thinning hair
  • loss of pubic or facial hair in people assigned male at birth, caused by raised levels of estrogen
  • clubbing, where your fingernails or toenails change shape due to increased blood flow
  • thickened or ridged nails
  • Terry’s nails, a condition that changes the color of your fingernails to white, with a brown or red band at the tips

About 47% of people with cirrhosis develop hyperpigmentation, resulting in gray blotches that appear on your shins and the tops of your feet.

Hyperpigmentation can be due to a hormone imbalance resulting in the overproduction of melanin, a pigment that colors your skin. You may lighten the blotches with prescription medication, such as hydroquinone, and topical retinoids.

People with cirrhosis may also develop the following rare skin symptoms:

It’s important to see a doctor if you have cirrhosis and are developing any skin symptoms. It may be an indication that the disease is progressing.

If your skin symptoms are negatively affecting your quality of life, a doctor may be able to treat the condition and provide relief.

Skin symptoms are common in people with cirrhosis and other liver diseases. Itching, dry skin, and skin lesions are common symptoms. Some skin symptoms, like paper money skin, are more specific to people with alcohol-related cirrhosis.

Some of these symptoms are treatable. A doctor can diagnose your symptoms and determine your best treatment plan.