The early stages of fatty liver disease often don’t cause symptoms. But changes in your face and skin, such as puffiness, changes in color, and itching, could suggest fatty liver disease.

Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease. While it may be common, the symptoms are often subtle. Over time, you may notice changes in your face that aren’t due to another known cause.

Keep reading to find out whether there’s a connection between your face and fatty liver disease.

What does your liver do?

Your liver has more than 5,000 separate functions in your body. Some of the most important functions include:

  • breaking down toxins
  • helping your body use nutrients in your food
  • regulating your blood sugar
  • preventing excess bleeding

Severe liver damage can be deadly because you can experience significant bleeding.

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Fatty liver disease develops when your liver stores too much fat in its cells. Heavy alcohol use can cause fatty liver disease. But you can also develop NAFLD if your diet is high in calories and fat.

Fatty liver disease can cause inflammation and, in some cases, damage to healthy liver cells. Some people with the condition don’t experience symptoms. Others may note symptoms like fatigue and abdominal pain.

You may see some of the effects of fatty liver disease on your face. Possible facial symptoms include the following:

1. Puffiness

Advanced liver disease can affect your liver’s ability to make proteins, which can impair your blood flow and fluid removal. As a result, you may notice your face appears slightly puffier.

2. Dark skin in the crease of your neck

Fatty liver disease can contribute to increased insulin resistance, which means your body can’t use insulin effectively.

The resulting buildup of excess insulin in your body can cause a condition called acanthosis nigricans. This condition causes skin folds, such as on the crease of your neck, to darken.

3. Rosacea

Rosacea is a skin condition that can cause your skin to appear very red. You may also notice small red blood vessels or white bumps on your face when you have rosacea.

Although not everyone with rosacea has fatty liver disease, rosacea may be a sign of it.

4. Rash around your mouth

Chronic liver diseases like fatty liver disease can cause your body to not absorb certain nutrients as effectively. One such mineral is zinc. Many people with NAFLD have a zinc deficiency.

According to a 2022 review, a common complication of zinc deficiency is dermatitis. It often presents as skin irritation around your mouth. The irritation looks like a rash that has small fluid-filled or solid-appearing bumps.

5. Itching

Fatty liver disease can lead to skin itching, including on your face. The itching is mostly due to an excess of bile salts in your body.

Scratching usually does not provide relief and may make the irritation worse.

6. Jaundice

Advanced liver disease can lead to jaundice. This condition causes your skin and the whites of your eyes to appear yellow. Symptoms of jaundice usually appear in your eyes and face before spreading to the rest of your body.

Jaundice occurs when there is an excess of bilirubin, a yellow-orange pigment that’s a byproduct of the breakdown of red blood cells. If your liver isn’t working well enough, too much bilirubin builds up and gives a yellow appearance to your skin.

Treatments for facial symptoms related to fatty liver disease depend on your symptoms. For example, a doctor may prescribe medications like cholestyramine to reduce facial and skin itching.

The best way to reduce symptoms is to try to reverse the effects of fatty liver disease. But this isn’t always possible. Even so, trying to at least stop the disease from progressing is important.

There are no medical treatments to reverse fatty liver disease. But addressing the underlying causes can help you stop progression or even reverse the disease.

For example, if you have obesity, losing weight through changing your diet and exercise routine can help slow the progression.

Fatty liver disease most commonly affects people with type 2 diabetes and people with obesity. About 90% of people with severe obesity have fatty liver disease.

Maintaining a moderate weight and managing chronic health conditions like type 2 diabetes can help prevent fatty liver disease. Here are some specific steps you can take:

  • Limit alcohol consumption to no more than one drink per day for women and no more than two drinks per day for men.
  • Choose unsaturated fats, such as fish, nuts, and seeds, in your diet whenever possible.
  • Consider eating more whole grains, fruits, and vegetables instead of prepackaged, high fat options whenever possible.
  • Wash fruits and vegetables before eating them. This can reduce your pesticide exposure, which reduces the workload on your liver from filtering toxins.

Refraining from smoking may also help prevent fatty liver disease.

Fatty liver disease is a common condition with sometimes “silent” symptoms. But you may experience symptoms on your face.

If you are at risk of fatty liver disease and notice these changes in your face, consider talking with a doctor about testing for the condition. People with type 2 diabetes and obesity tend to have the greatest risk.

Limiting alcohol intake and maintaining a moderate weight can help you prevent (or possibly reverse) fatty liver disease. These steps can also help reduce your risk of severe liver failure.