How Hepatitis C Can Affect Your Skin

Below are some of the most common skin conditions seen in people living with HCV, along with a few conditions that are more rare.

Jaundice

If your skin or the whites of your eyes look yellow, you may have jaundice. This condition occurs when your liver can no longer break down bilirubin, a yellow substance found in the hemoglobin of red blood cells.

With jaundice, you may also experience dark urine and pale-colored stools. Jaundice symptoms aren’t specific to HCV, however. Cirrhosis or liver injury of other types can also cause jaundice.

Ascites

This condition causes balloon-like swelling — and sometimes pain and tenderness — in your abdominal area. It’s caused by fluid buildup around your liver when it becomes damaged.

With ascites, you may also experience rapid weight gain and difficulty breathing. Like jaundice, ascites can also be caused by other liver injury or disease.

Itching (pruritus)

Like other systemic diseases, HCV may cause excessive skin itching, known as pruritus. This, in turn, can lead to the urge to scratch your skin, which may cause cuts and infections.

Pruritus may also be associated with lichen planus and hives.

Lichen planus

Lichen planus causes a skin rash consisting of small bumps that may be clear and shiny, red, or purple in color. Over time, these bumps may become scaly and itchy.

Lichen planus can occur anywhere on your body, but it tends to be most common on the arm and wrist areas.

Hives (urticaria)

Hives are extremely common, with an estimated 20 percent of people experiencing them at some point over the course of a lifetime. These red, raised bumps are extremely itchy, and they may come and go.

While hives are often associated with allergies, they’re also seen with viral conditions like HCV.

It’s also possible to experience hives or other itchy rashes at the injection site when receiving treatment for HCV. Speak with your doctor if this is the case to discuss your treatment options.

Blood spots (purpura)

This red or purple blotchy rash can be associated with a blood clumping complication called cryoglobulinemia.

HCV can cause abnormal clumping, which you may be able to see just underneath your skin. The resulting rash may be painful and itchy.

Spider angiomas

Spider angiomas consist of dilated blood vessels that form just underneath the skin. These painless spots have red centers along with red extensions that form “webs.”

While extremely common in adults, numerous spider angiomas are especially characteristic of liver problems, according to a 2020 review.

Porphyria cutanea tarda (PCT)

PCT is caused by a buildup of porphyrin proteins in the blood. This rare skin condition is characterized by widespread blistering lesions that may become worse after sun exposure.

With PCT, you may also experience hyperpigmentation, itchy skin, and swelling.

Necrolytic acral erythema (NAE)

Like PCT, NAE is another type of rare skin condition that may be seen with HCV. NAE causes scaly plaque-like rashes, mostly on the legs.

In the earliest stages, NAE may be mistaken for eczema or psoriasis.

Treating HCV with antiviral medications may help decrease the incidence of symptoms, including those that affect the skin.

However, treatment for specific HCV skin conditions varies widely and will depend on the exact causes as well as the severity. In some cases, treatment involves addressing the discomfort caused by these skin concerns.

Just some of the options include:

• diuretics to help get rid of extra fluids
• calamine lotion, topical corticosteroids, or emollient creams for dry, itchy skin
• antihistamines to alleviate hives and skin itching

While HCV starts in the liver, it can affect other areas of the body, too. You may experience other skin and body symptoms, such as:

• edema, a condition that causes your lower legs, ankles, and feet to swell
• dry eye or eye ulcers
• dry mouth or mouth ulcers
• skin ulcers
• joint pain
• color changes in your feet or hands
• bruising easily

HCV may not cause any noticeable symptoms for months — or even years — until your liver becomes damaged. This is known as cirrhosis.

Chronic damage may then lead to ESLD, which is also called liver failure.

With significant ESLD, you may experience more bruising, fluid retention, itching, and jaundice.

Other signs and complications of ESLD include:

• severe fatigue
• muscle and joint weakness
• hepatic encephalopathy, which may cause memory loss, confusion, and coma
• appetite loss
• unintentional weight loss
• nausea or vomiting
• abdominal pain (especially on the upper right side)
• high blood pressure
• kidney disease
• internal bleeding

It’s important to address any skin changes with your doctor for a full diagnosis and treatment options. In some cases, skin changes may occur before you notice any other obvious signs of this liver disease.

Even if you have already been diagnosed with HCV, you should still tell your doctor about any unusual skin conditions you’re experiencing. This could indicate problems with your treatment or perhaps further progression of the hepatitis C infection.