Hepatitis C can affect the skin in several ways. Some people experience symptoms like skin discoloration, swelling, hives, and itching. Certain treatments for hepatitis C may also irritate the skin.

Hepatitis C is caused by the hepatitis C virus (HCV). HCV infection causes liver inflammation, sometimes leading to serious liver damage.

The liver filters toxins, produces proteins important for blood clotting, and aids digestion. Liver damage interferes with its ability to perform these functions.

This can lead to a variety of symptoms, including those that manifest in the skin.

While HCV infection causes some skin conditions, others may be related to irritation from injectable treatments for hepatitis C. Skin conditions unrelated to hepatic C are also possible.

If you have hepatitis C and experience new or unusual symptoms, it’s important to consult with a healthcare professional.

You should also make an appointment with your healthcare professional if you experience any of the following symptoms or suspect any of the following conditions:

Itching (pruritus)

Like other systemic diseases, hepatitis C 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.

Hives (urticaria)

Hives are a type of rash. 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 hepatitis C.

It’s also possible to experience hives at the site of injectable medications. Speak with your doctor if this is the case to discuss your treatment options.

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 in the arm and wrist.

Jaundice

You may have jaundice if your skin or the whites of your eyes look yellow. 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 hepatitis C, however. Liver injury and cirrhosis caused by other conditions may also lead to jaundice.

Ascites

This condition causes balloon-like swelling, 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.

Spider angiomas

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

While extremely common in adults, numerous spider angiomas are especially characteristic of liver problems.

Purple spots (purpura)

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

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

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 worsen after sun exposure.

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

Necrolytic acral erythema (NAE)

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

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

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

However, treatment for specific skin conditions varies widely. It ultimately depends on the exact cause and severity. PCT, for example, may be treated with ultraviolet (UV) light therapy.

In some cases, treatment involves addressing the discomfort caused by these skin concerns. This may include:

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

Additional skin symptoms include:

  • bruises
  • color changes in your feet or hands
  • skin ulcers or sores
  • swelling in your lower legs, ankles, and feet (edema)

Other symptoms may include:

  • dry eye
  • dry mouth
  • feeling extremely tired or weak (fatigue)
  • joint or muscle pain
  • mouth ulcers or sores
  • nausea or vomiting

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

Cirrhosis may lead to ESLD, which is also called liver failure. With significant ESLD, you may experience more bruising, fluid retention, itching, and jaundice.

Other ESLD symptoms include:

  • abdominal pain, especially on the upper right side
  • appetite loss
  • breathlessness
  • daytime sleepiness
  • insomnia
  • muscle cramps
  • nausea or vomiting
  • severe fatigue
  • unintentional weight loss

ESLD may also lead to:

  • anxiety
  • depression
  • hepatic encephalopathy, which may cause memory loss, confusion, and coma
  • high blood pressure
  • internal bleeding
  • kidney disease

It’s crucial to discuss any skin changes with a healthcare professional. Skin changes can sometimes appear before other noticeable signs of liver disease. These symptoms may also be a sign of a different condition unrelated to hepatitis C.

If you’ve already been diagnosed with hepatitis C, it’s still important to inform your clinician about any unusual skin symptoms. These changes might signal issues with your treatment or the advancement of the hepatitis C infection.