Itching

Itching refers to the unpleasant sensation that causes the need to scratch. The medical term for it is pruritus. Itching can be caused by many conditions, including liver disease. It can be located in a few areas, or be all over the body. For some people, itching can be mildly distracting or irritating. For others, it can be very intense and impact quality of life. Itching related to liver disease is usually worse in the evening and at night, and it doesn’t usually involve a rash or open sores.

Causes

Skin conditions such as allergies, drug reactions and dry skin can cause itchiness. Itching in people with liver disease is usually caused by a build-up of toxins that have not been filtered by the liver. It is more common in some liver diseases (like primary sclerosing cholangitis), than others.

Treatment

Skin Care

Skin care is usually recommended before trying medicine, or along with medicine.

  • Avoid harsh soaps, body washes and bubble baths.
  • Use gentle lightweight skin cleansers (eg. Cerave, Cetaphil- both glycerin based), and only apply to limited areas such as armpits and groin.
  • After a bath or shower, pat your skin dry and apply lotion within two minutes of getting out, while skin is still damp.
  • Use hypoallergenic lotion with ceramides (eg. Cerave) that are free from fragrance and additives. Do not use the moisturizers on areas of broken skin.
  • Apply baby oil to your skin up to three times a week.
 Medications

People with liver disease might be prescribed medicine that decreases the feeling of itching, or that helps get rid of built up toxins.

Self Care Tips:

  • Baths are better than showers (daily in lukewarm water for at least 15 minutes).
  • Keep skin cool by wearing light and cool clothing.
  • Avoid scratching – keep fingernails short, encourage massaging rather than scratching, wear gloves at night.
  • Maintain a humid home environment, especially in the winter.

Let your healthcare provider know if:

  • you develop new itching.
  • your itching is not getting better with treatment.

References:

The information on this page was adapted (with permission) from the references below, by the Cirrhosis Care Alberta project team (physicians, nurse practitioners, registered nurses, registered dietitians, physiotherapists, pharmacists, and patient advisors).

This information is not intended to replace advice from your healthcare team. They know your medical situation best. Always follow your healthcare team’s advice.

References: 

  1. US Department of Veterans Affairs, Veterans Health Administration 
  2. Canadian Liver Foundation
  3. Davison SN on behalf of the Kidney Supportive Care Research Group. Conservative Kidney Management Pathway; Available from: https//:www.CKMcare.com.
  4. Bhalerao A, Mannu GS. Management of pruritus in chronic liver disease. Dermatol Res Pract. 2015;2015:295891. doi: 10.1155/2015/295891. Epub 2015 Mar 10. PMID: 25861254; PMCID: PMC4377431.
Last reviewed March 15, 2021
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