We also spoke to Dr Sachin Gupta, Senior Consultant in Dermatology, Amrita Hospital, Faridabad, to know about the subtle signs that we need to observe. “Internal imbalance is often reflected in the skin. Before the patient feels ill, there may be noticeable changes here when liver function is compromised. When to have a check-up,” he mentioned.“Disease is rarely confirmed by a single symptom. It is important to pay attention to any persistent itching, unexplained yellowing, new spider vessels, unusual pigmentation, or frequent bruising, particularly if multiple symptoms occur at the same time. Because a lab report may not always be the first indication of a liver test. It’s the mirror,” he insisted. Dr Sachin further shared five skin changes that medical professionals keep a close eye on.1. Jaundice, or yellowing of the skin and eyesThe most well-known sign is this one. Bilirubin builds up in the bloodstream and settles in tissues, initially the skin and then the eyes, when the liver is unable to process it effectively.It doesn’t always show up in a big way. In natural light, many patients first perceive a “dull yellow glow” instead of a deep yellow hue. Evaluation is necessary even for mild yellowing.2. Constant itching without rashThis is frequently described by patients as “something crawling under the skin.” Antihistamines hardly work, moisturisers are ineffective, and there isn’t a noticeable rash.When bile flow slows, doctors attribute this to bile salts accumulating in the skin. Clinicians take seriously the indication that the itching may get worse at night and become so bad that it interferes with sleep.3. Red veins on the face or chest that resemble spidersSpider angiomas are tiny, branching blood vessels that look like tiny red spiders. They frequently show up on the upper chest, neck, or cheeks.Even though one or two lesions might not be harmful, several new lesions, particularly in adults, frequently lead doctors to examine liver function because liver disease’s hormonal imbalance changes the behaviour of blood vessels.4. Skin darkening in foldsIt’s common to attribute gradual darkening around the neck, groin, or underarms to tanning or friction. However, when pigmentation appears suddenly or advances rapidly, dermatologists investigate further.Pigment pathways may be impacted by metabolic and liver-related disorders, resulting in persistent darkening that is unresponsive to standard creams.5. Slow healing and easy bruisingReduced clotting proteins, which are made in the liver, may be the cause of minor cuts bleeding longer than usual or small bumps leaving large bruises.Purple patches are frequently noticed by patients who do not recall any injuries. For medical professionals, this is more of a coagulation signal than a skin issue.At times, these signs can be just exposure to the sun or dryness. Sometimes the liver is pleading for care, so getting a timely test done is also advisable.Medical experts consulted This article includes expert inputs shared with TOI Health by: Dr Shifa Yadav, Consultant, Dermatology, Artemis HospitalsDr Arzoo Panjwani, Medical Advisor, Decode AgeDr Sanjay Goja, Director, Liver Transplant & HPB Surgery, Narayana Hospital, GurugramDr Sachin Gupta, Senior Consultant in Dermatology, Amrita Hospital, FaridabadInputs were used to explain the subtle skin changes that can hint towards liver dysfunction.
