What are the four stages of liver disease. How does liver damage progress over time. What causes liver failure and when should you seek medical attention. How is liver disease diagnosed and treated at different stages.

The Four Stages of Liver Disease: From Inflammation to End-Stage

Liver disease is a progressive condition that can severely impact one’s health if left untreated. Understanding the stages of liver disease is crucial for early detection and intervention. The liver, a vital organ responsible for numerous bodily functions, can undergo damage through various stages, each with increasing severity and impact on overall health.

The four stages of liver disease are:

1. Inflammation
2. Fibrosis
3. Cirrhosis
4. End-stage liver disease (ESLD)

Stage 1: Inflammation

Inflammation marks the initial stage of liver disease. During this phase, the liver becomes enlarged and inflamed as a response to various harmful stimuli. Interestingly, many individuals with liver inflammation may not experience any noticeable symptoms, making early detection challenging. However, if left unchecked, this inflammation can lead to permanent liver damage.

Stage 2: Fibrosis

As inflammation persists, the liver begins to develop scar tissue in a process known as fibrosis. This scarring replaces healthy liver tissue, gradually impacting the organ’s ability to function optimally. Like inflammation, fibrosis often progresses silently, with few or no apparent symptoms.

Stage 3: Cirrhosis

Cirrhosis represents a more advanced stage of liver disease, characterized by severe scarring throughout the liver. The extensive buildup of scar tissue significantly hinders the liver’s ability to perform its vital functions. It’s at this stage that individuals may start experiencing noticeable symptoms of liver disease.

Stage 4: End-Stage Liver Disease (ESLD)

ESLD is the final and most severe stage of liver disease. It encompasses conditions such as decompensated cirrhosis, stage 4 hepatitis C, and chronic liver failure. At this point, liver function has deteriorated dramatically, leading to various complications and a significant decline in quality of life. The only treatment that can reverse ESLD is a liver transplant.

Causes of Liver Damage and Failure: From Viruses to Toxins

Liver damage and failure can stem from a wide array of causes, ranging from viral infections to genetic conditions and lifestyle factors. Understanding these causes is essential for prevention and early intervention.

Viral Infections

Several viral infections can lead to liver damage, including:

• Hepatitis A
• Hepatitis E
• Chronic hepatitis B
• Chronic hepatitis C

These viruses specifically target the liver, causing inflammation and potentially long-term damage if left untreated.

Genetic and Autoimmune Conditions

Certain genetic disorders and autoimmune conditions can also contribute to liver damage:

• Wilson’s disease: A genetic disorder that causes copper accumulation in the liver
• Autoimmune hepatitis: Where the body’s immune system attacks liver cells

Lifestyle Factors

Lifestyle choices play a significant role in liver health. Key factors include:

• Alcohol misuse: Leading to alcohol-related liver disease
• Poor diet and lack of exercise: Contributing to nonalcoholic fatty liver disease

Medications and Supplements

Certain medications and supplements can cause liver damage, especially when misused:

• Acetaminophen (Tylenol) overdose
• Reactions to antibiotics, NSAIDs, or antiepileptic drugs
• Herbal supplements like ma huang and kava kava

Environmental Toxins

Exposure to certain environmental toxins can also lead to liver damage:

• Industrial chemicals
• Poisonous wild mushrooms

Recognizing the Symptoms: From Silent Progression to Visible Signs

The symptoms of liver disease can vary significantly depending on the stage and underlying cause. Early stages often progress silently, while advanced stages present more noticeable symptoms.

Early Stages: Inflammation and Fibrosis

During the early stages of liver disease, symptoms are often absent or subtle. This silent progression makes regular check-ups and liver function tests crucial for early detection.

Cirrhosis Symptoms

As liver disease progresses to cirrhosis, individuals may start experiencing:

• Fatigue or weakness
• Loss of appetite
• Unexplained weight loss
• Mild abdominal pain
• Nausea and vomiting

End-Stage Liver Disease Symptoms

ESLD presents with more severe and noticeable symptoms, including:

• Confusion or disorientation
• Jaundice (yellowing of skin and eyes)
• Severe skin itching
• Easy bruising or bleeding
• Fluid buildup in the abdomen, arms, or legs
• Darkening of urine
• Pale stools
• Blood in vomit or stools

Diagnosis and Treatment: Navigating the Path to Liver Health

Diagnosing and treating liver disease requires a comprehensive approach, often involving various medical professionals and treatment modalities.

Diagnostic Tools

Physicians employ several diagnostic tools to assess liver health and disease progression:

• Blood tests: To check liver enzyme levels and function
• Imaging tests: Such as ultrasound, CT scans, or MRI to visualize liver structure
• Liver biopsy: To examine liver tissue for damage and determine the stage of disease

Treatment Approaches

Treatment for liver disease varies based on the underlying cause and stage of progression. Common approaches include:

• Lifestyle changes: Reducing alcohol consumption, improving diet, and increasing exercise
• Medications: To treat underlying conditions or manage symptoms
• Antiviral therapies: For viral hepatitis
• Liver transplant: For end-stage liver disease

Prevention Strategies: Safeguarding Your Liver Health

While some causes of liver disease are beyond our control, many preventive measures can significantly reduce the risk of liver damage.

Lifestyle Modifications

Adopting a healthy lifestyle is crucial for maintaining liver health:

• Limit alcohol consumption
• Maintain a balanced diet rich in fruits, vegetables, and whole grains
• Exercise regularly to maintain a healthy weight
• Avoid risky behaviors that can lead to hepatitis transmission

Vaccination

Vaccinations play a vital role in preventing certain types of viral hepatitis:

• Hepatitis A vaccine
• Hepatitis B vaccine

Safe Medication Use

To protect your liver from medication-induced damage:

• Follow dosage instructions carefully, especially for acetaminophen
• Consult with a healthcare provider before taking new medications or supplements
• Avoid mixing alcohol with medications

When to Seek Medical Attention: Recognizing the Red Flags

Knowing when to seek medical attention is crucial in managing liver disease effectively. Acute liver failure is always a medical emergency requiring immediate care.

Symptoms Requiring Immediate Attention

Seek immediate medical care if you experience:

• Sudden confusion or disorientation
• Jaundice (yellowing of skin and eyes)
• Severe abdominal pain or swelling
• Persistent nausea and vomiting
• Extreme fatigue or sleepiness

Chronic Liver Disease Monitoring

For those with known chronic liver conditions, regular check-ups are essential. Consult your healthcare provider if you notice:

• Worsening of existing symptoms
• New symptoms developing
• Unexplained weight loss or gain
• Changes in urine or stool color

Living with Liver Disease: Strategies for Quality of Life

A diagnosis of liver disease doesn’t mean the end of a fulfilling life. With proper management and support, many individuals can maintain a good quality of life.

Emotional and Mental Health

Coping with liver disease can be emotionally challenging. Consider:

• Joining support groups for individuals with liver disease
• Seeking counseling or therapy to manage stress and anxiety
• Practicing mindfulness or relaxation techniques

Nutrition and Diet

A well-balanced diet is crucial for liver health:

• Consult with a nutritionist specializing in liver disease
• Focus on a low-sodium diet, especially if you have ascites
• Avoid raw or undercooked shellfish if you have chronic liver disease

Physical Activity

Regular, gentle exercise can benefit liver health and overall well-being:

• Engage in low-impact activities like walking or swimming
• Consult with your healthcare provider before starting any new exercise regimen
• Listen to your body and avoid overexertion

Understanding liver disease stages, causes, symptoms, and treatment options is crucial for maintaining liver health and managing the condition effectively. By recognizing early warning signs, seeking timely medical attention, and adopting healthy lifestyle practices, individuals can take proactive steps to protect their liver and overall well-being. Remember, liver disease often progresses silently, making regular check-ups and open communication with healthcare providers essential for early detection and optimal management.

Liver Disease Stages: Causes, Symptoms, Diagnosis, Treatment

Liver damage typically has four stages, beginning with inflammation and progressing all the way to cirrosis and end-stage liver disease (ESLD).

Liver disease refers to any condition that inflames or damages your liver.

Damage to your liver can accumulate through several stages of liver disease. Each stage has a cumulative effect on your liver’s ability to function properly.

The four stages of liver damage or disease are:

• inflammation
• fibrosis
• cirrhosis
• end-stage liver disease (ESLD)

Learn more about liver damage and disease.

Damage from liver disease can accrue throughout several stages. With each stage, your liver’s ability to function is increasingly affected.

Inflammation

In this early stage, your liver becomes enlarged or inflamed. Many people with liver inflammation don’t experience symptoms. If the inflammation continues, permanent liver damage can occur.

Fibrosis

Fibrosis happens when an inflamed liver begins to develop scars.

The scar tissue that’s generated in this stage takes the place of healthy liver tissue, but it can’t perform the same functions. This can start to affect your liver’s ability to function optimally.

Liver fibrosis can be hard to detect because symptoms aren’t often present.

Cirrhosis

In cirrhosis, severe liver scarring has occurred, leading to a buildup of scar tissue. Because there isn’t as much healthy liver tissue, it becomes very difficult for your liver to function properly.

While symptoms may not have been present in earlier stages, you may begin to experience symptoms of liver disease.

End-stage liver disease (ESLD)

ESLD is an umbrella term that can be used to describe conditions such as:

• decompensated cirrhosis, or advanced cirrhosis
• stage 4 hepatitis C
• chronic liver failure

At this stage, liver function has deteriorated dramatically.

ESLD is associated with complications such as ascites (a type of abdominal swelling) and hepatic encephalopathy (reduced brain function). The only treatment that can reverse ESLD is a liver transplant.

Liver failure is when your liver can’t work well enough to perform its many vital functions, such as clearing your blood of toxic substances and producing bile to help you digest food.

Liver failure can occur due to liver damage caused by liver disease. However, it’s not inevitable that liver damage and disease will lead to liver failure.

Liver failure can be a life threatening emergency, and it may be acute or chronic.

Acute liver failure comes on quickly and often occurs in people who don’t have a preexisting liver condition. Chronic liver failure occurs due to liver damage that develops slowly over time.

Causes of liver damage and failure include:

• viral infections, such as:
  • hepatitis A
  • hepatitis E
  • chronic hepatitis B
  • chronic hepatitis C
• genetic conditions, such as Wilson’s disease
• autoimmune conditions, such as autoimmune hepatitis
• alcohol misuse
• alcohol-related liver disease
• nonalcoholic fatty liver disease
• diseases that affect your bile ducts, such as cholangitis
• conditions that affect the veins of the liver, such as Budd-Chiari syndrome
• overdose of acetaminophen (Tylenol)
• reactions to other medications, such as antibiotics, nonsteroidal anti-inflammatory drugs (NSAIDs), or antiepileptic drugs
• reactions to herbal supplements, such as ma huang and kava kava
• exposure to toxins, such as those found in industrial chemicals or poisonous wild mushrooms

The cause of liver failure can depend on whether the liver failure is acute or chronic. In some cases, the exact cause of acute liver failure may be unknown. Chronic liver failure is associated with liver damage or disease.

Inflammation and fibrosis, the earliest stages of liver damage or disease, rarely cause noticeable symptoms. Symptoms are associated with more advanced stages.

Symptoms of cirrhosis

Early on, cirrhosis may cause symptoms such as:

• tiredness or weakness
• loss of appetite
• unexplained weight loss
• mild abdominal pain
• nausea and vomiting

Symptoms of ESLD

The symptoms of ESLD can include:

• confusion or disorientation
• jaundice
• severe skin itching
• easy bruising or bleeding
• the buildup of fluid in your abdomen, arms, or legs
• abdominal discomfort or pain
• loss of appetite
• darkening of your urine
• pale stools
• blood in your vomit or stool
• nausea or vomiting

They may be present if you have a condition like decompensated cirrhosis, chronic hepatitis C, or advanced chronic liver failure.

When to seek medical attention

Acute liver failure is always a medical emergency. If you’re experiencing symptoms consistent with acute liver failure, seek medical attention immediately.

These symptoms include:

• tiredness or sleepiness
• confusion or disorientation
• jaundice
• abdominal pain or abdominal swelling
• nausea or vomiting
• malaise, or feeling unwell

Chronic liver failure can sometimes be a medical emergency, especially in cases where:

• you develop confusion
• you have internal bleeding
• swelling becomes severe

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To diagnose liver issues, a doctor will start by taking your medical history and performing a physical examination.

Afterward, they may perform a variety of additional tests, including:

• Liver function tests: Liver function tests assess the levels of various proteins and enzymes in your blood. These proteins and enzymes can indicate how well your liver functions.
• Other blood tests: The doctor may also perform a complete blood count or test for conditions that can cause liver damage, such as viral hepatitis or genetic conditions.
• Imaging tests: Imaging technology such as an ultrasound, a CT scan, or an MRI can help the doctor visualize your liver.
• Biopsy: Taking a tissue sample from your liver can help the doctor see if scar tissue is present. The sample can also help them identify what may be causing your condition. Learn more about liver biopsy.

Various treatments are available for liver damage, disease, and failure.

Medications

Antiviral medications can treat a viral hepatitis infection, and immune-suppressing medications can treat autoimmune hepatitis.

Lifestyle changes

The doctor may recommend lifestyle changes as part of your treatment. These changes can include:

• abstaining from alcohol
• losing weight, if you have overweight
• avoiding certain medications

Acute liver failure treatment

Acute liver failure is often treated in a hospital’s intensive care unit (ICU). You’ll receive supportive care to help stabilize your condition and help you manage any complications during treatment and recovery.

If a healthcare professional suspects a medication overdose or reaction, they may give you drugs to reverse the effects. A doctor may also recommend a liver transplant for some people with acute liver failure.

Can liver damage be reversed?

According to the advocacy group American Liver Foundation, damage from the inflammation and fibrosis stages of liver failure may be reversed and healed over time if properly identified and treated early.

The liver damage caused by cirrhosis is often not reversible, although it can be slowed or stopped.

If you have ESLD, you may require a liver transplant. During a transplant, a surgeon removes the diseased liver and replaces it with a liver from a healthy donor.

You can help prevent liver damage, disease, and failure by making lifestyle changes that keep your liver happy and healthy. Here are some tips for improving liver health:

• Drink alcohol in moderation, and never mix medications with alcohol.
• Take medications only when needed, and carefully follow any dosing instructions.
• Consult a doctor before mixing medications.
• Maintain a moderate weight. There’s a connection between obesity and fatty liver disease.
• Get vaccinated against hepatitis A and hepatitis B.
• Have regular physicals during which your doctor performs liver function tests.

If you’re in the early stages of liver damage or disease, you can often heal over time with proper treatment and lifestyle changes.

However, the later stages aren’t reversible and sometimes require a liver transplant.

Liver failure can be a life threatening emergency that requires prompt medical intervention, regardless of whether it’s acute or chronic.

People diagnosed with liver disease are often monitored throughout their lives to ensure that their condition is not worsening or causing further liver damage. If you have concerns about liver health or liver failure, talk with a doctor.

Itchy Skin No Rash: Causes, Symptoms, and Treatments

Here are some possible causes of itchy skin without a rash.

Dry skin is a common cause of itchy skin without a rash.

In most cases, dry skin is mild. It can result from environmental conditions, such as low humidity and hot or cold weather. It’s also sometimes caused by activities that can decrease moisture in the skin, such as bathing in hot water.

In these cases, itchy skin can be treated and prevented with regular use of a moisturizer and a humidifier during drier times of the year. Also, avoid using strong soaps or cleansers that can dry your skin further.

Causes of more severe cases of dry skin can be genetic or caused by an underlying disease and must be treated by a dermatologist.

Dry skin is more common as you age. It can also be brought on by certain skin conditions, such as eczema.

Bug bites

Many insect bites cause itchy skin.

You may know you have a bug bite from the itch and a visible red patch or bump.

However, some are not so easy to detect. A tick bite, for example, may be quite small. You may have to perform a full-body scan to find a tick after being in a tick-infested area.

Here are some insects whose bite may cause you to itch:

• mosquitoes
• ticks
• wasps
• hornets
• bedbugs
• mites
• fleas
• gnats
• red ants
• flower bugs
• spiders

Most of the time, bug bites are nothing to worry about. The American Academy of Dermatology recommends using an ice pack or hydrocortisone cream for the itch, or taking an oral antihistamine.

However, if you have any serious symptoms, you should see a doctor or visit an emergency room. Serious symptoms include:

• rash
• fever
• body aches

Many types of medication can cause itchiness without a rash on some or all parts of the body.

Treatment of itchiness usually includes stopping use of the drug and replacing it with something else, or trying a lower dose.

The following are some medications that can result in itchiness without rash.

Statins

Statins and some other cholesterol-lowering medications, such as niacin, may result in all-over skin itchiness, including on the face and throat.

Statins may cause liver damage in some people, resulting in organ stress that leads to an itching sensation on the skin.

If you take a statin and you’re experiencing this symptom, talk with your doctor about changing your dose or trying a new medication.

If you’re taking niacin, itchy skin without a rash is a side effect that can be eased by taking aspirin beforehand.

Blood pressure medications

Itchy skin can be a side effect of some blood pressure medications, such as amlodipine (Norvasc). This may be from an allergic reaction to the medicine or from underlying liver disease.

Stopping use of a medication that causes itchiness can quickly resolve the issue in most people.

Opioids

Itchy skin is a common side effect of taking prescription opioids for pain relief. There are several medications that may help with this, including nalbuphine and nalfurafine hydrochloride.

Other medications

Many other medications may cause itchiness by damaging organs and body systems. This can happen when a medication is prescribed or used incorrectly.

Medications with a risk of itchy skin include:

• blood thinners
• antimalarial medications
• diabetes drugs
• antibiotics

The thyroid is an important type of organ called a gland. This gland is located in your neck. It releases hormones that regulate your growth and metabolism.

Having a thyroid disorder may cause itching without any rash. This is because the body’s cells, including those that make up the skin, stop working properly and dry out.

Often, thyroid disorders are linked to the autoimmune condition Graves’ disease. For most people, taking antihistamines along with treatment for their thyroid issues can help relieve itching.

The kidneys work as filters for your blood, removing waste and water to produce urine. Itchy skin without a rash is common in people with kidney disease, especially if it’s left untreated.

This happens because kidney disease can cause:

• dry skin
• a reduced ability to sweat and cool off
• poor metabolism
• an accumulation of toxins in the blood
• new nerve growth
• inflammation
• coexisting medical conditions like diabetes

If you have kidney disease, the best way to reduce itching is by sticking to your treatment plan with dialysis and any medications.

The liver is also important for filtering blood in the body. As with the kidneys, when the liver is diseased, the body becomes less healthy overall. This can lead to conditions that cause itchy skin without a rash.

Specifically, liver problems can cause cholestasis, an interruption in the body’s flow of bile. This may lead to jaundice, which has the following symptoms:

• dark urine
• yellow eyes
• light-colored stool
• itchy skin

Itchy skin is less common in people with alcohol-related liver diseases. It’s more common in people with autoimmune liver diseases or in cases of hepatitis.

Sticking to your treatment plan is the best way to prevent itchy skin caused by liver disease. Some experts also recommend taking medications to help ease symptoms. These medications include:

• cholestyramine (Questran)
• colesevelam (Welchol)
• rifampicin (Rifadin)

The pancreas is an important part of the body’s digestive system. Like those with liver disease, people with pancreatic cancer and other pancreatic issues may experience itchy skin caused by cholestasis and jaundice.

Treatment for pancreatic issues can help relieve itching, as can the medications cholestyramine, colesevelam, or rifampicin.

Many body parts need iron to stay healthy, including:

• blood
• skin
• hair
• nails
• organs
• body functions

Iron deficiency anemia is the condition that occurs when your body lacks enough iron to stay healthy. It’s common in:

• menstruating women
• people on vegan or vegetarian diets
• people who have lost blood from injuries

Itchy skin without a rash is a less common symptom of iron deficiency anemia. However, it may occur due to the lack of iron in your blood, which takes a toll on your skin.

Iron deficiency anemia can be treated by taking iron supplements and eating more iron-rich foods.

In severe cases, iron can be given intravenously. Intravenous iron may cause even more itchiness, but this side effect is uncommon in most people.

In some people, the body’s nervous system may trigger itching sensations.

The same types of nerve disorders that cause pain in the body may also cause itching without a rash. These include:

Stroke

Stroke is one cause of neuropathic itch. Researchers aren’t sure exactly why it happens, but they think it may have to do with changes in brain signaling. Damage to nerves from stroke can cause itch without a rash.

To diagnose neuropathic itch from stroke, your doctor may run tests and do a comprehensive physical exam. Diagnosis may be challenging, as your doctor has to rule out other causes for your symptoms.

Diabetes

Diabetes makes it more difficult for the body to produce enough insulin, a hormone that regulates blood sugar.

Itchy skin without a rash is common in people with diabetes, and it often affects the lower limbs. It’s caused by prolonged levels of high blood sugar in the body, which lead to complications such as kidney disease and nerve damage.

If you have diabetes, you can help relieve itching by keeping your blood sugar in target range as much as possible. This includes treating diabetes with medication and lifestyle changes, as well as moisturizing the skin and using anti-itch creams.

Shingles

Shingles is a viral disease that affects the body’s nervous system.

Shingles causes:

• burning
• pain
• tingling
• numbness
• itching

Itching from shingles often occurs 1 to 5 days before you notice a blistering rash on your body. This happens because the shingles virus kills off some of your sensory neurons.

While there’s no cure for shingles, taking antiviral drugs can help clear up your itchiness and other symptoms quicker.

Pinched nerve

Sometimes nerves become pinched or compressed due to injuries, osteoporosis, or excess weight that shifts bones or muscles directly onto a nerve.

Pinched nerves can’t function properly, so they often cause random sensations of pain, numbness, weakness, and in some cases itchiness without a rash.

Treating the underlying cause of your pinched nerve through physical therapy, surgery, or lifestyle changes can help relieve pressure on your pinched nerve and any itchiness that results.

There are a number of medications your doctor can prescribe for this kind of itch. Typically, they are the same categories of medications that treat neuropathic pain, seizures, and depression, such as some classes of opioids and antidepressants.

Hodgkin’s lymphoma

Hodgkin’s lymphoma is a cancer of the lymphatic system and can cause itchy skin.

The most common sign of Hodgkin’s lymphoma is swelling of the lymph nodes, usually around the neck, groin, or armpit.

Other symptoms include:

• fatigue
• unexpected weight loss
• fever
• night sweats
• persistent cough
• shortness of breath
• decreased appetite
• abdominal pain

Hodgkin’s lymphoma may result in persistent itch all over the body. The itch can feel stronger after you bathe or drink alcohol.

In rare cases, itchy skin without a rash is a sign of other cancers. Though experts aren’t sure exactly why this happens, it could be that some cancers cause itchy skin as a reaction to substances inside tumors.

Other types of cancers affecting the skin, such as melanoma, commonly cause itching. This itchiness most often occurs on the legs and chest.

Usually, this itching resolves with cancer treatment such as chemotherapy.

In some cases, cancer treatments may also cause itchiness without a rash. Certain treatments, like the drug erlotinib (Tarceva), bring on itchiness when they’re working.

Itchiness with other cancer treatments may be a sign of an allergy to a specific drug. If you are undergoing cancer treatment, it’s important to bring up any itchiness you may have with your doctor.

Certain mental health conditions may cause itchy skin without a rash. While experts aren’t exactly sure why mental health conditions can cause itching, they believe it’s linked to a chemical imbalance in the brain.

Anxiety and depression are often linked to random pain and itching without a rash, while people with psychosis and obsessive compulsive disorder (OCD) may feel like their skin is itching.

To resolve itching, it’s important to treat the underlying mental health condition. Courses of treatment can include talk therapy, medication, and lifestyle changes.

Itchiness with or without a rash is a common symptom in people living with HIV.

Because HIV reduces the immune system’s ability to fight infection, people with this disease are more prone to skin conditions that may cause itchiness.

Common complications causing itchiness in people living with HIV include:

• dry skin
• dermatitis
• eczema
• psoriasis

In some cases, HIV drugs may also cause itchiness.

To reduce itchiness, it’s important to stick to an HIV treatment plan. Treating any skin conditions and taking sedating antihistamines may also reduce itching.

In some people, phototherapy (exposing the skin to light) may also help reduce itchiness.

If you’re worried about your itchy skin without a rash, you should schedule an appointment with a doctor. They’ll give you a physical exam and ask questions about the history of your itching.

They may also recommend:

• blood tests
• urine sample
• X-rays or other imaging tests

The results of these tests can help your doctor understand if there’s an underlying health condition causing itchy skin.

If your doctor finds you have an underlying medical condition that’s causing your itch, they’ll recommend a treatment plan or send you to a specialist who can treat you.

For example, you’d see a neurologist (nerve specialist) for a nerve disorder, a psychologist or psychiatrist for a mental health condition, an oncologist (cancer doctor) for cancer, and so on.

If your doctor is unable to identify any underlying medical issues that could be a cause, they may refer you to a dermatologist.

A dermatologist is a doctor who specializes in skin disorders. They may be able to help get to the bottom of what’s causing your itchiness by:

• taking a skin biopsy
• asking questions
• visually examining your skin

While the most effective way to stop your itchy skin is to address the underlying cause, certain home remedies may provide you with instant, short-term itch relief.

Here are a few home remedies to try:

• Apply hypoallergenic and unscented moisturizers to your skin regularly (at least once a day).
• Apply over-the-counter (OTC) anti-itch creams, such as:
  • calamine lotion
  • nonprescription corticosteroid creams (use only for short periods of time)
  • menthol or capsaicin cream
  • topical anesthetics
• Take an OTC allergy medication containing antihistamines (note that these drugs may cause drowsiness).
• Add a humidifier to your house to help keep indoor air moist.
• Take a lukewarm or cold bath with Epsom salt, baking soda, or colloidal oatmeal to help soothe itchy skin, unless you know bathing makes your skin itch worse.
• Avoid scratching your skin. Covering itchy areas, wearing gloves at night, and trimming your nails short can help you avoid worsening the itch and prevent possible infection from scratching.
• Wear lightweight clothing to avoid aggravating itchy skin, as tight clothing may cause sweating that makes itching worse.

See a doctor about your itchiness without a rash if it:

• affects your entire body or sensitive parts of your body
• is happening along with other changes in your body, such as:
  • fatigue
  • weight loss
  • changes in bowel habits
• lasts 2 weeks or more and doesn’t feel better after trying home remedies
• occurs suddenly without any clear cause
• is so severe that it disrupts your everyday routine or sleep

You can connect with a dermatologist in your area using the Healthline FindCare tool.

Itchy skin is a common issue that’s not usually a cause for concern. It often occurs along with a rash and has a clear cause, such as an insect bite or sting or a sunburn. This type of itchiness usually goes away on its own.

However, sometimes skin may itch without a rash. In these cases, an underlying condition could be the cause. It could be something as simple as dry skin or as serious as cancer.

It’s important to talk with a doctor if you’re concerned. Medical treatment for your condition, home remedies, or both can help ease your itching.

Skin itching. Systemic diseases as the cause of skin itching – St. Petersburg State Budgetary Institution of Health “Dermatovenerologic Dispensary No. 4”

Itching is one of the forms of the skin analyzer, close to other types of skin sensations, such as touch, pain. Some researchers regard itching not as an independent sensation, but as a modified sense of pain. In areas of the skin devoid of the epidermis, itching is absent. Reflex actions leading to a temporary reduction in the sensation of itching include scratching, stroking, rubbing, pressure, pinching, kneading, and warming. Severe itching is relieved only by severe self-damage of the skin, resulting in the sensation of itching being replaced by a feeling of pain.

Due to the subjectivity of pruritus, the difficulty of its precise definition, the mechanism of pruritus is largely unclear. Itching is the second most common reason for a patient to visit a dermatologist.

The causes of itching are extremely varied.

Firstly, it acts as a subjective symptom of many skin diseases (fungal infection, urticaria, atopic dermatitis, eczema, lichen planus, scabies, etc.) Itching is a signal of danger, an undesirable effect on the body as a protective reaction to bites of blood-sucking insects and various skin impurities.

Secondly, itching can occur as an independent disease.

Thirdly, itching can be a symptom of various diseases of internal organs, including latent ones (diabetes mellitus, myxedema, iron deficiency anemia, psychoneurosis, liver disease, leukemia, malignant neoplasms, chronic renal failure, helminthiasis, systemic lupus erythematosus, progressive paralysis , multiple sclerosis, stroke, gout). In some diseases, itching has a certain prognostic and diagnostic significance. In chronic cholestasis, which accompanies many liver diseases (cirrhosis, extrahepatic obstruction of the bile ducts, hepatitis of various etiologies), itching is one of the most painful and most constant symptoms for the patient. The development of intrahepatic cholestasis and therefore itching is promoted by drugs: phenothiazines, erythromycin, anabolic steroids, testosterone, oral contraceptives, progesterone. Aspirin, quinidine, B vitamins and nicotinamide can cause itching without any skin rash. With primary biliary cirrhosis, itching is observed in 100% and in 50% of patients it is a reason to see a doctor. The disappearance of itching in liver diseases in some cases is a poor prognostic sign indicating liver failure. The cause of itching in liver diseases is considered to be an increase in the level of bile salts in plasma. Itching can occur with cholestasis of pregnant women in the later stages and completely disappear after childbirth.

Separate forms of generalized pruritus include senile pruritus, altitude and caisson pruritus. Senile pruritus is more often observed in men aged 60-70 years. It is painful, worse at night. On the skin, as a rule, there are no scratches, “polishing” and thinning of the free edge of the nail plates are observed. The causes of senile itching are varied (atherosclerosis, decreased activity and atrophy of the intestinal glands, prostatic hypertrophy, degenerative changes in peripheral nerve endings, atrophic processes in the epidermis, sebaceous, sweat glands, dermis, xerosis).

Altitude pruritus is observed in some people when climbing to an altitude of 8000-10000 m or more and is one of the symptoms of altitude sickness. Itching that occurs when immersed in water is a manifestation of decompression sickness (caisson itch).

Voynilko M.V.

Question to the doctor: what symptoms can tell about diseases of the liver

Doctors of antiquity called the liver the main organ for a person.
Galen considered it to be a sort of center of the organism’s universe. The definitions of temperament types proposed by Hippocrates (“ratio of parts”) – melancholic, choleric, phlegmatic – are directly related to the bile that the liver produces. And this terminology is still used today.
In Chinese medicine, acupuncture for almost all chronic diseases is used to influence the liver meridian.
Modern hepatologists know how much the liver affects the state of many organs and systems, as well as thinking, memory, mood, vision, skin color.

The liver is our largest parenchymal organ, it occupies almost the entire upper floor of the abdominal cavity on the right. This is a huge biochemical plant. In fact, all proteins that circulate in the body are synthesized here. In addition, the liver is a hematopoietic organ and a thermoregulator, it provides detoxification of the body, actively participates in various areas of its life. So you can not live without a liver.

Is it possible to replace its function, as happens, for example, in kidney diseases, when, thanks to hemodialysis, the patient can live for years? Artificial liver systems for severe liver failure allow you to try to “pull” a person out of a dangerous situation for a while. But with a neglected disease, it is still impossible to live on artificial support for a long time. Therefore, if the disease is not amenable to radical treatment, the question of transplantation arises.

What can be done to prevent liver diseases or to diagnose them in time? What symptoms should alert? What signals of the body should be treated with particular attention? Which doctor should I contact? What to do in the first place: what examinations to pass, what tests to pass?
About this – Professor, Doctor of Medical Sciences, Head of the Department of Surgical Methods of Treatment and Antitumor Drug Therapy of the N.N. A.V. Vishnevsky Alexey Vladimirovich Zhao.

Jaundice

Yellow coloration of the sclera, the appearance of yellowness of the skin, dark urine (“beer color”), discolored (white) stools are evidence that there is a malfunction with the outflow of bile that our liver produces. Most often we are talking about obstructive jaundice, when stones block the bile ducts and the outflow of bile into the duodenum is disturbed. When this happens, you need to act quickly. Make an ultrasound of the abdominal cavity, take blood tests (general, biochemical – bilirubin, ALT, AST, alkaline phosphatase, urea, creatinine, albumin, cholinesterase) and – run to the surgeon. (More about obstructive jaundice and how it is treated at the A.V. Vishnevsky National Medical Research Center for Surgery: https://www.vishnevskogo.ru/news/vopros-vrachu-kak-lechat-mekhanicheskuyu-zheltukhu).

What to do if there are no signs of cholelithiasis and tumors (they can also prevent the outflow of bile) and the surgeon said: “We have nothing”?
The next stage is a gastroenterologist-hepatologist. He will assess the situation for jaundice of another origin – parenchymal, which may be based on viral hepatitis.
If the gastroenterologist-hepatologist does not find anything, but there is jaundice, then what to do next? Contact an infectious disease specialist, because it may be infectious hepatitis.

In practice, unfortunately, the sequence is most often reversed. Jaundice begins, a person calls an ambulance, he is hospitalized with suspected infectious hepatitis. He can spend several days in the infectious diseases hospital until it turns out that there is no infection. But I repeat: jaundice is an urgent matter, the diagnosis must be made quickly, and it is necessary to start with a surgeon in order to exclude “mechanics”.

Itchy skin

Where does a person usually go when they get itchy skin? To the dermatologist. This is correct, but we must keep in mind that the answer may not lie in the field of dermatology at all. Very often the reason is the accumulation of bile acids under the skin (they irritate the receptors, and skin itching begins). And bile acids accumulate precisely when the liver does not function well. These may be tumors that cause a violation of the mechanical passage of bile into the intestine. These can be diffuse liver diseases – primary sclerosing cholangitis, primary biliary cirrhosis. Or other diseases in which there are symptoms of cholestasis (impaired outflow of bile) – for example, drug-induced hepatitis. It provokes the use of medications (especially uncontrolled).
In any case, if you start taking a medicine and the result is jaundice or itching, think that drug-induced hepatitis may be the cause. Where do you need to go? To the gastroenterologist-hepatologist.

Changes in the skin

When the liver is not in order, some hormones are poorly utilized, and small subcutaneous vessels begin to dilate. Telangiectasias appear – spider veins (they are also described as “spiders” – “spiders”). Their presence should lead you to the idea that something needs to be addressed to a gastroenterologist-hepatologist.
Another symptom of liver problems can be xanthelasma – yellowish plaques on the eyelids associated with the deposition of cholesterol under the skin.

Coat of tongue, bitterness in the mouth

They say that the tongue is the mirror of the stomach. If the tongue is coated, white or yellowish, if you also constantly feel bitterness in your mouth, you need to be examined. The reason here may be the reflux of bile from the duodenum into the stomach, and from there into the esophagus, associated both with various liver diseases (for example, fatty hepatosis), and with diseases of the gastrointestinal tract and the development of neoplasms.
Make an ultrasound, take blood tests (general, biochemical – bilirubin, ALT, AST, alkaline phosphatase, urea, creatinine, albumin, cholinosterase) and – contact a gastroenterologist-hepatologist.

“Liver” smell

One of the signs of liver disease is the smell of baked apples from the mouth. This is a specific smell of products of nitrogen metabolism – it arises from the fact that the liver does not provide normal detoxification. Previously, doctors, having discovered such a symptom in a patient, could say without any computed tomography: you have something with the liver, let’s urgently be examined.
By the way, any bad breath indicates that there is a problem – either in the gastrointestinal tract, or in the oral cavity (teeth), or in the tonsils. You need to go to the doctor and find out what exactly is the matter. It is very important.

“Liver” palms

Red palms (palmar erythema) may be one of the manifestations of liver disease. Consult with a gastroenterologist-hepatologist!

Bruising, increased bleeding

Bruising that appears out of the blue (a person touched something and immediately – a huge bruise), bleeding gums – what could be the reason for this?
99% of blood coagulation factors are synthesized in our liver. When it works poorly, blood clotting deteriorates and there is increased bleeding. If a hematologist excludes “his” pathology, the situation should be studied by a gastroenterologist-hepatologist – the problem may be in the liver.

Enlargement of the abdomen

One of the later signs of liver problems is an increase in the volume of the abdomen. A person drinks a lot of fluids, but little urine. The fact is that with certain diseases, ascites begins – the accumulation of fluid in the abdominal cavity. And this is an urgent reason to do an ultrasound scan and contact a gastroenterologist-hepatologist.

Deterioration of memory, attention, vision, sleep disturbances, changes in mood attention, sleep inversions (you want to sleep during the day, but you don’t want to sleep in the evening), decreased visual acuity, hand tremors.
An inadequate mood is also a clinical manifestation of liver dysfunction. It can be a state close to euphoria, when a person laughs for no reason and it is not clear what amuses him so much. Or, on the contrary, the mood is constantly bad, up to depression.

When, for one reason or another, the detoxification function of the liver is disturbed, ammonia accumulates in the blood, which has a toxic effect on brain cells. Don’t blame everything on stress, suggest a mental disorder, or explain (in the case of an elderly person) dementia. Rule out liver disease first.

Risk groups

Against the background of past and chronic liver diseases, unfortunately, malignant tumors often develop. Early diagnosis of these tumors is in the hands of the patient. He should say to himself: nothing bothers me, but I know that I have chronic hepatitis. This means that once every six months – an ultrasound of the abdominal cavity and an analysis for alpha-fetoprotein are required – this enzyme can increase in 40-50% of cases if primary liver cancer occurs.

Listen to yourself!

If you don’t have any of the above symptoms, great. Be physically active, do not abuse alcohol, fatty and spicy foods. But in no case do not neglect regular medical examinations (screening, as they say now), because diseases can be asymptomatic. Take special responsibility for your health if you are over 40, as the incidence of cancer is increasing in this age group.

And don’t forget to listen to your body! If you don’t like something, don’t waste time: do an ultrasound scan, take a blood test and contact a specialist (start with a surgeon). No need to panic and immediately think about the rarest and most severe diseases.