Liver disease and itching are closely connected; in fact, itching is a tell-tale sign of liver disease when it involves a generalized itch across the whole body, known as pruritus. Itching can also be associated with kidney failure and other systemic diseases, but when people experience itching, yellowing of the skin and eyes, and abdominal tenderness, liver disease is the likely culprit. There are medications available to manage the itchy skin so patients with liver disease will feel more comfortable.

The precise mechanism behind the connection between liver disease and itching is not well understood. In healthy individuals, the liver acts as a filter, removing toxins and irritants from the bloodstream so they can be eliminated. People with liver disease have inefficient blood filtration as a result of liver impairment, and some researchers have suggested that liver disease and itching go hand in hand because irritants build up in the blood and deposit in the skin. Another sign of liver disease is blood vessel irritation leading to spidering veins just under the skin, an indicator that the vessels are inflamed because of something in the blood.

It is also possible that liver disease and itching are associated as a result of neuropathy. Irritants in the blood can damage the nerves, causing them to send confused or mixed signals to the brain. The nerves may read neutral or nonexistent sensations as itching, in which case the patient's skin is totally normal, but it still feels itchy.

The more advanced the liver disease, the more severe the itching can become. The liver becomes less able to filter effectively and the patient has a buildup of toxins in the blood that cannot be eliminated by other organs. People with liver disease and itching can seriously injure themselves scratching as they attempt to cope with the pruritus. Some may try wearing gloves at night so they don't scratch themselves in their sleep.

Management of itchy skin can be accomplished in a number of ways. Medications can blunt the sensation, topical applications can soothe irritated skins, and patients can also try meditation and guided imagery as techniques for coping with the itching. If the underlying liver disease can be managed, this should cause a reduction in symptoms, making the patient feel more comfortable and reducing the risk of complications like infections caused by incessant scratching. Patients should be alert to changes in skin color and texture, as these may indicate a decline in liver function.