Why Does My Skin Itch So Badly?

Many people with liver disease struggle with chronic, very itchy skin. Not everyone with liver issues develops this symptom, but if you do, it can be very uncomfortable. For some, the persistent itch interferes with their sleep.

I have naturally dry skin to begin with, but the itching became really unbearable as my metabolic issues worsened. I still experience itching even after a liver transplant, and my skin remains very dry. It can be distressing as your skin becomes scaly, and the urge to scratch can be very intense.

What’s the connection between NASH and itchy skin?

If you experience bleeding, rashes, or anything that seems beyond standard dry, itchy skin, see your physician immediately. These recommendations are specifically for the itchy skin associated with liver disease. A physician needs to determine the exact cause of your itching.

The connection between NASH and itchy skin is complex; scientists don’t really know exactly what causes this sensation in liver disease. You should discuss the itching with your physician first to determine whether there may be other underlying causes.

I have tried many things to deal with the discomfort, and I actually found one thing that works for me. But let’s start with the easiest recommended solutions.

How to soothe NASH-related itchy skin

Your best bet is to try different remedies and see if they work for you. Whatever you try, avoid scratching. This is easy for the experts to say, but hard to avoid when your skin is crawling.

Scratching can break the skin, causing bleeding and possible infection. Experts suggest keeping your fingernails short, so if you do scratch, you’re less likely to hurt yourself. Some people wear gloves to bed so they don’t scratch themselves in their sleep.

Through my journey with NASH and itchy skin, I have found several habits that seem to help:

Temperature control

I take short, cool showers. Hot water seems to irritate my skin. I try to pat my skin dry but leave it slightly damp. As soon as it is mostly dry, I apply moisturizer.

Sun and sweat protection

I stay inside when it’s really hot outside. Sweating seems to trigger my itchy skin, and I have many reasons to avoid the sun. I never want to get sunburned, as that creates itchiness on its own. I always wear sunscreen, specifically one for sensitive skin, as many common brands are very hard on delicate skin.

Fragrance-free living

I use gentle, fragrance-free soaps and moisturizers. I don’t, and really never have, used perfume. Many serious moisturizers have no fragrance. I recommended one that I used to a friend once, and she told me it didn’t smell good. I then knew that her itchiness was not in the same league as mine because I did not care that it didn’t smell like flowers—I just wanted the itching to stop!

Cool compresses

Sometimes when my skin feels very inflamed, it helps to put a cold, wet washcloth on the area. It takes away the need to scratch and feels soothing.

Choosing the right materials

I have come to prefer very soft sheets, towels, and clothes touching my skin. I can’t wear wool, for example, and I love flannel sheets. Soft, loose clothing seems to help. I love the feel of cotton against my skin.

The solution I have had the most trouble consistently using is wearing gloves when cleaning or doing the dishes. But my skin and my fingernails thank me when I do.

I also use a humidifier in my bedroom, especially during winter. Even a bowl of water next to your bed puts humidity into the air. The dry air from heated indoor environments really seems to affect my skin and worsen the itching.

Skincare and moisturizing strategies

Many people use cleansers, especially on their faces. I found that I didn’t need to use a cleanser on my face every day, but again, I have very dry skin. Other people with oily skin might be less inclined to skip that step. But all of these choices affect the itching.

I don’t use soap—or at least limit the use of soap—on certain parts of my body. My arms, for instance, are so dry that using soap on them actually hurts. I use soap under my arms, but only water on my arms.

You will want to moisturize your skin constantly. I was used to moisturizing only once a day, if that, before developing liver disease. Now I know you really can moisturize more than once a day.

There are hundreds of lotions, creams, ointments, and oils to choose from. They all contain a mix of oil and water, sometimes with other ingredients. Pay attention to those other ingredients.

• Lotions: These are what most people are used to, but they are the least effective because they contain the most water.
• Creams and ointments: Creams have less water than lotion, and ointments have even less.
• Oils: I use castor oil on my skin. Even though it is an oil, it absorbs quickly and does not feel oily to me. It doesn’t really have a fragrance, and it hydrates and soothes my skin.

Always choose fragrance-free and alcohol-free products. Everyone has different preferences, so you need to try different ones to see how they feel on your skin and whether they stop your itching. If it burns or causes pain, stop using it.

When to see a specialist for persistent itching

If you have tried all these things and you do not get relief from the itching associated with NASH, it may be time to see a dermatologist.

Talk to a doctor before using any “anti-itch” agent on your skin. It may contain chemicals that will make things worse instead of better. Products that say “unscented” can also contain chemicals used to mask scents that may make your condition worse. Look for the label “fragrance-free.” Also, consult a doctor before trying any over-the-counter (OTC) topicals, such as corticosteroids.

In addition, there are medications that a doctor can prescribe that may help inhibit bile acids or remove bile salts from your body. These can provide significant relief for your itching. However, they also have serious side effects, so they require a thorough consultation with a physician.

I hope that you find a routine that works for you, helps limit your itching, and soothes your skin.