• Infections

Skin Hepatitis B Symptoms: How Does the Hepatitis B Virus Affect My Skin?

Medically reviewed and edited by Jarrod Nero, MSN, APRN, FNP-C

What is Hepatitis B?

Hepatitis B is an infectious liver disease that can result in serious complications such as liver damage, liver failure, and cancer.

Hepatitis B is typically regarded as a sexually transmitted infection (STI), although it can be transmitted through blood and from mother to child during birth.

The symptoms of hepatitis B can vary. Some people may experience various changes in their skin, among other symptoms, while others experience no symptoms at all.

There are two types of hepatitis B, namely acute hepatitis B and chronic hepatitis B.

Around 2.4 million people in the U.S. are living with a chronic hepatitis B infection, but only 25% of people with the disease have been diagnosed.

What are the Symptoms of Hepatitis B?

The symptoms of hepatitis B are very nonspecific and have no hallmark features. People suffering from the infection may exhibit the following:

• Flu-like symptoms

• Appetite loss

• Nausea

• Jaundice (yellowing of the skin and eyes)

• Pale stools and dark urine

• Fatigue or weakness

Because these symptoms frequently overlap with other conditions, only a blood test can confirm a hepatitis B diagnosis.

Contact LifeMD and for a lab referral at a facility near you — they’ll be able to run the necessary tests and send the results to your LifeMD patient portal.

How Does Hepatitis Affect the Skin?

The hepatitis B virus does not directly impact the skin. Instead, the virus causes liver failure which results in certain skin changes.

When the liver is damaged, it is unable to carry out its normal metabolic processes, which include making proteins (including clotting factors), detoxifying the blood, maintaining blood glucose levels, and aiding in fat absorption.

Liver damage — or liver cirrhosis — caused by hepatitis B may affect the skin in the following ways:

Jaundice

Jaundice is the most well-known symptom of hepatitis B, although most people who are infected will not experience this.

This condition is characterized by a yellow discoloration of the skin and sclera (the white of the eye), which is caused by the impaired breakdown of dead red blood cells associated with liver failure.

In a person with a healthy, functioning liver, part of the red blood cells — known as the haem — is broken down by the white blood cells to form a substance called bilirubin. This is the yellow pigment that is taken up by the liver and excreted.

With liver failure or damage, the liver’s ability to get rid of bilirubin is impaired, causing more yellow pigment being circulated and getting deposited into the skin.

Itchy skin

Also known as pruritus, itchy skin is a common symptom of liver failure.

Bile is made in the liver and used in the absorption of fat from food. With hepatitis B, the liver cells swell, blocking the flow of bile. This causes bile to be forced out from the normal bile ducts and into the circulatory system. This bile then accumulates in the skin, causing itching.

One study shows that almost 30% of people with chronic liver disease experience itchy skin at some point.

More uncommon skin symptoms

The following symptoms are rare in those with hepatitis B infection, but there are more ways that the condition can affect the skin.

Spider angioma (spider nevus)

Commonly known as spider veins, these are small, dilated blood vessels that are shaped like spiders. They typically appear red or purple, and can be seen just below the skin’s surface.

Caput medusae

This condition is characterized by large veins radiating outward from the naval in the shape of the head of Medusa, known from Greek mythology.

Scarring in the liver causes blood vessels to become blocked and blood to be transferred to other vessels instead — this includes the blood vessels around the naval which become swollen.

Caput medusae is a sign of serious liver issues

Palmar erythema

This refers to redness of the palms due to the surface capillaries in the hands being dilated. This is a common symptom in pregnancy, but it may also indicate liver failure.

Striae (stretch marks)

Chronic liver disease often causes fluid to accumulate in the abdomen, resulting in a stomach that resembles a “beer belly.” This distension of the abdomen forms stretch marks.

Skin abrasions

If pruritus is one of the symptoms you’re experiencing, you may start to itch, and then scratch, which will result in marks or abrasions on the skin.

Bruises

One of the defining features of liver failure is excessive bleeding. This is due to the liver being unable to produce clotting factors once it is extensively damaged.

Small injuries may cause large bruises under the skin, as blood is not able to clot as effectively anymore.

Where Can I Learn More About Hepatitis B?

Have you experienced any of the above-mentioned symptoms? LifeMD can help. Simply visit our site to schedule an appointment today.

Jarrod Nero, MSN, APRN, FNP-C

Jarrod, a board-certified Family Nurse Practitioner, earned his B.S. in Nursing from William Carey University and an M. S. in Family Health Nursing from the Southern University of Baton Rouge. He lives in New Orleans with his partner and son.

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