LIVER SPOTS! What are you? - CARiNG Pharmacy

LIVER SPOTS! What are you?

Have you seen spots like the one shown above on your skin? Some of you might know them as liver spots. Would it surprise you to know that liver spots are, ironically, NOT caused by the liver? So then what are they?!

Liver spots, also known as age spots or sunspots, are actually areas of increased pigmentation on your skin[1,2]. They are either oval or circular in shape and are flat[1]. They appear in areas of your skin that have had the most exposure to ultraviolet (UV) radiation, a.k.a sunlight[2]. This exposure can increase the production of melanin, the pigment which gives your skin color[1].


Liver spots typically affect people above the age of 50, but can also affect younger people with light skin who are regularly exposed to UV radiation[1]

BUT DON’T PANIC! There are actually a few really easy ways to prevent the formation of liver spots.

  • Wear sunscreen! They protect your skin against UV radiation [1,2,3]

  • Avoid excessive exposure to sunlight! Especially between 10am and 2pm when UV rays are the most intense [1,2,3]

  • Cover up exposed areas of your skin when spending time outside during the aforementioned time [1,2,3]

Well then, I guess we all owe the liver an apology right? NOT QUITE. While not responsible for liver spots, there are other skin conditions that are caused by the liver and are often the first clues of liver disease : 

 

1. Jaundice

Jaundice is a condition caused by the build-up of bilirubin in your blood and is a symptom of liver damage. The liver is unable to process bilirubin and hence, it accumulates in the blood[4].

 

 

2. Acanthosis Nigricans

Acanthosis nigricans, dark skin in the body’s folds and creases, can be caused by insulin resistance that could lead to diabetes and fatty liver. Although this is not the only cause of this condition, it still warrants a trip to the doctor[5].

 

 

3. Skin Itchiness
Skin itching, which is often not relieved by scratching, can be caused by the build-up of bilirubin and other toxins in the blood. It may indicate one of many liver conditions, namely hepatitis, backup of bile flow, damaged bile ducts or liver cancer[6]. 

 

4. Vascular (blood circulation) signs on skin[7]
Liver diseases may manifest on the skin through the following:

  1. Spider angiomas may be indicative of alcoholic hepatitis or liver cirrhosis.
  2. Palmar erythema (red palms) commonly occurs in liver cirrhosis (scarring)
  3. Paper-money skin which are numerous blood capillaries scattered throughout the skin, usually related to alcoholic liver damage
  4. Finger clubbing, or deformities around the finger and toe nails, may indicate hepatitis or damage of bile ducts.
  5. Ascites, where fluid collects in abdominal spaces, often relates to severe liver damage.
  6. Bier spots are small, white macules usually on the arms and legs that may signal liver disease.

REFERENCES

  1. Age spots (liver spots). Mayo Clinic. (Web accessed November 2023). Web link: https://www.mayoclinic.org/diseases-conditions/age-spots/symptoms-causes/syc-20355859
  2. Liver Spots. Cleveland Clinic. (Web accessed November 2023). Web link: https://my.clevelandclinic.org/health/diseases/21723-liver-spots
  3. What can Get Rid of Age Spots? American Academy of Dermatology Association. (Web accessed November 2023). Web link: https://www.aad.org/public/cosmetic/age-spots-marks/get-rid-spots
  4. Jaundice in adults. Health Direct. (Web accessed November 2023). Web link:  https://www.healthdirect.gov.au/jaundice
  5. Acanthosis nigricans. NHS UK. (Web accessed November 2023). Web link: https://www.nhs.uk/conditions/acanthosis-nigricans/ 
  6. What to know about liver disease and itching. Medical News Today.  (Web accessed November 2023). Web link: https://www.medicalnewstoday.com/articles/liver-disease-itching#prevalence 
  7. Skin manifestations of liver diseases. A. Koulaouzidis, S. Bhat, J. Moschos (2007). Annals of Hepatology.