Chronic hepatitis C virus infection mainly affects the liver. However, sometimes hepatitis C can affect an organ or body system other than the liver. This is referred to as an extrahepatic manifestation.
There are a number of known hepatitis C-related extrahepatic manifestations. In general, these are uncommon and the vast majority of HCV-positive individuals may not develop these additional problems. Skin diseases are among the most common extrahepatic manifestations. Here are a few that people with hep C may be more prone to have:
- Pruritus – This is the medical term for itching. The vast majority of itch problems are unrelated to hepatitis C. However, hep C can cause dry skin or a build-up of bilirubin, which can cause pruritus. Dry skin is common, whereas bilirubin build-up is generally uncommon. High bilirubin levels can be associated with advanced liver disease and should be evaluated.
- Cutaneous lichen planus – This skin disorder usually begins with pinhead-sized, shiny eruptions. Later these eruptions can become rough and scaly lesions. The rash is accompanied by itching and responds favorably to treatment.
- Porphyria cutanea tarda (PCT) –This rare condition is caused by a deficiency of a liver enzyme essential for cellular metabolism. Areas that are exposed to the sun may blister, ulcerate, turn dark, or bruise. Hair may increase on the forehead, cheeks, or forearms, and the urine may turn pink or brown.
- Necrotizing cutaneous vasculitis – This skin disorder is a result of circulation problems, originating in the blood vessels. There are many factors that may cause this condition.
Rashes are common if you are on hepatitis C treatment, particularly if ribavirin is prescribed. If you have a skin problem, consult a dermatologist. An out-of-control itch or rash can create a lot of misery. Do not dismiss a skin problem. The liver may be the largest internal organ, but the skin is the largest organ. It is also the first line of defense in the immune system. Taking care of your skin is taking care of your whole body.
The following are tips can help prevent and minimize itching and rash:
- Drink sufficient water
- Keep skin well hydrated
- Avoid soap
- To prevent dry skin, apply hypoallergenic cream immediately following bathing. Add a couple of drops of lightweight oil to the cream for extra protection. Neutrogena sells an excellent body oil. Baby or coconut oil are also good choices.
- Use sun protection. If you use sunscreen, choose a product that has at least an SPF of 15. Hats, long sleeves, and avoiding the sun will help your skin.
- Try not to scratch. Scratching leads to more itching and can cause the skin to break down. Apply cold packs or firm pressure with a blunt object to areas that are itchy.
- If a rash develops, talk to your doctor about nonprescription and prescription hydrocortisone products. In some cases, antihistamines may be recommended.
Keep in mind that in general, itching and rashes are common for everyone, regardless of hep C status. However, if you do consult a dermatologist, it is worth mentioning that you have hep C, as that may cue them to consider one of the hepatitis C-related extrahepatic manifestations.