If You Notice This on Your Arms or Legs, Have Your Liver Checked

Don't disregard this subtle skin symptom, experts say.

Your liver plays an essential role in how your body digests food and rids your system of toxic substances. For those with liver disease, this ability can become dangerously compromised, leading to cirrhosis (scarring of the liver) or even liver failure. That's why experts are alerting the public to some of the more subtle symptoms of liver disease. They say there's one in particular you may notice on your arms or legs that could help tip you off to a problem—and it often occurs in the earlier stages of the disease. Read on to find out which sign to look out for, and how to differentiate it from similar-looking conditions.

RELATED: If You Notice This on Your Skin, Get Your Liver Checked, Says Mayo Clinic.

If you notice Bier spots on your skin, get checked for liver disease.


Though the connection between your liver health and skin may not seem obvious, experts say that superficial skin disorders are frequently among the very first signs that something is wrong with that organ. "Cutaneous changes may be the first clue that a patient has liver disease. Recognizing these signs is crucial to diagnosing liver conditions early," explains a 2009 report published in the Cleveland Clinic Journal of Medicine (CCJM).

In particular, rare disease specialists say that Bier spots on your arms, legs, or hands can sometimes signal liver disease. You'll recognize these as small, white spots that appear on the skin surrounded by a red halo.

RELATED: If You Notice This on Your Hands, Get Your Liver Checked, Doctors Say.

Skin conditions are common in those with liver disease.

At doctors appointment physician shows to patient shape of liver with focus on hand with organ. Scene explaining patient causes and localization of diseases of liver, hepatobiliary system, gallbladder

Skin symptoms are surprisingly common in people with liver disease, impacting nearly half of those with the condition, experts say. "Cutaneous lesions often accompany alcoholic cirrhosis and have been detected in up to 43 percent of people with chronic alcoholism," the CCJM report states. Given that roughly three million Americans are currently living with alcoholic cirrhosis, it is estimated that at least 1,290,000 people experience liver-related skin disease.

In addition to Bier spots, patients with liver disease have also been known to develop jaundice, spider angiomas, palmar erythema, "paper money" skin, and more.

Here's how to distinguish between Bier spots and pigmentation disorders.

Composite image of nurse holding patient hand on a bed

The CCJM report describes Bier spots as "small, irregularly shaped, hypopigmented patches on the arms and legs," and admits that this description can be easily confused with several other dermatological conditions. Thankfully, there's one defining feature that can help reveal whether you've got a problem that goes more than skin-deep. "A key distinguishing feature is that Bier spots disappear when pressure is applied," says the report. They add that Bier spots are likely to disappear when you raise the affected limb. "This is not the case in true pigmentation disorders," the research team wrote.

For more health news sent directly to your inbox, sign up for our daily newsletter.

Here's why Bier spots may appear.


The CCJM report explains that Bier spots are likely the result of inflammation in the skin and veins. This can interfere with circulation, resulting in the constriction of small vessels. Though liver disease can cause Bier spots, experts from the National Institute of Health (NIH) point out that many cases are idiopathic—meaning that no underlying cause is found. In rare cases, "they are part of a systemic disease such as cryoglobulinaemia, polycythaemia, scleroderma, aortic hypoplasia and coarctation, alopecia areata, Peutz-Jeghers syndrome, lichen planus, rapid heartbeat (tachycardia), lymphedema and excessive sweating of the hands (palmar hyperhidrosis)," says the NIH.

Speak with your doctor if you notice this change in your skin—especially if you have reason to believe that cirrhosis or other organ damage could be at the root of the problem.

RELATED: If Your Breath Smells Like This, Get Your Liver Checked, Experts Say.

Lauren Gray
Lauren Gray is a New York-based writer, editor, and consultant. Read more
Filed Under