The Weird Hepatitis C Sign Most People Miss, According to Doctors

Hepatitis C is a viral infection impacting millions of people in the world. Nearly 58 million people worldwide have hepatitis C, with an estimated 2.4 to 3 million people living with it in the United States.

“Hepatitis C is a virus that affects the liver,” explains Dr. Aditi M. Stanton, MD, a board-certified gastroenterologist with Gastro Health in Cincinnati, Ohio. “Over time, inflammation and damage from the virus can cause scarring of the liver, which can eventually lead to liver cirrhosis (permanent scarring of the liver.)”

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Hepatitis C can be contracted in a handful of ways. “It is spread through contact with infected blood, which can occur through sharing needles or syringes, unregulated tattoos or body piercings, sexual activity with an infected person, or blood transfusions before 1992 (when blood transfusions began to be tested for hepatitis C),” adds Dr. Stanton.

Related: 'Inside My Hepatitis C Journey, from the Day I Was Diagnosed to Finally Receiving a Cure'

There are many typical signs and symptoms associated with hepatitis C, including jaundice (yellowing of the skin), dark urine, light stool, fatigue, nausea, flu-like illness, joint pains, decreased appetite and abdominal pain.

Symptoms can also become more serious, leading to cirrhosis (scarring and damage to the liver)—and in more rare cases, liver cancer and even death.

“Patients who develop cirrhosis because of chronic untreated hepatitis C can have confusion spells, fluid retention problems, bleeding from the GI tract and symptoms of liver failure,” adds Dr. Sudha Kodali, MD, a hepatologist at Houston Methodist.

However, a majority of people with hepatitis C are asymptomatic (showing no signs or symptoms). According to the Centers for Disease Control and Prevention, 75-85% of people with hepatitis C may not show symptoms.

In 2013, two medications were approved by the Food & Drug Administration (FDA) to treat hepatitis C. Since 2014, hepatitis C has become a curable virus (with cure rates at 95%), and is treated with antiviral medication called direct-acting antiviral (DAA) medication. However, there is currently no vaccine to prevent hepatitis C.

Related: What People Who Inject Drugs Should Know about Hepatitis C Treatment Options

The Weird Hepatitis C Sign Most People Miss

Some people with hepatitis C may experience skin itchiness or skin rashes.

“Hepatitis C can cause skin manifestations that can vary in appearance, intensity and location,” says Dr. Kodali. “They can range from small skin bumps to red patches to extremely painful ulcers that can appear anywhere on the body. These are called extrahepatic manifestations.”

However, you may mistake a hepatitis C skin rash for an allergic reaction or bug bite.

“This type of reaction can look like hives or bug bites, with red, raised, blotchy bumps on the skin,” explains Dr. Stanton.

Other skin conditions associated with hepatitis C include lichen planus, which looks like flat, scaly bumps that are purple or red. “These can show up on the wrists or arms, or inside the mouth as irritated white patches and sores,” adds Dr. Stanton.

Hepatitis C is also associated with the skin conditions porphyria cutanea tarda and mixed cryoglobulinemia syndrome.

“Porphyria cutanea tarda (PCT) appears as blistering skin lesions, fragile skin, scarring, and itching,” says Dr. Stanton. “Mixed cryoglobulinemia syndrome appears as red lesions on the legs and lower extremities.”

Another uncomfortable skin condition that may be a symptom of hepatitis C is edema, which is when fluid builds up in the body.

“Edema can cause swelling in the legs, ankles, and feet,” says Dr. Stanton.

Related: Your Top Questions About Hepatitis A, B, C, D and E, Answered

How to Treat Hepatitis C Skin Rashes

If you find that you have any skin symptoms that you think may be related to hepatitis C, you should discuss them with your hepatitis C doctor. Treatments for hepatitis C skin rashes can be both topical and oral.

“Symptomatic treatment for rashes and itching can include anti-histamines and calamine lotion,” explains Dr. Stanton. “However, in some cases, the best treatment for skin conditions related to hepatitis C is treatment of the virus itself with antiviral agents (DAAs).”

However, some people may need additional medications and a consultation with a skin specialist or dermatologist as well, adds Dr. Kodali.

Ultimately, prevention is one of the most important ways to prevent hepatitis C skin rashes from flaring up.

“One-time testing for hepatitis C for all adults above age of 18 is recommended based on current guidelines,” says Dr. Kodali. “Early diagnosis is essential so that irreversible liver damage, and associated complications and others including skin problems can be avoided.”

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Sources

• Dr. Aditi M. Stanton, MD, a board-certified gastroenterologist with Gastro Health in Cincinnati, Ohio

• Dr. Sudha Kodali, MD, a hepatologist at Houston Methodist