LIVER-TO-SKIN CONNECTION

It has been known for centuries that the health of our liver is reflected on our skin. While this link has been observed most commonly in the case of serious chronic liver conditions like hepatitis B/C, alcoholic liver disease, and autoimmune liver diseases, we are also beginning to understand how what we put into our body on a regular basis may have more subtle effects on the skin. Read below to understand more about the relationship between your liver and skin and how you can use this information to improve skin and overall health. 

WHAT TYPES OF SKIN CONDITIONS?

An unhealthy liver can induce a variety of general cutaneous (skin) conditions, the most common of these being pruritus, or the urge to scratch. In an inflamed or cirrhotic (scarred) liver, the bile acids that are produced for digestion don’t get properly delivered to the bile duct. When they build up in the liver, they overflow into the bloodstream and can cause local or general itchiness [1]. Other common skin conditions include spider angiomas (veins), erythema of the palms, and jaundice. Additionally, psoriasis and other autoimmune disorders are more common in those with poor liver health [2]. Although there is little clinical data to connect liver health with acne prevalence, we know that drinking water and eating a diet free of high glycemic foods benefits acne vulgaris; it wouldn’t be a far stretch to posit that this is partially due to relieving your liver as it must process everything we ingest. 

ESTROGEN AND THE LIVER

The liver is the second largest organ in the body, your skin being the first. The liver is responsible for many critical functions, including processing nutrients from food, producing bile to aid in digestion, and metabolizing (breaking down) drugs and toxins in the body [3]. One of the most significant ways in which the liver impacts skin health is through the regulation of hormones. The liver plays a crucial role in metabolizing hormones such as estrogen, which can have a significant impact on skin health. Estrogen is responsible for maintaining skin hydration, collagen synthesis, and wound healing [4]. However, when the liver is not functioning correctly, it can lead to hormonal imbalances, which can cause skin problems such as dryness, wrinkles, and acne.

TARGETING THE LIVER FOR BETTER SKIN 

While clinical evidence is still lacking, here are a few steps or supplements that can be used to improve liver function and the skin simultaneously [5–7]:

1. Drinking more water: water helps to dilute toxins that your liver is trying to eliminate.
2. Aerobic exercise: increasing your heart rate increases blood flow throughout the body, speeding up the rate at which the liver can metabolize substrate.
3. Milk thistle (active ingredient- silymarin): has been shown to protect against the toxic effects of alcohol consumption.
4. Glutathione: produced in large quantities in the liver, this powerful antioxidant can help reduce the effects of oxidative stress.
5. N-acetyl cysteine: a precursor to Glutathione 

In conclusion, the evidence of the liver-skin connection is clear, and it highlights the importance of maintaining liver health for overall skin health. The liver plays a crucial role in regulating hormones, detoxification, and nutrient absorption, which all impact skin health. It is essential to maintain a healthy liver through a balanced diet, exercise, and limiting exposure to toxins. 

Sources:

[1] Patel AD, Katz K, Gordon KB (2020) Cutaneous Manifestations of Chronic Liver Disease. Clin Liver Dis 24, 351–360.

[2] Tula E, Ergun T, Seckin D, Ozgen Z, Avsar E (2017) Psoriasis and the liver: problems, causes and course. Australas J Dermatol 58, 194–199.

[3] Vernon H, Wehrle CJ, Alia VSK, Kasi A (2022) Anatomy, Abdomen and Pelvis, Liver. In StatPearls StatPearls Publishing, Treasure Island (FL).

[4] Rzepecki AK, Murase JE, Juran R, Fabi SG, McLellan BN (2019) Estrogen-deficient skin: The role of topical therapy. International Journal of Women’s Dermatology 5, 85–90.

[5] Hanje AJ, Fortune B, Song M, Hill D, McClain C (2006) The Use of Selected Nutrition Supplements and Complementary and Alternative Medicine in Liver Disease. Nutr Clin Pract 21, 255–272.

[6] Sacco R, Eggenhoffner R, Giacomelli L (2016) Glutathione in the treatment of liver diseases: insights from clinical practice. Minerva Gastroenterol Dietol 62, 316–324.

[7] El-Serafi I, Remberger M, El-Serafi A, Benkessou F, Zheng W, Martell E, Ljungman P, Mattsson J, Hassan M (2018) The effect of N-acetyl-l-cysteine (NAC) on liver toxicity and clinical outcome after hematopoietic stem cell transplantation. Sci Rep 8, 8293.