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EspañolHepatitis B skin symptoms: What are the early signs of hepatitis B skin symptoms?
Overview: What do hepatitis B skin symptoms look like?
Hepatitis B virus (HBV) is a viral infection affecting the liver. A routine vaccine series given to newborns is the hepatitis B vaccine. It is very effective and markedly decreases the chance that the vaccinated will get hepatitis B. Most people (95%) with healthy immune systems fight off the virus within six months of infection. Some may have no symptoms during the infection, but others may have flu-like symptoms followed by symptoms of liver dysfunction. Some, however, end up with a chronic HBV infection of the liver. After being infected by hepatitis B, some people will feel tired, feverish, and feel sick. They may also have a skin rash. As the virus affects the liver, the most visible sign is yellowing of the skin and eyes, a condition called jaundice. Even more skin, nail, and hair symptoms occur in people with advanced chronic infections and serious liver damage.
Key takeaways:
Hepatitis B skin symptoms are a common health condition that can affect anyone regardless of age, sex, race, or ethnicity.
Early signs of hepatitis B skin symptoms include skin rash and jaundice.
Serious symptoms of hepatitis B, such as altered mental status, behavior changes, personality changes, severe vomiting, or excessive bleeding, may require immediate medical attention.
Hepatitis B skin symptoms are caused by a symptomatic hepatitis B infection or liver dysfunction, liver scarring, or liver failure caused by an HBV infection. You may be at risk for contracting hepatitis B if you use intravenous drugs, are male and have sex with other males, or are in a sexual relationship that is not monogamous. Other risk factors include hemodialysis, working in healthcare, exposure to blood products, or living with a person with chronic HBV. Infants of HBV-infected mothers and travelers to areas with high rates of HBV infection are also at risk for contracting HBV.
Hepatitis B skin symptoms require a medical diagnosis.
Hepatitis B skin symptoms may or may not require treatment, depending on the duration of the infection. Hepatitis B skin symptoms typically resolve within six months unless the underlying infection develops into a chronic illness.
Treatment of hepatitis B skin symptoms may include antiviral drugs and supportive care. Read more about viral hepatitis treatments here.
Untreated hepatitis B could result in complications like chronic infection, liver injury, cirrhosis, liver cancer, and liver failure.
Use coupons for hepatitis B skin treatments like Hepsera (adefovir dipivoxil), Baraclude (entecavir), or Epivir (lamivudine), to save up to 80%.
What are the early signs of hepatitis B skin symptoms?
Most people infected with hepatitis B develop an acute infection that usually clears up in about six months. Some people have no symptoms during the entire period.
The early signs of hepatitis B infection are flu-like symptoms such as loss of appetite, fever, nausea, vomiting, joint pain, and feeling sick. The most likely skin symptom is a skin rash. Other possible skin symptoms during this early stage include:
Hives
Skin redness
Other hepatitis B skin symptoms
During the early stage of acute hepatitis B infection, skin symptoms include:
Rash
Redness
Red bumps and spots (lichen planus)
Purple or red spots
Dry, flaky, and raised spots on the skin (Gianotti-Crosti syndrome)
Later symptoms of an acute hepatitis B infection are caused by liver dysfunction:
Yellowing of the eyes (icterus)
Yellowing of the skin (jaundice)
Itchiness (pruritus)
Chronic hepatitis B infection is a lifelong infection that develops after an acute hepatitis B infection. A chronic hepatitis B infection gradually reduces liver function and can cause skin symptoms like jaundice. Eventually, a chronic HBV infection can result in liver cirrhosis from liver failure.
The skin symptoms of liver cirrhosis or liver failure include:
Yellowing of the eyes
Yellowing of the skin
Itchiness
Scabs from itching
Dry skin
Red palms
White spots
Bulges or plaques around the eyelids
Blood vessel problems such as:
Skin discoloration (ecchymoses)
Clusters of small red spots (petechiae)
Blue spots or bumps
Gum bleeding
Spider web-shaped blood vessels (spider angioma)
Swollen veins around the navel
Nail problems such as:
Curving of the nails (clubbing)
Separation of the nail from the nail bed
White nails
Discolored nails
Brittle nails
Nail thinning
Discoloration of the base of the nail
Loss of pubic hair
Loss of beard
RELATED: What causes jaundice? Diagnosis, prevention, and treatment
Types and stages of hepatitis B skin symptoms: How can I tell which one I have?
Healthcare professionals distinguish between two types of hepatitis B infection:
Acute hepatitis B infection is a short-term infection that lasts about six months and completely resolves. A person can have no symptoms or develop flu-like symptoms and liver dysfunction symptoms. 95% of adults who are infected with HBV have an acute infection followed by complete recovery.
Chronic hepatitis B infection gradually injures the liver and can cause significant complications and early death. Chronic hepatitis B can cause a host of skin symptoms because of long-term liver damage and scarring. A few adults may develop chronic infection, but unvaccinated infants and children are more likely to develop chronic HBV. Many of the most severe skin rashes and blood vessel symptoms are caused by chronic hepatitis B.
An acute hepatitis B infection goes through four stages:
In the incubation stage, typically lasting from six weeks to six months, there are no symptoms as the virus takes hold
In the first stage (the prodromal stage), which lasts for a few days, people experience flu-like symptoms like loss of appetite, fever, nausea, joint pain, and skin rash
In the jaundice stage (icteric stage), typically lasting one to two weeks, liver function is compromised, and people may notice their skin and the whites of the eyes turning yellow—the skin might also feel itchy
In the recovery stage, the liver gradually regains full function, and the skin gradually returns to normal
When to see a doctor for hepatitis B skin symptoms
An acute hepatitis infection first causes flu-like symptoms for a few days and then liver dysfunction symptoms, such as jaundice, that can last for several months. Always see a doctor or other healthcare professional if the skin or eyes start turning yellow.
A healthcare professional diagnoses hepatitis B based on a thorough history and a physical examination, but a definitive diagnosis requires blood tests. These blood tests will identify proteins from the hepatitis B virus to confirm the infection and measure liver enzymes to determine liver health.
RELATED: Understanding your liver panel results
Complications of hepatitis B infection
An acute hepatitis B infection typically clears without lasting complications. Chronic hepatitis is more insidious. The virus reactivates episodically, and each reactivation injures the liver. Most people with chronic infections experience one or more complications, such as:
Reduced liver function
Liver scarring (cirrhosis)
Liver cancer
Liver failure
Early death
How to treat hepatitis B skin symptoms
Healthcare professionals often treat acute hepatitis B by providing symptom relief and support. Most healthy adults clear the infection without treatment. If liver function is severely compromised or the infection lasts longer than six months, then healthcare professionals will prescribe antiviral medications and administer a hepatitis A vaccine in unvaccinated patients. Children routinely receive hepatitis A vaccines at ages 12 months and 18 months.
Chronic hepatitis B cannot be cured. The goal of antiviral therapy is to reduce the amount of virus in the body and help protect the liver from further injury. Currently, healthcare professionals use three types of antiviral drugs: interferons, nucleoside analogs, and nucleotide analogs. Interferons activate the immune response to the virus. Nucleoside analogs and nucleotide analogs shut down the virus’s ability to replicate. These therapies do not eliminate the hepatitis B virus from the body. However, a new generation of therapies is being developed to target other processes in the virus lifecycle and may be able to eliminate the virus from the body.
RELATED: Hepatitis 101: How to prevent—and treat—an infection
Signs hepatitis B is getting better
The recovery phase of an acute hepatitis B infection typically lasts months. In this phase, the liver slowly regains function as it heals. Symptoms such as yellow skin, dark urine, fatigue, and weakness will gradually improve. However, a blood test is the only way to know the infection is over. It’s slightly complex, but as people get over a hepatitis B infection, blood tests stop registering hepatitis B surface proteins (called antigens) and instead start showing immune system antibodies to those proteins. The infection is over when there are only antibodies and no antigens in the blood, usually six months after the infection starts.
Living with hepatitis B
Chronic hepatitis B is considered a lifelong illness. The goal is to limit liver damage, so people with hepatitis B should do the following in pursuit of that goal:
Take all medications as prescribed
Keep all healthcare provider visits and blood tests on schedule
If you haven’t had one, get the hepatitis A vaccine series
DO NOT DRINK ALCOHOL—drinking damages the liver
Don’t take acetaminophen (Tylenol)
Avoid smoking for the same reason
Avoid breathing in chemicals from paints, household cleaners, and other toxic fumes—these, too, damage the liver
Avoid eating raw shellfish because they may cause a bacterial infection of the liver
Eat a healthy diet that is low in fats and sugars
Maintain a healthy weight
Exercise
Control other chronic conditions such as high blood pressure or diabetes
Most importantly, get vaccinated
The best way to treat hepatitis B is never to get infected. If you haven’t been vaccinated as a baby, then get vaccinated. The Centers for Disease Control and Prevention (CDC) recommends all infants, children, teens, and adults younger than 60 years old be vaccinated for hepatitis B whether or not they have any risk factors. The hepatitis B vaccination series is 3 individual vaccines given over 6 months. Vaccination is good for all people and imperative for people with known risk factors:
The use of illicit intravenous drugs or sharing needles
Men who have sexual contact with other men
People who are in a sexual relationship where one or both partners are not monogamous
People who have a sexual relationship with a partner with hepatitis B
People who live with an infected person
People who have a sexually transmitted infection (STI)
People on hemodialysis
People planning to travel to areas that have a high hepatitis B infection rate, such as Eastern or Central Europe, Spain, South America, Central America, the Caribbean, Africa, the Middle East, South Pacific (except for Australia and New Zealand), or north, east, or southeast Asia
Healthcare workers who handle blood products, body fluids, needles, syringes, or other possibly contaminated medical devices
People who work or live in residencies for developmentally disabled people
Anyone with a chronic liver disease should also get vaccinated. These people are not in a high-risk group, but they can’t afford to get viral hepatitis on top of their current liver disease.
What’s next? Additional resources for people with hepatitis B skin symptoms
Test and diagnostics
Hepatitis B, StatPearls
Hepatitis B: diagnosis and treatment, American Family Physician
Understanding your liver panel results, SingleCare
Treatments
Healthy liver tips, Hepatitis B Foundation
Hepatitis B, StatPearls
Hepatitis B: diagnosis and treatment, American Family Physician
Scientific studies and clinical trials
Chronic hepatitis B: new potential therapeutic drugs target, World Journal of Virology