A common skin sign of cirrhosis caused by fatty liver disease is spider angiomas—small, web-like clusters of blood vessels that appear just beneath the skin, usually on the face, chest, or arms.

Fatty liver disease often progresses silently, showing few symptoms in its early stages. But over time, this condition can lead to serious liver damage, including cirrhosis. One of the lesser-known warning signs of cirrhosis can actually appear on your skin. Noticing this symptom early may help you seek treatment before the damage becomes severe. Keep reading to learn more.

What is fatty liver disease?

Fatty liver disease happens when too much fat builds up in the liver. Particularly, this condition can be linked to alcohol use (alcoholic fatty liver disease), but in many cases, it develops in people who don’t drink much or at all. This type is called nonalcoholic fatty liver disease (NAFLD).¹

At first, fatty liver may not cause any symptoms. But over time, the extra fat can lead to liver inflammation, scarring (fibrosis), and eventually, cirrhosis—a late-stage liver disease that permanently damages liver tissue.

What is cirrhosis?

Cirrhosis is the final stage of chronic liver disease. It develops when healthy liver tissue is replaced with scar tissue. This scarring prevents the liver from working properly.²

When cirrhosis develops, it can affect your whole body. One place where signs may appear is your skin.

The skin sign: Spider angiomas

One of the most visible signs of cirrhosis is something called spider angiomas (or spider nevi). These are clusters of tiny blood vessels that spread out like a spider’s web. They usually appear on the:

Face (especially around the nose and cheeks)
Neck
Upper chest
Arms

Each spider angioma has a central red spot with thin lines spreading outward. When you press on them, they usually fade for a moment and then return.³

Why do they happen?

Spider angiomas develop because of high estrogen levels in people with cirrhosis. The liver usually helps break down hormones like estrogen. But when liver function is impaired, hormone levels can rise. This hormonal imbalance causes small blood vessels near the skin to expand, creating the spider-like appearance.

Other skin signs of cirrhosis

Spider angiomas are not the only skin symptoms of cirrhosis. Others include:

1. Jaundice

This causes the skin and whites of the eyes to turn yellow. It happens when the liver can’t clear a substance called bilirubin from the blood.

2. Itchy skin (pruritus)

Liver damage can lead to a buildup of bile acids in the bloodstream, causing intense itching.

3. Easy bruising and bleeding

When the liver stops making enough proteins needed for clotting, you may bruise easily or bleed more than normal.

4. Red palms (palmar erythema)

This is another sign linked to increased estrogen levels in the body.

5. Dark patches on the skin

These may appear in body folds like the neck or armpits, especially in people with insulin resistance or diabetes.

What to do if you notice spider angiomas

Seeing one or two spider angiomas might not mean you have cirrhosis. Many healthy people, especially women, pregnant individuals, or those taking birth control pills, may develop them. However, if you have multiple spider angiomas and other symptoms like fatigue, yellowing of the eyes, or abdominal swelling, it’s time to see a doctor.

Your healthcare provider may run blood tests, imaging scans, or even a liver biopsy to check how your liver is functioning.

How to support liver health

If you’ve been diagnosed with fatty liver disease or want to protect your liver, here are the key steps:

Eat a healthy, balanced diet. Focus on vegetables, fruits, lean protein, and whole grains.
Avoid alcohol. Even small amounts can worsen liver damage.
Stay active. Aim for at least 30 minutes of moderate exercise most days.
Lose weight if needed. Reducing body fat helps lower liver fat.
Control blood sugar and cholesterol. Conditions like diabetes and high cholesterol increase the risk of fatty liver.
Avoid unnecessary medications or supplements. Some can strain your liver.

When to seek medical help

See a doctor if you experience:

Unexplained skin changes
Long-lasting fatigue
Yellowing of the skin or eyes
Swelling in the legs or abdomen
Confusion or memory problems

FAQs

1. Are spider angiomas always a sign of liver disease?

No. They can occur in healthy people, especially children, pregnant women, or those taking hormonal medications. However, multiple spider angiomas in adults can be a sign of liver disease.

2. How many spider angiomas are considered abnormal?

Having more than five, especially if they appear on the upper body and are accompanied by other symptoms, may suggest liver disease.

3. Can spider angiomas go away on their own?

They may fade if hormone levels return to normal or after treating the underlying liver condition, but sometimes they persist.

4. Is fatty liver disease reversible?

In the early stages, yes. Lifestyle changes like diet, exercise, and weight loss can reduce liver fat and improve liver function.

5. Can skin symptoms be the first sign of liver problems?

Yes. For some people, changes in skin appearance, like spider angiomas or jaundice, are the first visible signs of liver trouble.

Fatty Liver Disease Symptoms: The Sign On Your Skin That Indicates Cirrhosis