This type of swelling often worsens at night and may improve somewhat after sleeping with the legs elevated.

2. Spider Veins and Abnormal Veins on the Legs

People with chronic liver disease often develop spider veins or enlarged surface veins, especially on the thighs and calves.

Why This Happens

– The liver normally breaks down estrogen.

– When the liver fails, estrogen builds up in the body, weakening blood vessel walls.

– This leads to visible, web-like purple or red veins on the legs.

These veins are not just cosmetic—they are a hormonal signal of chronic liver stress.

3. Severe Itching of the Legs (Cholestatic Pruritus)

Relentless itching—especially on the shins and calves—can be an early sign of cholestasis, a condition where bile flow from the liver is impaired.

Key Features

– No obvious rash at first

– Deep, constant urge to scratch

– Worse at night

– Skin may become thickened, scarred, or infected from scratching

Why It Happens

When bile backs up into the bloodstream, bile salts accumulate in the skin, triggering intense nerve irritation.

This symptom is especially common in:

– Biliary cirrhosis

– Fatty liver disease

– Hepatitis-related liver damage