There are plenty of reasons why you might notice some redness, itching or inflammation on your face. In fact, everything from stress to illness to hormones to aging could be to blame. But if symptoms persist and are accompanied by other health conditions, they may actually be a sneaky sign of fatty liver disease—and something you should act on fast. Here, the fatty liver face symptoms you should know and what to do about them.
What is fatty liver disease?
“Fatty liver disease, also known as hepatic steatosis, is the buildup of fat in the liver,” says liver disease specialist Maria Hernandez, MD, a gastroenterologist with Gastro Health in Miami, FL. “This condition is often associated with other common conditions, such as diabetes, hyperlipidemia, alcohol abuse and obesity.” 
There are two main types of fatty liver disease: Alcoholic fatty liver disease, which develops as a result of excessive alcohol use, and nonalcoholic fatty liver disease (NAFLD), which is not related to alcohol use and is most common in those with type 2 diabetes, obesity and high cholesterol.
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Despite being quite common, fatty liver is often referred to as a silent disease. “This is because patients are usually asymptomatic until they develop cirrhosis, or extensive scarring of the liver that leads to liver failure,” explains Dr. Hernandez. This more advanced form of the condition is known as nonalcoholic steatohepatitis (NASH).
“The time from initial diagnosis to the development of cirrhosis is unpredictable,” she says. “But once cirrhosis occurs, patients experience significant symptoms.” Among those may be signs of fatty liver disease that can surprisingly manifest on the face.
Fatty liver symptoms on the face
Is it a skin condition, or liver trouble? These are the most common fatty liver disease symptoms that can appear on your face.
Rosacea
“Fatty liver can affect the follicular structures on the face, leading to the development of rosacea,” says Dr. Hernandez. In other words, fatty liver can cause inflammation in the hair follicles on the face, contributing to the development of rosacea symptoms like redness, pimples and broken blood vessels.
Darkening of the skin
“As the disease progresses to cirrhosis, other skin abnormalities may develop, including acanthosis nigricans or darkening of the skin, often seen on the back of the neck,” Dr. Hernandez says. The reason: People with fatty liver often also develop insulin resistance, or the inability to use insulin effectively, which is the primary cause of acanthosis nigricans.
Spider veins

Visible, sprawling veins on the face and trunk are another possible symptom of fatty liver disease, notes Dr. Hernandez. These are directly caused by the buildup of fat in the liver, which can lead to more sluggish blood flow and more visible veins.
Itching
About one in five people with fatty liver disease experience itching, according to a study in the journal Biomedicines, which can manifest on the face. Scientists are still trying to figure out the reason, though they suspect that accumulated bile salts may play a role.
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Jaundice
A final facial sign of late-stage fatty liver disease is jaundice, or yellowing of the skin and the whites of the eyes. This is a result of the liver not effectively filtering bilirubin, the pigment that causes jaundice.
What to do if you notice fatty liver symptoms on your face

“Generally, patients with fatty liver do not experience significant symptoms early in the disease,” says Dr. Hernandez. But if you do notice any of these warning signs, she recommends discussing them with a gastroenterologist or liver specialist, especially if you’re at an increased risk for fatty liver. “All patients with type 2 diabetes, obesity, hyperlipidemia, hypertension, alcohol abuse or a family history of fatty liver should undergo evaluation to determine if they have fatty liver.”
She also stresses the importance of healthy lifestyle choices. “Fatty liver disease can be prevented and possibly even reversed by certain lifestyle changes,” she says. “Things like losing weight, avoiding drinking alcohol, increasing physical activity, eating fruits and vegetables with a low glycemic index and even increasing coffee consumption can all help protect the liver.”
By managing fatty liver disease itself, the symptoms on your face should diminish with time. If they don’t and your fatty liver is under control or has even been reversed, it’s worth consulting your dermatologist to see if a skin condition may be to blame. 
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5 Signs of Fatty Liver Disease That Show Up on Your Face, From Redness to Darkened Skin