Do Spider Angiomas mean Cirrhosis? - British Liver Trust

British Liver Trust

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Do Spider Angiomas mean Cirrhosis?

Psqueek profile image
34 Replies

I noticed three spider angiomas on my chest. They are not really noticeable unless you shine and flash light on them and then I see the small red legs. I have no other symptoms at all. I drink maybe 3 glasses of wine 3 nights a week. Should I rush to the doctor or can this wait until my regular appointment.

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Psqueek profile image
Psqueek
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34 Replies

Stop drinking alcohol immediately. Spider angiomatas are suggestive of liver disease including cirrhosis but you need a blood test, ultrasound & FibroScan to determine if liver damage is causing them & how bad the damage is. The FibroScan would determine the extent of any damage. If your liver is cirrhotic you may be in an early stage and if you do everything right it will be able to compensate and you could live a normal life. I wouldn’t wait to get evaluated. See your doctor and show him the spider angiomatas and tell him that you want to be evaluated for liver disease. A blood test and an ultrasound won’t necessarily pick up cirrhosis. A FibroScan will.

Psqueek profile image
Psqueek in reply to

Do you know if the spider Angioma dare an early sign?

Chris884 profile image
Chris884 in reply to Psqueek

Don’t know about what you are asking. But don’t know why these people are telling you bloods and ct and ultrasound won’t show cirrhosis. If that was the case why do them.

in reply to Psqueek

Looking it up in the book by hepatologist Melissa Palmer it's listed as a sign 'suggestive of cirrhosis'. It doesn't mean that you definitely have cirrhosis. The fact that yours are so faint that you need a torch shone on your skin to see them is a good sign.

Dr. Melissa Palmer's Guide To Hepatitis and Liver Disease:

"Signs That Suggest Cirrhosis

Enlarged blood vessels found on the upper chest, back, face, and arms, resembling little red spiders, are known as spider angiomatas. They characteristically blanch (turn white) if light pressure is applied to their centers."

Chris884 profile image
Chris884 in reply to

So what if you have them in your lower legs what does that mean then

in reply to Chris884

If they are on the legs they are more likely to be varicose veins. The ones associated with liver disease are typically found on the upper chest, back, face, and arms.

Chris884 profile image
Chris884 in reply to

So if I have them on lower legs it wouldn’t be cirrhosis

in reply to

Liver damage is only one reason people get them. Apparently healthy people get them as well. There is no mention in the book by Melissa Palmer of them appearing on the legs due to liver disease. Spider angiomatas due to liver or thyroid disease tend to appear on the upper body.

Chris884 profile image
Chris884 in reply to

Then why do people on here say ct scan with iv contrast and ultrasound will show cirrhosis. Doesn’t make sense what you guys are saying. From what I hear if you have cirrhosis of the liver both will show it. Which is it.

in reply to Chris884

I don't know about a CT scan with IV contrast but an ultrasound shows the size and structure of the liver. It may pick up signs of fibrosis as a 'coarse echo texture' however a liver might be normal in size and smooth in outline when measured with an ultrasound and give the appearance of being healthy when in fact the tissue is fibrotic or cirrhotic.

FibroScans measure stiffness. Some stiffness may be due to things like inflammation but if the FibroScan score is high enough e.g. over 30 then you can be pretty sure that it's cirrhotic even if some of the score is due to inflammation. This was nicely explained in the YouTube video that someone posted a link to in a recent topic asking how accurate FibroScans are. The video is well worth watching.

Chris884 profile image
Chris884 in reply to

Ok well I have had a few ct scans and they keep saying liver appears normal with no focal lesions

in reply to Chris884

It's a pity you couldn't convince a doctor to send you for a FibroScan to put your mind at ease. I've had two here in Australia as well as two ultrasounds & they were worth getting to verify that my liver is neither fibrotic nor cirrhotic & that all I had was hepatitis due to overuse of painkillers. Next week I'm going for an MRI which I expect will confirm that my liver is healthy. All of these tests are paid for by Medicare. The gastroenterologist I saw suggested I get an annual FibroScan for peace of mind and he told me that if I have any more problems like an abnormally fluctuating platelet count he's willing to do a biopsy. I don't expect it to come to that!

MarkAS profile image
MarkAS in reply to Chris884

If that’s what they’ve told you then sounds to me you are fine. Take it as an early warning and a good 6 consecutive months of no alcohol will do your liver a world of good.

in reply to

Exactly my point about the ultrasound Edward. I will debate a bit on the video tho as quite a number of studies have shown that inflammation can incredibly affect liver stiffness in some with severe alcoholic hepatitis. Some have been in the 50s of kpa and returned to normal ranges without cirrhosis. However as we both know some have gone from 75 kpa and returned to normal ranges but with cirrhosis as the liver can become soft in some again over time. Really the only sure bet for a fibroscan is to see the same cirrhotic range results over and over again over time.

Casinobo profile image
Casinobo in reply to

I wonder why fibroscans are not real popular in the U.S. I received n ultrasound and CT scan but, if I want a foibroscan I would have to seek a private company that provides them. They seem inexpensive. You would think most insurance companies would provide them. Best wishes 😀

in reply to Chris884

Because it doesnt always show up on ultrasound. This is the same as your other post where you were talking about blood work. This " why bother doing it then" sort of question. Its called the clinical picture. That means that a bunch of tests combined are required for diagnosis. The results of those tests all need to be consistent over time as well. Doctors dont look at a single symptom and diagnose from that alone as that would be careless and unprofessional. Ultrasounds can show nodular regeneration and severe changes to the liver surface but it would not and has been proven not to be a strong tool for the use in detecting moderate fibrosis and early stage cirrhosis. If it shows up than great you've found it. But if it doesnt show up yet you have other key features and symptoms that are a signature of cirrhosis than further tests will be done to verify. Like fibroscans and biopsies. To even think that there is not many cases where an ultrasound has not shown cirrhosis yet a biopsy has confirmed it otherwise is a lack of research on your part. CT scans would definitely be a stronger and more sensitive test to detect cirrhosis. But again they are not 100 percent. NOTHING is 100 percent accurate. As for spider anigiomas youd have to get a doctor to confirm that first of all they are indeed spider anigiomas as many people confuse them with other types of dermatological spots. They can appear anywhere on your body but as Edward has said they are most commonly found on the upper body in liver disease. Spider anigiomas are usually a sign of nothing serious if you have one. But if you have multiples than it becomes cause for concern as they are strongly associated with liver disease. STILLLLL does not on it's own mean you have cirrhosis. Spider anigiomas can be present and very florid in cases like severe acute alcoholic hepatitis.

ja1nsa profile image
ja1nsa

Just a couple other quick things, you do sound fine, but LFTs will help. Check the plans of your hands for redness at room temp. Check your nails for clubbing (though I have and still cannot see it). Check nails for "moons" - no moons could mean something. Check for Jaundice. I had all the above, maybe something, maybe nothing. Get to your GP and ask is best advise.

Psqueek profile image
Psqueek in reply to ja1nsa

I guess my question is if it were Spider Angioma assosicated with liver disease would there be other symptoms?

in reply to Psqueek

Not necessarily . The thing with liver disease is unlike cancer where people with it will have or do have all the tell tale manifestations , the symptoms of the liver vary in people. Some can have no spider angiomas and cirrhosis. Some have all the symptoms some have none and some have a variable mix of them. What causes spider angiomas is an elevation of estrogen in the body. The reason having one or 2 is not necessarily bad is that in men testosterone lowers with age and they can show up because of the balance between the lowered testosterone and estrogen. But this also happens in liver disease. Some other liver disease symptoms caused by this can include enlarging breasts in men and testicular atrophy.

in reply to

Your drinking habits dont seem to coincide with alcoholic liver disease tho. If it is the liver I would get checked for other etiologies as well.

Psqueek profile image
Psqueek in reply to

How much alcohol causes cirrhosis?

in reply to Psqueek

In women the daily amount is far less . So possible. But at 3 glasses 3 times a week does not seem very excessive. For the angiomas they are more common I women again because of the estrogen

Pussycat65 profile image
Pussycat65 in reply to Psqueek

I have Non Alcoholic Liver Cirrhosis as I have never drunk! I have had all the tests, scans etc but still they cannot tell what has caused this. 100% of my Liver is affected! Spider veins only affect the upper body if you have Cirrhosis.

Psqueek profile image
Psqueek in reply to

I am female and 56

Vincentzeke profile image
Vincentzeke in reply to ja1nsa

Do you have cirrhosis?

GrandmaDylan profile image
GrandmaDylan

I have had spider naevie for several years and have asked at least 5 doctors what they were and did they suggest liver disease. Not one of them knew what they were. In may this year a locum gp referred me to a dermatologist to see what they were! Whilst I was waiting for the dermatologist appointment I had to see a haematologist as I was anaemic. She recognised them and asked me how much I drink. I don't drink. She felt my abdomen and said my liver was enlarged and to ask my gp for a referral for a liver scan. The liver scan showed an enlarged liver and spleen with varices and portal hypertension. I personally would ask your gp to refer you for a liver scan. It can pick up such a lot and is non invasive. I saw the hepatologist yesterday who said that the number of spider naevie I have is more suggestive of autoimmune hepatitis. You don't tend to get so many if it's not AI. Spider naevie are only ever on the upper part of the body ie from the waist up. Deb

Psqueek profile image
Psqueek in reply to GrandmaDylan

How many did you have?

GrandmaDylan profile image
GrandmaDylan

I have had multiple spider naevie mainly on my arms for several years. I have asked numerous doctors what they were and were they due to my liver. I am virtually tea total. They all said they didn't know what they were until finally a locum gp who didn't have a clue what they were referred me to the dermatologist who then arranged for me to have laser treatment for them. The hepatologist I saw last week was horrified and said all doctors were taught about spider naevie in medical school. You can have them without having cirrhosis but I have dozens of them so mine were an extreme case. I wouldn't worry about yours, they can be associated with oestrogen and weak blood vessels. Personally I'd wait for your next appointment. Take care. Deb

HermioneGranger profile image
HermioneGranger in reply to GrandmaDylan

Hi Deb. I wonder if you’d mind sharing the result of your laser treatment for spider naevie? Have they gone completely? I have one that upsets me every time I see it and would love to have it removed.

Was it an IPL laser? Sorry for so many questions; I’ve never known anyone who had them treated. Thanks so much.

GrandmaDylan profile image
GrandmaDylan

I don't mind you asking at all. I don't know what kind of laser it was sorry. I have 3 spots on my face and one is particularly bad. They're no better but I have lot's over my chest, back , shoulders and arms. He treated about 15 on my chest and they're not as dark as they were. I'm having 4 sessions, three months apart so my next appointment is on 20th Feb. I don't think they'll treat them all. It doesn't hurt at all so there's no need to worry about pain. I will need to stay out of the sun and wear really strong sunblock. Good luck, I hope you manage to get rid of your spider naevie. Deb

HermioneGranger profile image
HermioneGranger in reply to GrandmaDylan

So helpful, thank you! I’ll speak with a dermatologist.

Straightface profile image
Straightface in reply to GrandmaDylan

hi

Know its a while since your post but hope you don't mind me trying to message you. You sound like a very nice person so I hope you won't.

I just wondered how you had gone on with the spider nevi and if you had got them all sorted.

I have two very very small ones on my face ( they don't look like the normal ones as one is star shaped with just four lines coming from it and the other is more or less star shape ) and have been worrying myself sick thinking they are caused by cirrhosis. I can't see any more anywhere else. I have no other symptoms and feel very well apart from all the anguish I am causing myself through worry.

You mentioned that it can be normal to have them and I wondered if you had researched this and what could be the cause if it wasn't cirrhosis. I have spent quite a lot of time in the sun so didn't know if this could cause them or if it could be down to age.

I hope that you are keeping well, and I wish you all the best xx

Smally1369 profile image
Smally1369

I have dozens of them on my upper chest , arms, hands , face and neck odd one on legs. I recently discovered a photo and noticed the date was 2002. I have had them for at least 17 years , I am fair skinned.

They have caused me to become a liver hypochondriac. I have been to a hepatologist and had US, yearly LFTS, Biomarkers ELF blood tests ( neg) etc etc etc. From what I been told I don't have liver disease. In fact my hepatologist wasn't concerned by them as they are non specific.

I am perfectly healthy apart from the liver anxiety. I have been told by half a dozen doctors there is nothing wrong with my liver. Not a day goes by that I don't think about whether the doctors are wrong. Anxiety symptoms I've had so many liver related after Googling, when I get over one another pops up, at the moment it's brain fog , started off as a couple of tip of the tongue moments, now blown it all out of proportion. Must be my liver I keep thinking , one day ,I hope soon I will believe what the docs keep telling me.

My advice is see a hepatologist and stay off Dr Google it has done nothing for me expect cause mental health issues

Straightface profile image
Straightface in reply to Smally1369

Hi. I know its a long time since your post but i have only just read it.

I just wanted to say that I am exactly like yourself. I stupidly looked up the symptoms of cirrhosis on internet and have since spent days googling about spider nevi and convinced myself I had cirrhosis because I had found two very small ones which could only be seen through a magnifying mirror. I am perfectly fit apart from what the worry is causing me. I have no other symptoms.

The worry seems to be taking over all my life at the moment. haven't been to doctor because too frightened. I just wondered if you had managed to cure your fears and how you had done it.

Hope you don't mind me messaging you, and you might not get it,but it felt like I was reading my own story.

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