In late pregnancy cholestasis, the symptoms are usually itchy, often mostly itching from skin damage in late pregnancy. In some people, it is more common after 30 weeks and tends to be milder during the day and worse at night, with persistent itching, usually starting in the palms of the hands or feet and gradually progressing to the proximal part of that limb. Some people may feel itching on the face as well. The itching usually lasts for about 3 weeks on average, and in severe cases may cause nausea, vomiting, loss of appetite, or insomnia. Scratch marks can often be seen on the skin of the extremities. Some people develop jaundice a few days after the onset of itching, and in some cases, jaundice and scratching are present at the same time.