High bilirubin may cause itchy skin, but there are some causes such as hemolysis that cause high blood bilirubin that do not cause itching. Generally high serum bilirubin can be divided into hemolytic, hepatocellular, cholestatic and congenital non-hemolytic according to the etiology. 1. Hemolytic: such as thalassemia, hereditary spherocytosis, etc., often with skin jaundice, fever, chills, headache and other manifestations, often not accompanied by itching. 2. Hepatocellular: such as viral hepatitis, autoimmune hepatitis, toxic hepatitis, drug-induced hepatitis, etc., often with skin jaundice, fatigue, loss of appetite, etc., and in severe cases, there may be mild skin itching. 3. Cholestatic: such as intra- and extra-hepatic bile duct stones, cancerous embolism, hepatic schistosomiasis, drug-induced cholestasis, primary biliary cirrhosis, etc., there is often itching of the skin, and sometimes itching can be the first symptom, and at the same time there are manifestations of jaundice, bradycardia, clay-like stools, and so on. 4. Congenital non-hemolytic: such as Gilbert’s syndrome, Rotor’s syndrome, etc., generally due to the hepatocyte bilirubin uptake, binding or excretion of obstacles caused by itchy skin. Therefore, high bilirubin does not necessarily cause itchy skin, the appearance of high bilirubin is recommended to consult a doctor in time to identify the cause of the disease, so as to avoid delaying treatment. Itchy skin may be caused by high bilirubin, or other skin diseases, should be to the regular hospital for a clear diagnosis.