High direct bilirubin can cause itching on the body. Direct bilirubin is formed when bilirubin combines with glucuronosyltransferase in the liver. Direct bilirubin is elevated in the blood when acute or chronic hepatitis, cirrhosis, or hepatocellular carcinoma occur, which can cause damage to liver cells, or when gallstones, cholangitis, or pancreatic cancer occur, which can cause biliary tract obstruction. When direct bilirubin is high in the body, the concentration of bilirubin in the skin tissue increases, which can stimulate the peripheral nerves of the skin and cause itching of the skin all over the body. Reducing the level of direct bilirubin by alleviating the liver damage or relieving the biliary obstruction can relieve the itching symptoms. If the direct bilirubin level is high, you should have a relevant examination, clarify the cause of the disease under the guidance of the doctor and standardize the treatment.