Multiple Sclerosis Itching; Causes, Treatments, and More
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Multiple Sclerosis Itching: Causes, Treatments, and More

Overview

Highlights

  1. It’s common for people with MS to experience strange sensations (also known as dysesthesias).
  2. Itching is one potential sensory disturbance of MS. It’s different from allergic itching because it’s not accompanied by a rash or skin irritation.
  3. If itching is mild, no treatment is necessary. Over-the-counter topical treatments are not useful for this type of itching.

Have you ever felt an itch that just wouldn’t go away? One where the more you scratch, the more it itches? Although itching for no apparent reason may sound like a psychological problem, it’s a very real phenomenon for people with multiple sclerosis (MS).

It’s common for people with MS to experience strange sensations (also known as dysesthesias). These sensations can feel like pins and needles, burning, stabbing, or tearing. Itching (pruritus) is another symptom of MS.

These physical feelings are often early signs of MS. They occur in about 20 to 50 percent of people with MS, according to the Multiple Sclerosis Foundation.

What Is MS?

Symptoms Icon

MS is a disease of the central nervous system. It occurs when the body’s immune system abnormally attacks the body’s central nervous system. The cause of MS is unknown. According to the National MS Society, it is thought to be a reaction to environmental factors in people genetically susceptible to those factors.

In people with MS, the immune system mistakenly attacks myelin. Myelin is the protective coating that surrounds nerves. When this coating is attacked, nerves are vulnerable to damage. This disrupts signals between the brain and the rest of the body. Symptoms vary according to the location of the damage. They can even cause disability. 

Sometimes demyelination (the process in which myelin is destroyed) can cause electrical impulses that create strange sensations. Paroxysmal symptoms (temporary neurological disturbances) are generally more fleeting than those of full-blown MS attacks.

Causes of MS Itching

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Itching is just one potential sensory disturbance of MS. As with other symptoms of MS, itching may come on suddenly and occur in waves. It may last a few minutes or for much longer. Itching is one family of these disturbances. They are different from allergic itching because they are not accompanied by a rash or skin irritation.

There may be other causes of MS-related itching. Some disease-modifying medications are administered by injection. These may cause temporary skin irritation and itching at the injection site. An allergic reaction to medications like interferon beta-1a (Avonex) also may result in itching. 

An allergic skin reaction to some drugs that are given intravenously (by IV) may cause the skin to itch. In clinical trials, one of the common side effects of the oral medication dimethyl fumarate (Tecfidera) was the sensation of itching.

Treating MS Itching

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If itching is mild, no treatment is necessary. Over-the-counter topical treatments are not useful for this type of itching.

If itching is severe, prolonged, or begins to interfere with daily living, talk to your doctor. Medications used to treat dysesthetic itching include anticonvulsants, antidepressants, and antihistamine hydroxyzine.

Medications

According to the National MS Society, there are some medications that are successful at treating this type of itching. They are:

  • some anticonvulsants, specifically carbamazepine (Tegretol), phenytoin (Dilantin), and gabapentin (Neurontin)
  • antidepressant, amitriptyline (Elavil)
  • antihistamine hydroxyzine, Atarax

Natural/Alternative Remedies

Practicing mindfulness can help reduce your stress. According to the Mayo Clinic, stress has been found to worsen neurological symptoms. Since MS itching is one of those symptoms, mindfulness may also help reduce the symptoms of this type of sensation.

According to the American Academy of Neurology, there is some weak evidence that reflexology helps to treat strange sensations, numbness, and tingling that you may have on the skin. 

It is important to note that it’s recommended to avoid magnetic therapy if you have MS. This type of therapy can cause the skin to feel a burning sensation.

Lifestyle Changes

There are not any specific lifestyle changes that are used to treat itching in MS. However, there are some changes that help reduce the overall symptoms of MS. These include:

  • healthy diet
  • exercise (including yoga)
  • massage for relaxation

Managing your overall symptoms can help manage the causes of this type of itching.

Outlook

Icon Outlook

MS-related itching is irritating and distracting. However, it usually does not pose a long-term risk.

Itching creates a strong desire to scratch, but this can actually increase the feeling of itchiness. Vigorous scratching can break and damage the skin, which can lead to infection.

The good news is that, in most cases, no treatment is necessary. The symptoms will subside on their own. However, if your itching also has an external rash or visible irritation, see your doctor. This may be a sign of an allergic reaction or infection and is probably not related to MS disease activity.

You Asked, We Answered

  • I practice self-control from itching during the day, but I often wake up with scratches all over my body from itching in my sleep. Any tips on ways I can prevent this?
  • The only foolproof way to avoid this is to wear gloves to bed. I know this sounds inconvenient, but it works! The gloves don’t have to be heavy or thick, but they do need to completely cover your fingernails. You can also keep all your fingernails trimmed neatly, apply topical anti-itch medications (Benadryl, OTC hydrocortisone), and talk to your doctor about taking oral antihistamines at night (to prevent the urge to itch).

    - Dr. Steve Kim
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