When you experience unusual skin sensations without a skin-related cause, this is known as dysesthesia. Possible causes include multiple sclerosis (MS), diabetes, and shingles.

Dysesthesia is a general term for unusual skin sensations that healthcare professionals cannot explain by skin-related causes. It’s commonly associated with MS but can be a symptom of other conditions.

Dysesthesia often involves feelings such as burning, an electric shock, or a general tightening around the body. It usually occurs in the legs, feet, arms, and hands but can affect any part of the body.

Dysesthesia is characterized by a feeling of discomfort when something touches your skin. Anything from clothing to a gentle breeze can trigger the symptoms.

The condition can be mild to intense and may include:

  • aching or throbbing sensations
  • a feeling that your skin is crawling
  • burning or stinging sensations
  • shooting, stabbing, or tearing pain
  • electric shock-like sensations

These sensations might be constant or only occur occasionally, and they can also vary depending on the type of dysesthesia you’re experiencing.

There are several distinct types of dysesthesia, including scalp, cutaneous, and occlusal. However, not all cases of dysesthesia fall into these categories.

Scalp dysesthesia

Also called burning scalp syndrome, scalp dysesthesia involves pain, burning, stinging, or itching on or under the scalp. There’s usually no rash, flaking, or other visible irritation.

Occlusal dysesthesia

Occlusal dysesthesia (OD), also called phantom bite syndrome, is discomfort in the mouth when biting, usually with no obvious cause.

The underlying cause of OD isn’t well understood. Sometimes, doctors diagnose it as a psychological condition, but it can be related to jaw misalignment as well.

Dysesthesia vs. paresthesia vs. hyperalgesia

It’s easy to confuse dysesthesia with paresthesia or hyperalgesia, both of which can occur with MS.

Paresthesia describes sensory symptoms, such as numbness and tingling, “skin crawling,” or a “pins and needles” feeling.

Hyperalgesia refers to increased sensitivity to painful stimuli.

While dysesthesia and paresthesia have their own definitions, some consider dysesthesia to be a type of paresthesia. In some cases, you might hear the terms used interchangeably.

Dysesthesia is caused by nerve damage or a problem with the central nervous system. It causes the nerves to send mixed signals to the brain, resulting in unusual and often painful sensations.

For example, you may have painful sensations in your leg even though it’s not injured. It’s a communication problem between your brain and the nerves in your leg, which stimulates a pain response.

MS causes the formation of scar tissue, or lesions, in the brain and spine. These lesions interfere with signals between the brain and the rest of the body.

According to the National Multiple Sclerosis Society, more than half of people with MS experience pain as a significant symptom.

One common type of dysesthesia experienced by people with MS is the MS hug because it feels like a tight hug around your chest. You might describe it as a crushing or vice-like grip causing pain and tightness in your chest and ribs.

Here are some other reasons a person with MS might have strange sensations or pain:

Of course, your symptoms could be unrelated to MS. They could be due to injury or another underlying condition.

Like other symptoms of MS, dysesthesia can come and go. It can completely disappear without treatment. Like many other symptoms of MS, when you and your doctor find the correct treatment, you’ll experience dysesthesia less frequently.

Dysesthesia isn’t unique to MS. Other conditions that affect the nervous system and may cause dysesthesia include:

  • diabetes, due to nerve damage caused by chronic high glucose levels
  • Guillain-Barré syndrome, a rare neurological condition in which the immune system attacks and damages part of the peripheral nervous system
  • Lyme disease, which can cause neurologic MS-like symptoms, including itching and burning sensations
  • HIV, due to resulting peripheral sensory and motor nerve disorders
  • shingles, when tingling and pain occur near lesions

There are various treatments for dysesthesia, but finding the right one for you may take trial and error.

Over-the-counter pain relievers such as acetaminophen (Tylenol) and ibuprofen (Motrin) usually aren’t effective for treating neuropathic pain, like dysesthesia, according to the National Multiple Sclerosis Society.

Doctors usually treat dysesthesia with the following medications:

  • Antiseizure agents: Doctors may prescribe antiseizure agents to help alter nerve activity. They include gabapentin (Neurontin), pregabalin (Lyrica), carbamazepine (Tegretol), and phenytoin (Dilantin).
  • Certain antidepressants: These can help change your body’s response to pain and include amitriptyline (Elavil), nortriptyline (Pamelor), and duloxetine (Cymbalta).
  • Certain topical pain relief creams: Creams commonly used contain lidocaine or capsaicin.
  • Tramadol (Ultram, ConZip, Ryzolt): Doctors rarely prescribe Tramadol. They usually only prescribe this opioid for people experiencing severe pain.
  • Hydroxyzine (Atarax): Hydroxyzine is an antihistamine that helps relieve itching and burning sensations.

A doctor will prescribe the lowest possible dose for you and adjust upward if needed.

Before starting a new medication, ask your care team about the potential short-term and long-term side effects. Be sure to tell them about all the medications you take, including supplements, to avoid medication interactions.

They may recommend a topical treatment if dysesthesia causes you to scratch your skin severely.

Natural remedies

The following natural remedies may provide some relief from chronic pain associated with dysesthesia, especially when combined with medication:

If you’re interested in using herbs and supplements to help manage dysesthesia, check with your healthcare professional first to ensure the supplements won’t interact with any medication you take.

Is dysesthesia the same as neuropathy?

Dysesthesia is a type of neuropathic or nerve pain.

Is dysesthesia a symptom of anxiety?

There is some evidence that psychological symptoms like anxiety can trigger dysesthesia symptoms. Anxiety can trigger a flare of dysesthesia if you have an underlying disease like MS.

Is dysesthesia an autoimmune disease?

Dysesthesia can be a symptom of an autoimmune disease or condition, such as MS or Guillain-Barré syndrome.

Persistent dysesthesia can interfere with your life in several ways, such as:

  • skin or scalp irritation or infection due to scratching or rubbing
  • daytime fatigue due to difficulty with sleep
  • an inability to perform everyday tasks due to pain or being distracted
  • isolation from avoiding social outings
  • irritability, anxiety, or depression

If dysesthesia symptoms interfere with your day-to-day life, it’s advisable to contact your primary care physician or a neurologist to rule out other possible causes of pain.

Dysesthesia doesn’t always require treatment. But if you seek help, there are various options to help manage it and improve your overall quality of life.

Read this article in Spanish.