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.
What is MS?
MS is a disease of the central nervous system (CNS). 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’s 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 aren’t able to function as well, which disrupts signals between the brain and the rest of the body. Symptoms vary according to the location of the damage and can 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
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 much longer.
Itching is one family of these disturbances. It’s different from allergic itching because MS-related itching isn’t 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) may result in itching as well. 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
If itching is mild, no treatment is necessary. Over-the-counter topical treatments aren’t 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 the antihistamine hydroxyzine.
According to the National MS Society, there are some medications that are successful at treating this type of itching. They are:
- anticonvulsants: carbamazepine (Tegretol), phenytoin (Dilantin), and gabapentin (Neurontin), and others
- antidepressants: amitriptyline (Elavil) and others
- antihistamine: hydroxyzine (Atarax)
Practicing mindfulness can help reduce your stress. According to the Mayo Clinic, stress has been found to make neurological symptoms worse. 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’s important to note the recommendation that you avoid magnetic therapy if you have MS. This type of therapy can cause a burning sensation on the skin.
There aren’t 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.
MS-related itching is irritating and distracting. However, it usually doesn’t 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 probably isn’t related to MS disease activity.
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 KimAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.