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That Crazy Itch You Just Can

That Crazy Itch You Just Can’t Satisfy

It’s the height of the summer and everybody in our household is feeling the heat.  I tend to melt like a snowflake while Rob can’t get enough of the sun.  Even the kitty cats are getting in on the summer action by shedding their year round furry coats.  Not only is fur flying, but these little guys are crazy itchy and desperately want to be scratched.  If I could translate kitty behavior into the English language, here is what a typical grooming session might sound like:

Musette: “Mommy, I’m just going to rub my face against your hand a couple of times, okay?  Oh, yes, please pet me; that’s nice.  You are going to use the brush? Awesome.  Oh wait, scratching is even better.  Go ahead, scratch…oh, a little over here…no, there…go back.  Ah, itchy, itchy, itchy… Thank you!  Here’s a little love bite.  Oh please don’t stop scratching, this fur is driving me crazy!”

The poor cats can’t help it when they get itchy and neither can we.  Did you know that intense itching can be a symptom of multiple sclerosis?  It’s not the most common symptom associated with MS, but one which can be rather annoying, comes on suddenly, and is sometimes downright painful.

What is pruritus?

Pruritus, or itching, is defined as an unpleasant sensation of the skin that provokes the urge to scratch.  The itch can be localized or widespread, acute or chronic, and range from mild to intractable (hard to control).  Itching can occur anywhere on the body.

Pruritus is associated with many skin disorders (e.g. eczema, psoriasis), histamine reactions (e.g. insect bites, poison ivy), and some systemic diseases (e.g. Sjögren’s syndrome, hyperthyroidism, liver disease, diabetes).  Pruritus can also be associated with neurologic or psychiatric disease, certain blood disorders (e.g. leukemia, iron deficiency, multiple myeloma), and reaction to medications (e.g. opioids, estrogen, simvastatin).

MS and itchiness

When pruritus occurs as a symptom of multiple sclerosis, it is similar to other neurologic sensations – pins and needles, burning, stabbing, or tearing pain – known as dysesthesias.  The itching with MS is often paroxysmal, coming on suddenly with great intensity, but temporary in nature and lasting anywhere from a couple of seconds to minutes.  It can be the type of itch which seems to get worse the more you try to scratch it.

Itching can occur anywhere on the body (face, head, torso, arms, legs, hands, feet) and is often symmetrical, but not always.  Heat triggers pruritus for some people with MS and for others, it seems to be related to movement or tactile stimulation.  For some reason, the itching often occurs at night with an intensity that has the power to wake you up from sleep.

There may be other causes of MS-related itching.  Disease-modifying therapies that are administered by injection may cause temporary skin irritation and itching at the injection site. Allergic reaction to medications such as interferon beta-1a or natalizumab may cause itchiness.  In clinical trials, one of the common side effects of the oral medication dimethyl fumarate (Tecfidera) was flushing, followed by the sensation of heat or itching.

Treatment for MS itching

If the itching is mild, no treatment is necessary and often the symptom will go away on its own.  If the itching is severe, prolonged, or disrupts your daily life, you should talk to your doctor about possible treatments.

Pruritus (itching) associated with MS is neurologic in origin, so cortisone cream and other topical treatments are usually not very helpful.  There are, however, some medications which may be useful in diminishing the itch, including anticonvulsants (e.g. gabapentin, carbamazepine, phenytoin), antidepressants (e.g. amitriptyline, paroxetine, mirtazapine), and the antihistamine hydroxyzine (Atarax).

Resist the urge

It is tempting to scratch the itch, but doing so may actually increase the feeling of itchiness.  Scratching too hard can also cause problems such as broken or damaged skin that bleeds or becomes infected.  Try to resist the urge to scratch.

Ice or cold packs

You may want to experiment with applying ice or cold packs to temporarily relieve the itching.  Cold seems to override the itchiness and “confuse” the already mixed up nerve signals.  But never apply ice directly to skin (always wrap in a towel or washcloth) and never leave ice on one area for more than 15-20 minutes at a time.

If your itching is accompanied by an external rash, bumps, or visible irritation (not caused by scratching), see your doctor.  This may be a sign of an allergic reaction or infection and is probably not related to MS.

Keeping your skin in good condition

Keep in mind that having MS does not exempt you from developing more common causes of crazy itchiness, such as dry skin in the winter.  It is a good idea to try to keep your skin in good condition year round.  Avoid hot showers and harsh soaps.  Gently exfoliate on occasion and keep your skin moisturized.

Please call your doctor when you experience crazy itchiness, caused by MS or otherwise, so that you can find some relief.1-5

Lisa Emrich | Follow me on Facebook |Follow me on Twitter | Follow me on Pinterest

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The MultipleSclerosis.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. Butler DF. Pruritus and Systemic Disease (updated 31 May 2012). In: Medscape Drugs and Diseases. Retrieved 12 July 2014 from http://emedicine.medscape.com/article/1098029-overview
  2. Itching. National Multiple Sclerosis Society, n.d. Retrieved 12 July 2014 from http://www.nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms/Itching
  3. Pietrangelo, Ann. Multiple Sclerosis Itching: Causes, Treatments, and More. Healthline.com, 23 April 2014. Retrieved 12 July 2014 from http://www.healthline.com/health/multiple-sclerosis-itching
  4. Stachowiak, Julie. Itching as a Symptom of Multiple Sclerosis. About.com, 19 May 2014. Retrieved 12 July 2014 from http://ms.about.com/od/signssymptoms/a/Itching-As-A-Symptom-Of-Multiple-Sclerosis.htm
  5. Taylor JS, Zirwas, MJ, Sood A. Pruritus. In: Disease Management Project (Dermatology). Cleveland Clinic Center for Continuing Education. Retrieved 12 July 2014 from http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/dermatology/pruritus-itch/

Comments

  • Pchic
    7 months ago

    lol i just had to sign up so i could say– i am owned by a kitteh named Muesette too 😀
    sure enough we are both ITCHY!

    i’ve lived with some unidentified autoimmune condition for almost 2 decades. tho its some form of CTD and not MS, the chronic itching and wierd stabbing or hairs/feathery tickling is all so familiar. especially at night, usually most intense between 2am-5am, improving as the sun rises. there’s reasons why that period is called the witching hours… i do believe this might be one of them!

    after trying many things with no or only mild relief, i finally discovered a plain vinegar spray is wonderfully soothing and cooling. and effective for several hours so you can actually get some rest before the sun comes up. the sharp smell may be offputting at first but dissipates as it evaporates.

    i discovered this treatment by realizing that the only part of my body NOT afflicted by random itching, was my hands and as a green housekeeper, white vinegar was my cleaning staple – it was always on my hands.
    hope this brings relief to others suffering the itch from hell!

  • Lisa Emrich moderator author
    7 months ago

    Hi Pchic!

    Thanks so much for commenting. I’m sorry that you experience these crazy sensations too. It’s interesting that vinegar seems to help for you. Thank you for sharing.
    Best,
    Lisa

  • Amanda
    2 years ago

    Thank you for writing this… I have been experiencing itchy shoulders and neck. I try to explain it how my skin feels itchy, but when I go to rub it it hurts to touch…I just say it kinda feels like a sunburn because it is hard to explain to people.

  • paizley
    3 years ago

    Usually my nose. Like right now. Intense itching, face and scalp starting to itch also. Now my ears. Capsaicin works well as a counter-irritant. I’d rather feel the burn than the itch. I have actually rubbed a piece of habanero on my face to stop the itching. Otherwise I’ll rub my self raw!

    Sometimes my legs feel like little gnats are flying around or tiny bugs are crawling all over. Palms and fingers might itch. I always have to look to see if something’s actually there like if there’s a hair in my nose or on my face causing the itch. So annoying and distracting. It makes me miserable. I can’t concentrate and if it happens at night, I can’t sleep.

    Sometimes it feels like someone is pushing a large darning needle from the inside out. It hurts!

  • Victoria A. Davenport
    3 years ago

    I have some itching on my skin but I have been able to deal with it. However, the itching on my scalp is driving me crazy. My neurologist told me to go to a dermatologist. I’m thinking that will probably not work since I am sure it is due to the MS. He did give me Gabapentin. I took one and was so dizzy, I could not walk and had major bowel pains from it. Does anyone have any suggestions? I can put ice on my skin but I don’t know what to do for my scalp.

  • Marilyn2016
    2 years ago

    I have crazy scalp itch. Diagnosed as seborric dermatitis. Like a baby’s “cradle cap”. Then I have some kind of crazy rash on my back that also itches madly. Gabapentin helps as do Rx steroid ointments. But it really is horrible.

  • Casey
    4 years ago

    Thank you for writing this article. In 2011 I had a bout with severe MS Pruritus. At the time nobody knew what it was, not my MS Neurologist, not the 27 specialists in 4 hospitals. I was given epipen, too many drugs to mention, I was sent to a burn unit to burn a layer off my skin, they thought it was a skin disorder, then they thought it was an adverse reaction to my medication, internal medicine, dermatology, adverse reactionc clinic , neurology, specialist after specialist, after specialist. I was submerged in water for 18 hours a day, when I was not in water, my hands were tied down. I was on the verge of suicide not that I was ever suicidal but I literally thought I was going insane the intense scratching all over my body I just wanted it to stop. I scratched so bad my skin was raw and bleeding, bruised. I was covered in bruises, blood, scabs from the intense scratching. I was sent to the ER, several ER’s my partner was with me and they thought he was beating me that is how bad my body looked, I took pictures documenting every episode hoping something could figure it out. I was scratching so intensely even the people in the ER begged the nurses to take me first. It was bad, it was really bad. My MS neurologist was certain it had nothing to do with MS or perhaps could be a adverse reaction to interferon (I drug I had been on for years). My partner was in Pharmacology although he was not able to practice in Canada, he developed drugs in his own country. He was certain it was not an adverse reaction. Finally prednisone and combination of other drugs worked. I was high as kite, completely out of it and unable to work. Fast forward to 2015…I began experiencing same issues again. Right around the same time. I said it cannot be related to the drugs I am on….I did my own research. My partner did research in other countries. Turns out MS Pruritus exists. It is a symptom of MS. It is not as common as MS Fatigue (which I have) or Neuropathic Pain (which I have) or Optic Neuritis (which I had) but it exists. Sadly nobody in the medical field had a clue what I was experiencing in 2011. Not the MS Neurologist not the 26 other doctors across 4 hospitals. No one has a clue. It began in June to the point I was hospitalized in August. I am an advocate of my own health, I took pictures, I documented everything who I saw, what they said, what I went through, what was done in the hospital, the IV’s given the dosages, who did the intake etc. in great detail, what I experienced in a 5 month period. I do not want anyone with MS to go through the ordeal that I went through trying to get appropriate treatment. Hydroxyzine works (if you work, its hard to function), Gabapentin works (again it makes you tired especially the 3600mg you need to stop the itching), finally at the hospital I was put on Prednisone (after 4 month ordeal). I just want other with MS who are experiencing this to know they are not alone. I also want those in the medical field to understand that this IS related to MS.

  • Marilyn2016
    2 years ago

    My neuro told me that pruritis was not a symptom of MS–WRONG! And it’s like they’re never wrong–their patients are crazy. This makes me crazy. Your experience was heartbreaking. I’m so sorry.

  • zenhead
    4 years ago

    itches and pain, like a push-pin in my leg or the underside of my big toe, also some sort of skin sensitivity on my arms, feels like a rash or allergic reaction – possibly all related? all def annoying!

  • Hayley Grace
    4 years ago

    I had intense itching on my torso and thighs. My Dr prescribed Allegra along with Zantac 150 mg in the morning and Hydroxyzine (Atarax) 10 mg at bedtime. This combination stopped the itch in it’s tracks.

  • Lisa Emrich moderator author
    4 years ago

    Hayley,
    So glad to hear that you found something that works so well. Very good to know. Thank you for sharing.
    Lisa

  • Vavavic
    4 years ago

    As a MS patient , I too experienced extreme itching , primarily on my head and scalp . Welts would rise on my skin and itch was almost unbearable.I tried every anti-itching product I could find but the itching was unrelived .Neither my neurologist or my primary care physician had ever known itching to be a symptom of MS. After some search on the internet, I found several articles that indicated the connection. I was started on gabapentin and was very fortunate to have relief.
    Thank-you for posting the article .I know it will be helpful to it really would’ve helped several years ago when I was in such a quandary.

  • Lisa Emrich moderator author
    4 years ago

    Hi Vicky,

    Thank you for your comment. I’m sorry that you were challenged with this for so long without relief. But it’s great that gabapentin, which works to calm abnormal sensations, helped to relieve the itch.

    Hopefully people looking for information will find helpful suggestions that they can take to their doctors. Like you, gabapentin has helped with these type of MS symptoms for me as well.

    Best,
    Lisa

  • Aprld63
    4 years ago

    Thank you for bringing this issue up. I’ve had an itch in the middle of my back almost constantly for years and nobody could figure out why. It’s in just the right spot I can’t reach so use whatever I can get my hands on to try and scratch. At least now I know why it’s like that so often. I’ll mention it to my neuro next visit.

  • Lisa Emrich moderator author
    4 years ago

    Hi Aprld63,

    Oh boy, I’ve had some of those middle of back itches that can be so difficult to get. Glad you’ll be able to bring this up at your next doctor’s visit.

    Lisa

  • Realtorddl
    4 years ago

    I wondered why at times I itched like crazy.
    I had an ointment for something else and I found it worked great on the itch. Mupirocin ointment . 2%. It is a RX.

  • Lisa Emrich moderator author
    4 years ago

    Hi Realtorddl,
    That’s great to hear that there are some ointments which are effective. Although not everybody would have a prescription of mupirocin laying around, it is good to know in case others want to ask their doctors about it.
    Thanks,
    Lisa

  • eenns79
    4 years ago

    I am a 35 yr old mother of one. She is 19 months old. I was diagnosed at 8 wks postpartum. This was one of my most persistent symptoms. It mimicked shingles because of the lesions on my c-spine. It was horrible. I scratched until I was bleeding. Even in my sleep! Thank you for bringing information about this symptom.

  • Lisa Emrich moderator author
    4 years ago

    Hi eenns79,
    Congratulations for your daughter! How is motherhood going? I’m sorry to hear that your experienced such painful itching. I’ve had shingles before and know just how bad that pain can be. More than ouch. I hope that you are doing well now. Thank you adding your story.
    Lisa

  • Cathi
    5 years ago

    For years, I had no idea that the horrible itching that woke me up at night & always on my back in the exact spot I can’t reach was MS related. I always scratch it, usually until I draw blood! I’d rather have something burn than itch so I have been known to douse it with alcohol.

  • Lisa Emrich moderator author
    5 years ago

    Cathi,
    It’s amazingly easy to scratch so hard or long to draw blood. Ouch! I’ve done that on my leg before. Very brave of you to use alcohol to make the itch burn. Double ouch.
    🙂 Lisa

  • Victoria A. Davenport
    5 years ago

    Thank you so much for this article. I have been having this problem for months and months. I did not know what was causing it. I have read so many articles on MS and not one time have I seen anything about itching. At least now I know that it is due to my disease and I won’t think I have a major skin problem on top of it! I have scratched until I am bleeding and have applied moisturizers daily. I do not take hot baths because my legs go numb. I take about a five minute luke warm bath and get out as soon as possible!

  • Lisa Emrich moderator author
    5 years ago

    Victoria,

    I’m sorry to hear that you’ve had this crazy itching, and for so long. It can really begin to take over. When the itching gets bad, I keep small towels or washcloths in the freezer to use to calm down the itch. It really does help. You should tell your neuro about the itching at your next appointment. He/she might have additional recommendations.

    Be well,
    Lisa

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