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).

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.

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.

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.
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