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Multiple sclerosis (MS) may cause altered sensations on the skin. Although rare, some people with MS experience pruritus, known more commonly as itching. This itching sensation is a type of sensory abnormality, known medically as cutaneous dysaesthesia. It is commonly associated with neurological (nerve) diseases, including MS.
According to a study of 428 people with MS, 12 percent of participants reported experiencing painful altered sensations at some time in their lives. MS-related itching sensations can occur anywhere on the body and can affect one or both sides. It most commonly affects the face, torso, arms, and legs.
Abnormal sensations such as itching in MS are a type of neuropathic (nerve) pain. This sensation is not usually associated with a relapse. In other words, you may experience itching whether or not you are experiencing a flare-up, a new lesion, or other MS symptoms.
Although this itching is felt in the skin, it is not caused by skin problems, such as allergies, irritation, or a rash. Instead, this sensation results from nerve damage caused by MS.
When you have MS, your body’s white blood cells attack the central nervous system. The central nervous system consists of the brain and spinal cord. MS attacks cause inflammation and strip the body’s nerves of their protective coating (myelin), in a process known as demyelination, leaving the nerves vulnerable. This reduces their ability to transmit electrical signals to the brain. When the brain is unable to interpret the nerve signals it is receiving, it tries to relate them to a sensation it has already experienced, including burning or itching.
In some cases, dysesthesias such as itching may resolve without treatment. They may also go away and return at different times. Placing an ice pack covered in a cloth onto the skin may help numb the itching sensation.
If MS itching is highly uncomfortable or has a significant impact on your daily life, your primary care doctor or neurologist may prescribe certain medications to help manage this symptom.
Because itchiness in MS is not caused by a problem with the skin or an allergic reaction, topical treatments, such as corticosteroids and antihistamines, are not effective. Instead, anti-seizure medications, also known as anticonvulsants, such as Neurontin (gabapentin), carbamazepine, and phenytoin, can sometimes help relieve this symptom. Certain antidepressant medications may also be used to treat dysesthetic itching. Atarax (hydroxyzine) can also be effective. It is important to weigh the balance of the benefits versus risks before starting any serious medications, as they can have significant side effects.
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