Itchiness in Multiple Sclerosis

Both sides of the body are usually affected

Itching and MS
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Do you find yourself constantly pulling up your pant legs or shirt sleeves to scratch away a sudden itchy sensation? While there are numerous causes of itchiness, the origin might be related to multiple sclerosis (MS) or a medication used to treat the disease.

Neuropathic Itch in Multiple Sclerosis

Unlike itchiness due to a mosquito bite or eczema, which arises because of inflammation in the skin, itchy sensations caused by MS arise due to abnormal nerve signals coming from the brain.

This phenomenon is called neuropathic itch. So there is no rash or bumps in the itchy area, although it might be red if you've been scratching.

Like most other MS symptoms, the miscommunication that causes neuropathic itch in people with MS is due to demyelination of nerves in your brain and/or spinal cord. Loss of the protective myelin covering around your nerves causes them to misfire, which can lead to sudden itchiness and other abnormal sensations, such as tingling, burning, or a pins-and-needles feeling.

Characteristics of MS-Related Itchiness

MS-related itchiness is typically paroxysmal, meaning it starts and stops abruptly. This characteristic offers an important clue pointing toward MS as the likely culprit, as opposed to the myriad other possible causes of itchiness. Itchiness in the same location on both sides of the body is another tip-off that this symptom is likely MS related.

While bouts of feeling itchy can happen six times per day or more, they usually only last a few seconds to minutes. Although they're short, these episodes can be very intense and disruptive, especially if you experience them at night. 

Neuropathic itchiness related to MS usually occurs in specific areas of your body, as opposed to feeling itchy all over.

Itchy sensations can occur virtually anywhere on your body, usually involving both sides. For example, both arms, legs, or both sides of your face might be involved. Occasionally, though, the itchiness may be confined to a single location, usually an arm or leg. 

Some people experience a combination of abnormal sensations, such as itchiness along with a burning or tingling feeling. Additionally, you might notice your bouts of itchiness are triggered by specific circumstances. Heat is a common trigger, such as when you're outside on a hot day or bathing. Certain movements might also provoke an itchy spell. 

Treatment Options

The good news is that paroxysmal symptoms like bouts of itchiness usually do not signal an MS relapse. However, this symptom can interfere with your daily activities and reduce your quality of life. Additionally, scratching might lead to other problems, such as a skin infection or scarring. If any of these circumstances apply to you, it's important to seek treatment as soon as possible.

Behavioral treatments are often helpful as are simple measures, like covering the itchy area with clothing. If these measures don't do the trick for you or your symptoms are severe, your doctor might recommend medication.

Options your doctor might consider include: 

  • Dilantin (phenytoin)
  • Lyrica (pregabalin)
  • Neurontin (gabapentin)
  • Tegretol (carbamazepine) 

With effective medical treatment, your episodes of feeling itchy usual do not recur. Importantly, topical treatments such as over-the-counter or prescription corticosteroids are not helpful for neuropathic itch because the root of the problem is your nerves rather than your skin. 

Other Considerations

While MS can certainly cause itchiness, so can many other conditions. And one of your MS medications might even be to blame. This is why it's a good idea to see your neurologist or primary care doctor if you experience unexplained itchiness—especially if it involves both sides of your body, or is persistent or worsening.

Some disease-modifying therapies can potentially cause itchiness as a side effect, including Copaxone (glatiramera), Lemtrada (alemtuzumab), Tecfidera (dimethyl fumarate), and Tysabri (natalizumab). An allergic reaction to your MS medication is also possible, which may cause generalized itchiness, hives, and/or a rash. If you suspect an allergic reaction, call your doctor immediately. Seek emergency medical care if you experience swelling of your lips, face, or tongue, or have difficulty breathing.

A Word From Verywell

We know how terribly uncomfortable, frustrating, annoying, and disruptive itchiness in MS can be, especially since usual home remedies and over-the-counter medicines typically provide no relief. While you might be tempted to tough it out, don't suffer in silence if you're experiencing frequent or persistent itchiness. See your doctor to determine whether this vexing symptom is related to your MS or another condition. Once you've pegged down the cause, you can work together to devise a treatment strategy that suits your needs.

Sources:

Oaklander AL. Neuropathic Itch. Semin Cutan Med Surg. 2011 Jun;30(2):87-92.

Patel T, Yosipovitch G. Therapy of Pruritus. Expert Opin Pharmacother. 2010Jul;11(10):1673-1682.

Tivoli YA, Rubenstein RM. Pruritus: An Updated Look at an Old Problem. J Clin Aesthet Dermatol. 2009 Jul; 2(7): 30–36.

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