Itchiness as a Symptom of Multiple Sclerosis

Itchiness is just one of many multiple sclerosis (MS) symptoms, but the underlying cause is different than in other cases of itchiness, which are related to inflammation of the skin.

With multiple sclerosis, itchiness is a manifestation of the demyelination of nerves that is the hallmark of the disease. Prescription medications used to treat MS can also cause or compound itchiness.

Symptoms

MS-related itchiness is typically paroxysmal, meaning it starts and stops abruptly. This characteristic offers an important clue that MS is 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. 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. 

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.

There is no rash or bumps in the itchy area, although scratching the area can turn it red.

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.

Causes

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

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.

Heat is a common trigger for MS-related itchiness, and certain movements might also provoke a spell.

In addition, 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 multiple sclerosis medication is also possible, which may cause generalized itchiness, hives, and/or a rash. If you suspect an allergic reaction, call your healthcare provider immediately.

Seek emergency medical care if you experience swelling of your lips, face, or tongue, or have difficulty breathing.

Treatment

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 that keep you from scratching are often helpful, as are simple measures like wearing clothes that cover the itchy areas.

With effective medical treatment, episodes of feeling itchy usual do not recur. Keep in mind that topical treatments, including 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. 

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