When itchiness, also called pruritus, is related to multiple sclerosis, it can be unpredictable, intense, and frankly, maddening. Somewhat similar to other neurologic sensations - pins and needles, burning, stabbing, or tearing pain - known as dysesthesias, MS-related pruritus is caused by interference with nerve signals.
The urge to scratch can be localized or widespread, acute or chronic, and range from mild to intractable (hard to control). 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.
Read more: MS Signs & Symptoms: What is Pruritus?
Treatment for MS-related itching
Pruritus in MS can be tricky to treat. If the itching is mild, treatment is usually unnecessary and the symptom often goes away on its own. If the itching is severe, prolonged, or disrupts your daily life, talk to your doctor about possible treatments.
Since itchiness associated with MS is neurologic in origin, cortisone cream and other topical treatments are rarely helpful. There are some medications, however, 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 resist the urge because scratching 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. And if the skin is itchy, but also numb, then you might cause a lot of damage before you realize it.
Instead, 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. 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.
Other causes of pruritus
Itching is a very common symptom that can have several causes, including underlying systemic disease. If itching is accompanied by 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.
See more helpful posts:
Butler DF. Pruritus and Systemic Disease (updated 21 Aug 2014). In: Medscape Drugs and Diseases. Retrieved 12 July 2015 from http://emedicine.medscape.com/article/1098029-overview
Itching. National Multiple Sclerosis Society, n.d. Retrieved 12 July 2015 from http://www.nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms/Itching
Taylor JS, Zirwas, MJ, Sood A. Pruritus. In: Disease Management Project (Dermatology). Cleveland Clinic Center for Continuing Education. Retrieved 12 July 2015 from http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/dermatology/pruritus-itch/