Similar to other neurological sensations and symptoms with multiple sclerosis such as burning, pain, pins and needles pruritus often comes on suddenly and sometimes with fierce intensity.  Generally, the sensation is temporary lasting anywhere from a few scant seconds to minutes (known as a paroxysmal symptom in medical terms) and often pruritus seems to get worse if one indulges in scratching. Pruritis can happen anywhere from one’s face to arms, legs, feet, head or anyplace between.

Overview: Pruritus (Itching)

Pruritis seems to occur mostly when heat triggers the symptom and strangely enough often the symptoms occurs at nighttime and often intense enough to awaken people from sleeping.  However, it can occur at anytime and as you might have estimated

The itching is often symmetrical happening on both sides of the body, thus both arms, feet or legs for example.  Further, after the pruritis subsides some patients report burning sensations, pain or the pins and needles sensations.

Pruritis may happen many times per day and as with all symptoms you should document them so as they can be reviewed with your healthcare team.

Some of the disease modifying treatments (DMT’s) may also result in itching especially those which are injections or infusions around the site of the treatment.  This is rare and if you should experience such a sensation after having a treatment you should contact your healthcare team as soon as possible as it may be an allergic reaction.  If the symptom does not subside rapidly and you cannot get hold of your neurologist a trip to the hospital is probably warranted as allergic reactions can become more severe.

What is Happening?

Itch Neural CircuitAs you may have already guessed pruritis is not a skin condition but instead a neurological symptom.  It can have various roots with other diseases as well but it is not uncommon with MS patients.  If you have never experienced pruritis before and have been diagnosed with CIS (clinically isolated syndrome) or multiple sclerosis pruritis could signal an MS Attack (exacerbation) taking place and thus again, its important to document the incident and contact your neurologists office soonest possible.

People afflicted with MS and have bout’s of pruritis know that this symptom just as is the case with burning, pins & needles and other sensations if a result of nerve conductivity effects which are the signatures of MS.  As attacks occur and damage the myelin sheath a tissue that surrounds nerves axon, electrical signals are impacted between nerves resulting in the symptoms of MS.

Fortunately pruritis does not tend to last long and some people have found ways of coping with these forms of symptoms.

Do be aware that excessive scratching can result in broken skin and infection.

So what can I do?

Realize that topical medications such as cortisone or benadryl and others will have no effect as again pruritis in MS is not due to a skin irritation but instead a neurological event. Thus if you go to your general practitioner doctor and inform them you have crazy itching they may say, “Try some cortisone” and of the itching is MS related it will have absolutely no effect.

See, this is also where MS can be confusing.  What if you actually do have dry skin or the itching is not related to MS such as a coming rash?

Many MS patients have taken it upon themselves to find solutions or partial solutions to pruritis as well as other similar annoying symptoms such as pins and needles feelings.

While we at MS Unites do not advocate any of these or advise you engage any of these prospect solutions as always, before trying anything to deal with any symptoms of MS make sure and speak to your health care professionals and most certainly your neurologist.

In researching what some folks do we have found these:

  • Using a TENS unit (Transcutaneous Electrical Nerve Stimulation) in the region of the sensation
    • People report that this often seems confuse the confuse the symptom lessening its impacts.
    • TENS units send out electrical impulses and are normally used in pain management.
      • Before EVER using a TENS unit make sure and realize WHERE and WHO and HOW to use one.  
      • Since TENS units can send strong electrical pulses they are not to be used on various parts of the body or with people who have pacemakers for example.
      • Before even considering using a TENS unit make CERTAIN to get the OK from your neurologist as it is a serious device.
  • Ice packs have been stated by some people afflicted with MS to lessen the sensations.
  • Using frozen vegetable peas in the area’s where the sensations are occurring.

Medications:

  • Brand Name: Atarax, Orgatrax and Vistaril
  • anticonvulsants, such as carbamazepine (Tegretol®), phenytoin (Dilantin®) and gabapentin (Neurontin®)
  • antidepressants, such as amitriptyline (Elavil®) and the MAO inhibitors
  • the antihistamine hydroxyzine (Atarax®).

All of the above are clearly to stimulate sensations that may impact the pruritis itching sensations.

With that said there are also some other theories that are more lurking towards many of these types of sensations.

Squirrel Itching HimselfThe human brain for the most part with sensory activity does not multi-task well.  That is to say the old phrase “If someone steps on your foot you will forget the itch of the mosquito bite” for example especially when it comes to lesser forms of pain that are not throbbing forms of pain.  So you may wish to try other sensory items.  For example I read one article where a woman when feeling pruritis would pinch herself at 90 degree angles several inches away from where the itching occurs.  We at MS Unites again do not advocate such a practice but she said it worked well for her.

Lastly there is the mind over matter.  This is difficult with sensations that are intense and down right annoying such as itching.  But, in some psychological circles it is said that people can somewhat train their thought processes into a realization that things such as itching, burning or other seemingly topical sensations are not different at all from varied emotional feelings.  That is to say, convince oneself that these sensations are not at all different than other feelings knowing they are temporary, will go away and are no different than holding an ice cube whilst one’s hands have a chill.  They are simply a sensation like a million others from the scent of a rose to the taste of a meatball or scrape on ones arm.

Do you have pruritis symptoms?

Please respond to this article with some commentary about it and what if anything you do to cope with it.

Sharing is caring and we all can benefit from one another’s experiences and how we cope with our MS symptoms.