MS Itching: Causes and Treatment Options

Neuropathic itching is an MS symptom that can drive you up the wall. Unlike with normal itching, the cause isn’t located on the skin, and scratching doesn’t provide much relief. But treatments are available.

Among the many symptoms that multiple sclerosis (MS) can cause, neuropathic itching is particularly frustrating.

It’s a type of dysesthesia, or chronic pain, which can lead to a sudden and extreme urge to scratch. It can even interfere with your daily activities, sleep, and quality of life.

There’s no official definition of neuropathic itching among researchers — it’s a less-studied topic in MS. But it’s thought to result from damage to neurons or glial cells in the nervous system.

Neuropathic itching can be a serious issue for many people with the condition. In one small 2022 study, 35% of people with MS reported chronic itching.

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What causes MS itching?

MS is an autoimmune condition in which the immune system attacks the nerve cells in your brain and spinal cord, damaging them and causing them to demyelinate.

The affected neurons can’t transmit nerve signals properly to move your muscles or accurately sense stimuli in your environment.

Researchers believe itching in MS is caused by the demyelination of nerves that help sense itch — potentially making it seem like an external stimulus is making your skin itch.

It’s called neuropathic itching because it has a neurological cause and isn’t caused by a skin condition or a stimulus on your skin, like a bug bite.

In MS, you might feel itching at locations on your skin all over your body.

Nerve demyelination is also associated with neuropathic pain in MS. They can go hand in hand — some people with the condition experience itching alongside neuropathic pain. Or they experience neuropathic itching but no neuropathic pain.

People who have itching in MS may be more likely to also experience fatigue, sensitivity to heat, cognitive impairment, and anxiety or depression, according to a small 2023 study.

What does MS itching feel like?

People with MS can experience itching in different ways.

Some people say it feels like bugs crawling on your skin.

In that same 2023 study, participants described the sensation as intense, tingling, and like a sudden extreme urge to scratch. They experienced itching most commonly in their face, scalp, trunk, and upper and lower extremities.

Scratching the itch only relieves the itch temporarily, and may even make it worse.

Treating MS itching

Here’s what works and what doesn’t to treat itching in MS.

Local anesthetics

A mixture of local anesthetics may also help, including topical ketamine mixed with amitriptyline or lidocaine. Capsaicin cream may also help.

Medications for neuropathic pain

Some people find medications for neuropathic pain also help, such as antidepressant medications or anti-seizure medications like gabapentin and vimpat, which you might already be taking for MS, say the Multiple Sclerosis Association of America and the National Multiple Sclerosis Society.

Avoiding triggers

Avoiding the heat may help since 52% of people in that 2023 study reported that warm temperatures make itching worse for them. Cooling the area, however, didn’t seem to be effective at relieving neuropathic itch in that study.

That said, using a cold pack is a low risk treatment you can try at home, so it may be worth a shot to see if it works for you.

Some people with MS find that stress can also trigger itching, so taking steps to avoid long-term stress will likely help.

Light therapy

Some people with MS have found that light therapy — controlled exposure to ultraviolet radiation — helps with their itching in MS.

It’s an effective treatment for chronic itching and skin inflammation in other conditions such as psoriasis and atopic dermatitis, and researchers have suggested it may work by directly affecting the sensory nerve fibers in the skin.

Other nondrug treatments

Other nonpharmacologic treatments may also help to relieve neuropathic itching, including cognitive behavioral therapy, acupuncture, and mindfulness and meditation practices, according to the National Multiple Sclerosis Society.

Traditional anti-itch treatments aren’t effective

You can’t treat itching in MS the same as you would other types of itching. Several go-to anti-itch treatments aren’t effective for itching in MS, including antihistamines, topical steroids, and pain relief medications.

If you’re experiencing itching, and you think it might be due to MS, talk with your doctor or the person who manages your MS. Your doctor may refer you to a dermatologist to rule out a skin condition, or even to an allergist to ensure it’s not a reaction to a food or other environmental trigger.

FAQs about itching in MS

Here are a couple of frequently asked questions about itching in MS.

Is itching an early sign of MS?

It’s unlikely but not impossible. Sensory changes are very common presenting symptoms of MS, though they tend to occur more commonly in the limbs and eyes. However, some people with MS say they experienced itching that wouldn’t go away years before they received an MS diagnosis.

What complications can occur if MS itching isn’t promptly treated?

The main complication of itching in MS is self-injury, like bruising or wounds, which can form if you keep scratching the same area. This can increase your risk of infection.

Over time, scratching can also cause skin changes like lichenification, in which the skin gets thicker and darker, and has changes in texture at the place where it has been scratched.

Scratching in the same spot over and over again may also damage local nerves over time, causing you to lose sensation. Losing sensation can make it harder to know when your scratching is injuring your skin, so you may continue to scratch to the point of injury.

The takeaway

The neuropathic itching that happens in MS isn’t just a pesky symptom — it can be debilitating and seriously affect your quality of life.

However, some of the same medications healthcare professionals recommend for neuropathic pain in MS may also be effective for MS itching. And topical anesthetics can help lessen your discomfort.

You can also try a few other nondrug approaches, such as light therapy, capsaicin cream, acupuncture, and mindfulness.