Itching and Multiple Sclerosis: Understanding Pruritus in MS

March 10, 2024

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Pruritus, encompassing symptoms like localized itching, crawling sensations, tingling or burning of the skin, troubles up to 35% of those with multiple sclerosis (MS). This perplexing phenomenon frequently defies visible examination findings, significantly reducing quality of life. Elucidating origin and patterns in MS promises progress tailoring therapy squelching torment for the estimated 1 million Americans battling this autoimmune condition targeting the central nervous system.

Understanding Pruritus in MS

Theories regarding pruritus in MS center on damaged myelin sheaths unveiling nerve fibers permitting aberrant signaling manifesting as itch. Demyelination likely also directly disrupts pathways regulating sensation. The chronic, relapsing inflammation intermittently afflicts new regions potentially explaining shifting localization though commonly symmetric and favoring limb distribution.

Causes of Pruritus in MS

Beyond MS inflicting direct insult to sensory nerves, additional factors compound pruritus including dry skin from poor circulation and mobility, reactions to medications, psychological stress and secondary infections. Rarely, brachioradial pruritus emerges featuring forearm itching from suspected nerve impingement. Recognizing exact origin shapes options curtailing symptoms.

Types of Pruritus in MS

Neuropathic pruritus stemming from MS demyelination and firing disturbances comprises the most common subtype without primary skin findings. Psychogenic pruritus associates with anxiety and depression exacerbating disease. Secondary pruritus follows reactive skin changes like xerosis and eczema. Thorough evaluation of individual characteristics facilitates customized treatment.


Diagnosing Pruritus in MS

Importance of Diagnosis

Because pruritus broadly engages sensory nerves, characteristics like localization, duration, seasonal/circadian variation and response to therapies assist identifying perpetuating factors guiding management.

Diagnostic Process

History interrogating past patterns, review of recent medication changes, skin inspection searching for subtle findings and judicious laboratory assessment establishing systemic stability all help clarify underlying dynamics fueling pruritus.

Living with Pruritus and MS

Management Strategies

Frontline, gentle skin care, antihistamines, topical corticosteroids and neurostabilizers like gabapentin address surface vulnerability and nerves. Phototherapy, nutritional optimization and lifestyle approaches bring additional benefit. Refractory symptoms may yield to novel biologic medications like omalizumab.

For brachioradial pruritus, cervical spine therapy, tapping, vibratory stimulation and cryotherapy offer relief by dampening nerve signals.

Improving Quality of Life

Despite growing armamentarium against pruritus, misery still haunts many with MS. Connecting with others sharing challenges through support organizations and prioritizing self-care assists enduring unrelenting, severe disease.



  • Pruritus in MS has complex, overlapping etiologies requiring tailored therapy.
  • Diagnosis hinges on recognizing patterns and response guiding management.
  • Multidisciplinary approaches address skin vulnerability, nerves and perpetuating factors.
  • Psychological support assists coping with severe, refractory disease.


Is itching always due to MS?

No, many conditions like infections, allergies, skin irritation trigger pruritus requiring evaluation.

What medications help MS itching?

Antihistamines, steroid creams, gabapentin, tricyclic antidepressants, phototherapy. New biologics show promise.

Are home remedies beneficial?

Possibly. Hydrating skin, cooling techniques, stress reduction offer low-risk temporary relief.

Can stress exacerbate MS pruritus?

Yes. Anxiety and depression may incite psychogenic itching demanding holistic care.

Where find more resources about itching with MS?

Reputable organizations like National MS Society and American Academy of Dermatology offer education and support.

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