Sensation of Bugs Crawling on Skin
Feeling like bugs are crawling on the skin, even when nothing is there, is a common but unsettling experience. This sensation, called formication, happens when nerves send false signals to the brain, creating the feeling of crawling, tingling, or itching without a physical cause. It can affect any part of the body and may come and go or persist over time.
Formication can stem from many factors, including nerve-related conditions, skin issues, medication side effects, or withdrawal from certain substances. Stress, lack of sleep, and hormonal changes can also play a role.
While the sensation is not always linked to a serious condition, it can signal an underlying health issue that needs attention. Knowing when to seek advice can help address both the discomfort and its root cause.
Definition of Symptom
The feeling of bugs crawling on the skin when no insects are present is called formication. Formication is a type of tactile hallucination. This means the person feels a physical sensation that is not caused by an outside source. It is also a form of paresthesia, which includes unusual skin sensations such as tingling, numbness, or a pins-and-needles feeling. Common ways people describe this include:
- Crawling sensation
- Itchiness or itching without a visible cause
- Tingling sensation
- Light stinging or burning feelings
Some may also notice mild tremors or muscle twitches along with the skin-crawling sensation. The symptom can affect small areas, like the scalp or arms, or spread over larger parts of the body. The intensity may range from mild irritation to strong discomfort.
These sensations can happen while awake or during rest, and they may come and go or persist for longer periods. While the feeling is real to the person experiencing it, there are no actual insects on or under the skin.
Possible Causes/Diseases Condition
Formication can be linked to a variety of medical, nerve-related, and mental health conditions.
- Neurological and Nerve-Related Causes: Nerve damage, such as in peripheral neuropathy or diabetic neuropathy, can trigger tingling or crawling sensations. Multiple sclerosis and other neurological conditions can also affect nerve signals in the skin.
- Hormonal and Metabolic Factors: Changes during menopause can alter nerve sensitivity and skin sensations. Hyperthyroidism and diabetes can also cause nerve-related symptoms that mimic crawling feelings.
- Mental Health Conditions: Delusional parasitosis and delusional infestation involve a fixed, false belief of being infested with insects. Depression, schizophrenia, and anxiety disorders can sometimes include tactile hallucinations.
- Infectious Diseases: Some infections, such as Lyme disease, syphilis, and HIV, can damage the nervous system and produce abnormal skin sensations.
- Skin and Medical Conditions: Scabies causes intense itching from an actual mite infestation, but lingering sensations may remain after treatment. Skin cancer or skin irritation from radiation therapy can also cause unusual feelings in the skin.
Other Possible Triggers
Fibromyalgia can cause widespread nerve pain and tingling. Morgellons disease is a controversial condition where patients report fibers or crawling sensations. Stimulant medications for ADHD or substances like cocaine and amphetamines may also lead to formication.
| Possible Cause Category | Examples |
|---|---|
| Nerve-related | Diabetic neuropathy, peripheral neuropathy |
| Hormonal/Metabolic | Menopause, hyperthyroidism |
| Mental Health | Delusional parasitosis, schizophrenia |
| Infectious | Lyme disease, HIV, syphilis |
| Other | Fibromyalgia, Morgellons disease |
Other Non-Disease Causes
Not all crawling skin sensations come from illness. Certain substances, medications, or physical factors can also trigger these feelings.
- Recreational drugs overstimulate the nervous system. This may cause tingling, itching, or the false feeling of insects on the skin.
- Some prescription medicines may have similar effects. For example:
| Medication Type | Possible Effect on Skin Sensation |
|---|---|
| Stimulants | Tingling, crawling feelings |
| Antidepressants | Nerve sensitivity changes |
| Antipsychotics | Rare sensory side effects |
- Alcohol withdrawal can also lead to temporary nerve overactivity. People going through withdrawal may notice itching, burning, or crawling sensations.
- Physical injury or skin damage can irritate nerve endings. Even after the skin heals, the nerves may still send abnormal signals to the brain, creating the crawling feeling.
These causes usually involve changes in nerve activity rather than an actual skin problem.
How It Causes the Symptom
Formication occurs when the brain misinterprets signals from the skin or nerves. The nervous system sends messages to the brain that feel like crawling, tingling, or biting, even though there is no physical cause. Damaged or overactive nerve pathways can cause this. Conditions such as peripheral neuropathy, Parkinson’s disease, or multiple sclerosis can disrupt normal nerve signaling.
Chemical changes in the brain can also play a role. Drug use, withdrawal, certain prescription medications, or mental health disorders can alter how the brain processes sensory information. Common triggers that affect nerve signaling include:
- Nerve damage from injury or illness.
- Hormonal changes, such as during menopause.
- Substance use or withdrawal.
- Side effects of medications.
- Mental health conditions, like anxiety or depression.
In some cases, stress or lack of sleep can make the sensations more noticeable. When the body is on high alert, skin sensitivity can increase.
Possible Complications
If the crawling sensation continues for a long time, it can cause skin damage. People may scratch or rub their skin often, which can lead to sores, scabs, and infections. Ongoing formication can also affect sleep. The discomfort may make it hard to fall asleep or stay asleep, leading to fatigue during the day.
Some people may experience emotional effects. Persistent symptoms can increase stress, anxiety, or feelings of frustration. In some cases, it may worsen existing mental health conditions. If the cause is an untreated medical condition, such as nerve problems or a vitamin deficiency, other health issues may develop over time.
| Possible Complication | How It Can Happen |
|---|---|
| Skin infections | Repeated scratching breaks the skin. |
| Sleep problems | Discomfort interrupts rest. |
| Anxiety or depression | Ongoing symptoms affect mood. |
| Worsening illness | Underlying condition is not treated. |
In rare cases, frequent skin injury from scratching can cause scarring or changes in skin color. This may be permanent if the damage is deep.
When to Seek Medical Attention
If the crawling sensation lasts for more than a few days or keeps coming back, you should see a doctor. Ongoing symptoms could mean there is an underlying condition that needs attention. Get help right away if the feeling is severe, spreading, or disrupting sleep. These symptoms can affect daily life and may need prompt evaluation. Contact a healthcare provider if:
- You may also feel pain, numbness, or weakness.
- You notice rashes, sores, or swelling on your skin.
- You experience mood changes, anxiety, or confusion.
- The sensation starts after beginning a new medication or drug.
A dermatologist can check for skin issues or allergic reactions. A neurologist can look for nerve-related causes like neuropathy or Parkinson’s disease. If mental health factors seem likely, a mental health professional can help identify anxiety, depression, or other conditions related to these sensations. Doctors may suggest blood tests, nerve checks, or skin exams to rule out vitamin shortages, infections, or other treatable problems.
