Formication is a tactile hallucination, which means a person feels a physical sensation, but there is no physical cause. The sensation can lead to itching, which may be worse at night and can be severe enough to impact on a person's quality of life.
Feeling sensations on the skin with no physical stimulation is a type of paresthesia, which may also include burning, tingling, numbness, and cold.
Formication is linked to several other medical conditions, as well as withdrawal from some drugs and substances.
Causes of formication
Formication is the feeling of itching when there is no physical cause.
Several conditions can cause formication. They include:
- Parkinson's disease
- Lyme disease
- diabetic neuropathy
- skin cancer
Formication can sometimes occur when a person is going through withdrawal from drugs, especially from opiates. The list below includes some of the drugs that can cause formication during withdrawal.
- opioid pain medications, such as codeine or morphine
- some antidepressants, such as SSRIs
Formication linked to drug withdrawal is usually temporary and should resolve when a person recovers from withdrawal.
If the sensation continues or is very intense, it could be due to drug psychosis. This may cause a person to believe that they have an actual infestation of bugs in their skin.
Alcohol withdrawal can also cause formication. People may experience visual hallucinations too, as well as other symptoms. It is, therefore, best to have a doctor or other professional oversee alcohol withdrawal, as symptoms may be severe.
It is essential to give the doctor full and honest answers at the appointment so that they can provide an accurate diagnosis. They may want to know:
- any other symptoms that are present in addition to formication
- at what time of day the crawling sensations occur
- what was happening when the sensations first started
- any medication being taken
- whether a person has used any recreational drugs
- if a person drinks alcohol
A doctor might also want to rule out scabies. Scabies is an infection of tiny mites that burrow in the skin. They cause extreme itching and leave a rash.
If formication is caused by medication, a doctor should be able to prescribe an alternative.
Treatment for formication will depend on the underlying cause. A topical cream, such as hydrocortisone, might lessen the itching for some people. Moisturizers or barrier creams may also help by keeping the skin healthy and hydrated.
It could also be worth placing an ice pack on the affected areas, which can provide a soothing effect for immediate relief.
If the cause of the formication is Parkinson's disease, shingles, or fibromyalgia, a doctor will prescribe appropriate medication and may create a long-term treatment plan.
If medication is the cause, a doctor can usually recommend alternatives. Sometimes, an antihistamine, such as Zyrtec or Benadryl, can help reduce the sensations of formication.
Some antihistamines can make people drowsy, so it is important to read the labels and ask a pharmacist questions about the side effects before using them.
If formication is linked to recreational drug use, quitting and finding professional support for withdrawal can resolve symptoms.
Formication can cause poor quality sleep and tiredness.
If a person is experiencing formication, they may be prone to constant scratching. This can break the skin, which can allow bacteria to enter and possibly cause infections to develop.
Potential complications of scratching include:
Other complications of formication include:
- poor sleep quality
- problems concentrating
- aching or feeling stiff
It is important to seek medical advice for any and all complications. Feeling tired or depressed can make formication worse.
Formication is a symptom of an underlying condition, so fully treating this condition should typically get rid of the symptoms. The condition may be physical, psychological, or related to substance misuse.
If the cause is not apparent, screening out possible conditions could detect something previously undiagnosed.
Speaking openly and honestly with a doctor will allow them to develop a personalized treatment plan to improve the condition as soon as possible.