Short answer: it’s usually a symptom called formication, a type of paresthesia where you feel like something is crawling on or under the skin. It has many possible causes, ranging from benign to medical, and sometimes it’s linked to nervous system issues, medications, or deficiencies. A calm check-in with a clinician is wise if it’s new, persistent, or associated with other symptoms. What it can feel like
- Sensations described as crawling, itching, tingling, or pins-and-needles.
- May be localized to one area or occur over larger regions of the body.
- Often worse at night for some people.
Common possible causes
- Nerve-related issues: nerve compression or irritation (for example, carpal tunnel or other entrapments) can amplify abnormal skin sensations.
- Medications or substances: certain drugs or withdrawal states can produce formication.
- Nutritional deficiencies: deficiencies in B12, iron, or folate can manifest with paresthesias.
- Sleep or hormonal factors: stress, anxiety, menopause, or sleep deprivation can contribute.
- Medical conditions: some disorders (e.g., fibromyalgia, Parkinson’s disease) and certain infections or toxins have been associated with formication.
- Less commonly, parasitic or skin infestation concerns (though true infestation is rare and often misinterpreted).
When to seek medical attention promptly
- If the crawling sensation is new and persistent, or it’s accompanied by weakness, numbness, vision changes, severe headache, confusion, or other new neurological symptoms.
- If it’s accompanied by signs of anemia or digestion changes (possible deficiencies or systemic issues).
- If it started after starting or changing medications, or if substance withdrawal is involved.
- If the sensation is severe or causing significant distress or sleep disruption.
What you can do now (practical steps)
- Track symptoms: note when it happens, where it’s strongest, and any triggers or accompanying symptoms.
- Review current medications and supplements with a healthcare provider to rule out drug-induced causes or interactions.
- Check for fatigue, sleep quality, stress, and anxiety levels; addressing sleep and stress can help in some cases.
- Ensure good skin care: avoid scratching to prevent skin damage, keep skin moisturized, and avoid harsh substances.
- Basic nutrient check: if vegetarian/vegan or have known dietary gaps, discuss a simple blood work panel with your clinician (including B12, iron studies, folate).
If you’d like, I can help you prepare a brief symptom journal template or suggest questions to ask a clinician to efficiently address formication and its possible causes.
