Dysesthesia

What is dysesthesia?

Dysesthesia is a set of symptoms that revolve around unusual touch-based sensations. It can refer to sensations that are unexpected or feel unpleasant, painful or just strange. You might feel these sensations for an obvious reason or it may be hard to point to a specific cause.

Dysesthesia can be elusive to diagnose and difficult to treat. If you have it, you may feel anxious or scared when trying to get answers. Many people with it worry that their loved ones or healthcare providers won’t believe them because it’s not a symptom someone else can see. Even worse, many fear they’ll face accusations of faking their symptoms. But this set of symptoms is real, and it can be very disruptive and have severe negative effects on your life.

Some types of dysesthesia are normal and healthy. An example of normal dysesthesia is feeling an itch or a tickle because something irritates your skin. But this can also be a symptom of a skin or neurological (nervous system-related) condition like nerve pain (neuropathic pain).

How your sense of touch works and how it relates to dysesthesia

Your tactile (touch) sense starts with nerve receptors throughout your body, most just below the surface of your skin. Those nerve endings are like sensors. They can detect a variety of properties, including:

• Texture: Does it feel smooth or rough?
• Temperature: Does it feel warm, hot, cool or cold?
• Pressure: This is how strongly something presses against your skin.
• Proprioception: This is your ability to feel the location of a body part in relation to the rest of your body. Imagine that you’re in a dark room and holding your hand right in front of — but not touching — your face. You can’t see your hand or feel it directly, but you still know it’s there.
• Nociception: This is the ability to detect imminent or ongoing damage to your body. An example is the pain one feels with a paper cut. The signals that happen because of it are what your brain processes into feelings of pain.

The nerve receptors send messages to your brain describing what they pick up. Your brain receives those signals and processes those into the sensations you feel.

But your nerve receptors can’t feel certain things. For example, humans don’t have skin hygroreceptors, a type of nerve receptor that detects moisture. That means you can’t actually feel if something is wet. Your brain processes temperature and texture into what you know as the feeling of wetness.

This ability to process sensations and fill in some of the gaps is generally useful. But it can also cause certain issues. Your brain may process signals from your nerves incorrectly. Your brain can also spontaneously generate dysesthesia sensations without nerve input.

Your brain’s ability “fill in the gaps” may also explain why mental health conditions can contribute to dysesthesia and similar concerns. Anxiety and depression can increase your worries about the cause of dysesthesia. But that doesn’t mean it’s an imaginary or “all-in-your-head” symptom set. These sensations feel every bit as real as they would if there were an obvious cause, but it’s real for a different reason.

What does dysesthesia feel like?

Dysesthesia is a positive sensation. In this context, positive and negative don’t mean good or bad. They’re an answer to the question, “Do you feel that?” A positive sensation is something you can feel. A negative sensation is one you can’t feel as strongly or don’t feel at all. Dysesthesia doesn’t involve negative sensation, so it’s not about numbness or the loss of sensation.

Dysesthesia can cause a wide range of sensations. Most people describe what they feel using the following words:

• Biting.
• Burning.
• Cool/cold.
• Crawling.
• Electric.
• Itching.
• Piercing.
• Pins-and-needles (the medical term for this, paresthesia, is a type of dysesthesia).
• Prickling.
• Pulling.
• Sharp.
• Tickling.
• Tingling.
• Warm/hot.
• Wet.

What are the most common causes of dysesthesia?

Dysesthesia can happen for dozens of reasons. Many of them are temporary or brief. Others are conditions that last years or are permanent. Frustratingly, most cases of dysesthesia happen for reasons that healthcare providers can’t find or explain.

The following include some of the possible causes of dysesthesia:

Nervous system causes

Dysesthesia can happen because of causes that affect your brain, spinal cord or nerves anywhere in your body. Some examples of neurological (nervous system-related) causes include:

• Ataxia-telangiectasia.
• Brain or spinal tumors.
• Central pain syndrome.
• Charcot-Marie-Tooth disease.
• Complex regional pain syndrome.
• Head injuries, such as concussions and traumatic brain injuries (TBIs).
• Herniated disks.
• Migraines.
• Nerve compression syndromes, like carpal tunnel syndrome and cubital tunnel syndrome (these can become persistent when they’re moderate or severe).
• Injury-related nerve damage (such as from burns or frostbite).
• Neuralgia (nerve pain) diseases, including occipital neuralgia and trigeminal neuralgia.
• Opioid-induced pain syndromes.
• Peripheral neuropathy.
• Pinched nerves or radiculopathy.
• Seizures.
• Spinal cord injuries.
• Spinal stenosis.
• Strokes or transient ischemic attacks (TIAs).
• Syringomelia.

Metabolic and endocrine causes

Metabolic and endocrine causes of dysesthesia can involve vitamin and mineral deficiencies, conditions that affect certain hormones and more. Examples include:

• Diabetes-related neuropathy (nerve damage).
• Electrolyte imbalances.
• Low blood sugar (hypoglycemia).
• Low parathyroid function (hypoparathyroidism).
• Low thyroid function (hypothyroidism).
• Menopause.
• Vitamin B1 (thiamine) deficiency (also known as beriberi), B5 deficiency, B6 deficiency and B12 deficiency.
• Vitamin B12 deficiency.

Infectious diseases

Infectious diseases can commonly cause dysesthesia when they attack or affect your nervous system. Examples of these conditions include:

• Any infection that can affect your brain and cause encephalitis or meningitis.
• Cytomegalovirus.
• Epstein-Barr virus.
• Guillain-Barré syndrome.
• Hansen’s disease (leprosy).
• Hepatitis C.
• Herpes simplex virus.
• Herpes zoster virus (shingles).
• Human immunodeficiency virus (HIV).
• Lyme disease.
• Tuberculosis.
• West Nile virus.

Autoimmune and inflammatory diseases

Autoimmune conditions are when your immune system attacks parts of your own body. Dysesthesia is possible when an autoimmune condition damages any part of your nervous system. These conditions can cause direct damage or they can damage nearby tissue, causing swelling that presses on nervous system structures.

These conditions can include:

• Fibromyalgia.
• Lupus.
• Multiple sclerosis.
• Rheumatoid arthritis.
• Sjögren’s syndrome.
• Transverse myelitis.

Toxic effects

Toxins and poisons can damage your nervous system, causing dysesthesia. Examples of this include:

• Arsenic poisoning.
• Carbon monoxide poisoning.
• Chemotherapy.
• Lead poisoning.
• Mercury poisoning.
• Neuropathy from alcohol use disorder.
• Radiation sickness or burns.
• Snake bites.
• Spider bites.
• Scorpion stings.
• Venomous stings/bites from other animals.

Other causes

Other conditions can also cause dysesthesia. These can involve conditions and circumstances that don’t fall under the others mentioned above. A few examples include:

• Allergies (like contact dermatitis from an allergic reaction).
• Amyloidosis.
• Formication (a touch-based hallucination that feels like bugs crawling on your skin).
• Multiple myeloma.
• Porphyria.
• Reynaud’s syndrome.
• Uremia.

How is dysesthesia treated?

Some causes of dysesthesia are temporary and go away on their own, so they don’t need treatment at all.

Treating dysesthesia usually involves treating whatever’s causing or contributing to it (if possible). Sometimes, it happens because of conditions that aren’t treatable. If you have dysesthesia, a healthcare provider can tell you more about your treatment options.

Because there are so many causes of dysesthesia, finding a treatment plan that works may take time and a trial-and-error approach. This is especially true when healthcare providers can’t find a cause for this symptom.

Possible treatment approaches can include:

• Medications that can change how your nervous system sends and relays tactile signals and processes them into what you feel.
• Mental health treatments to help you cope with the effects of dysesthesia (which can also lessen dysesthesia’s impact).
• Alternative treatments like hypnosis or acupuncture.

What can I do at home to treat dysesthesia?

Minor causes of dysesthesia, such as a skin reaction from an allergy or other irritant, are often treatable at home. However, the treatment can vary depending on the cause. If you have questions about the right way to treat minor dysesthesia causes, talk to or see a healthcare provider. They can offer guidance on the best way to self-treat minor dysesthesia causes. You’ll likely need an in-person physical examination to look for or rule out nervous system issues that might also be happening.

Is dysesthesia preventable?

Some causes of dysesthesia are preventable, but many aren’t. Whether or not it’s preventable depends on the cause.

Some key ways to avoid some of the preventable causes of dysesthesia include:

• Make hygiene a priority. Skin that’s clean and healthy is less likely to develop problems that could cause dysesthesia. Washing your hands is a good way to prevent the spreading of possible causes of dysesthesia (and other issues, too).
• Avoid known irritants. If you have an allergy to something, try to avoid contact with it. Examples include allergies to types of fabric (like wool) and certain types of cleaning products or additives that go in things you put on your skin like lotions or cosmetics.
• Don’t scratch. Dysesthesia may make you want to scratch, but that can make things worse.
• Avoid excess alcohol intake. That means no more than one drink per day for women and people assigned female at birth, and no more than two drinks per day for men and people assigned male at birth.

When should dysesthesia be treated by a doctor or healthcare provider?

People often first try to treat their symptoms at home. But when dysesthesia lasts for several days or begins interfering with your usual routine and activities, you should talk to a healthcare provider. Long-lasting or moderate-to-severe dysesthesia may be a symptom that something serious is going on.

Dysesthesia vs. paresthesia — what’s the difference?

Paresthesia is the sensation of “pins-and-needles” or tingling that you get when a leg falls asleep. It can also happen with many health conditions and events. Paresthesia is a type of dysesthesia. But it isn’t the only type.

Dysesthesia vs. allodynia — what’s the difference?

Allodynia and dysesthesia have many similarities. But they’re not the same thing.

Allodynia is when you feel pain from touch-based sensations that shouldn’t hurt. An example of allodynia is feeling pain from the touch of fabric or the spray of water from a showerhead or faucet.

The main difference between these two symptoms is that dysesthesia doesn’t have to involve pain. Allodynia, by definition, always involves pain.

Is dysesthesia a symptom of anxiety?

Anxiety can contribute to dysesthesia, but experts still don’t fully understand how or why. Many people with dysesthesia start experiencing it after traumatic or stressful events. But that’s not the case for everyone. More research is necessary to determine how these relate to each other and what can be done to treat one or both when they happen together.

Importantly, many people with dysesthesia develop anxiety related to this set of symptoms. This is especially the case when they have trouble getting a diagnosis or finding a provider who can treat dysesthesia or a condition causing it.

A note from Cleveland Clinic

If you have dysesthesia and have struggled for answers, that experience is much more common than you might realize. But your healthcare provider’s job is to help you, not to accuse or judge you. It may be difficult to find a provider with the knowledge, training and experience to recognize what you’re experiencing. But finding providers like that is possible.

If you or someone you love has dysesthesia, being an advocate — either for yourself or your loved one — can make a major difference. Persistence is a key part of understanding and trying to manage this set of symptoms. Not giving up can make a big difference. It may help you find a way to regain control of your life and keep dysesthesia from interfering with how you want to live.