[53M] Experiencing generalized formication

Patient Description

A 53-year-old male reports a persistent sensation of bugs crawling and biting over his skin, which has been ongoing for more than two years. The sensation is generalized and does not seem to be alleviated by any measures. Additionally, the patient has noted dry skin, hand numbness, and a general feeling of weakness. There are no specific triggers that worsen the formication, and no severe acute neurological or systemic symptoms such as sudden onset of severe pain, confusion, difficulty breathing, or loss of consciousness have been reported.

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Arora's Assessment

What might be happening

Based on your symptoms, here are a few possible conditions:

  • Neuropathy: This is a condition that affects the nerves, causing symptoms such as numbness, weakness, and the sensation of crawling or biting insects. It can be caused by a variety of factors, including diabetes, alcohol abuse, and certain medications.

    • Treatment typically involves managing the underlying condition and may include medications to control symptoms.
  • Delusional Parasitosis: This is a condition where a person has a persistent belief that they are infested with parasites, despite there being no evidence of an infestation. It can be caused by a variety of factors, including mental health conditions, substance abuse, and certain medications.

    • Treatment typically involves therapy and may include medications to control symptoms.
  • Post-Acute Sequelae of SARS-CoV-2 infection (PASC): Also known as Long COVID, this is a condition where symptoms persist for weeks or months following the resolution of acute COVID-19. Symptoms can include fatigue, difficulty thinking or concentrating, and changes in skin sensation.

    • Treatment typically involves symptom management and rehabilitation.

What you can do

Given the duration and impact of your symptoms, it's important to seek medical attention. A healthcare provider can perform a thorough evaluation and order appropriate tests. In the meantime, here are some things you can do:

  1. Keep a symptom diary: Document when your symptoms occur, what you're doing when they happen, and any potential triggers. This can help your healthcare provider identify patterns and potential causes.
  2. Stay hydrated and maintain a balanced diet: Good nutrition can support overall health and may help manage your symptoms.
  3. Practice good skin care: Keep your skin clean and moisturized to help manage dryness.

What you should look out for

Please seek immediate medical attention if you experience:

  • A sudden increase in the severity of your symptoms
  • New symptoms such as severe headache, chest pain, difficulty breathing, or confusion
  • Symptoms that interfere with your ability to eat, sleep, or perform daily activities

Remember, while I strive to provide accurate information, I'm not a doctor. Always consult with a healthcare provider for a formal diagnosis and treatment.

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1 yr ago

People Also Ask


What is formication and what causes it?

Formication is the sensation of insects crawling on or under the skin. It can be caused by various conditions, including neuropathy, mental health disorders, substance abuse, and certain medications.


How is neuropathy diagnosed and treated?

Neuropathy is diagnosed through a combination of medical history, physical examination, and tests such as nerve conduction studies or blood tests. Treatment focuses on managing the underlying cause and may include medications to relieve symptoms, physical therapy, and lifestyle changes.


What are the symptoms and treatment options for delusional parasitosis?

Delusional parasitosis is a psychiatric condition where a person believes they are infested with parasites despite no evidence. Treatment typically involves therapy and may include antipsychotic medications to help manage symptoms.


What is Long COVID and how can it affect the skin?

Long COVID, or Post-Acute Sequelae of SARS-CoV-2 infection, is a condition where symptoms persist after recovering from COVID-19. It can cause a variety of symptoms, including changes in skin sensation, fatigue, and cognitive difficulties. Treatment focuses on symptom management and rehabilitation.


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