What is the cause of formication (a sensation of ants crawling on the skin)?

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Last updated: March 5, 2025View editorial policy

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From the Research

Formication is a complex symptom that can be caused by various conditions, including peripheral neuropathy, substance withdrawal, certain medications, and psychiatric disorders, and its management should focus on addressing the underlying cause rather than just the symptom, as evidenced by the most recent study 1. The sensation of formication can be described as feeling like ants or other small insects moving across the skin's surface, and it is often associated with other symptoms such as numbness, tingling, or pain. Some of the possible causes of formication include:

  • Substance withdrawal, particularly from alcohol, cocaine, or methamphetamine
  • Certain medications, such as those used to treat depression or anxiety
  • Peripheral neuropathy, which can be caused by diabetes, vitamin deficiencies, or other conditions
  • Psychiatric disorders, such as anxiety or depression
  • Diabetic neuropathy, which can cause nerve damage and lead to formication
  • Parkinson's disease, which can cause nerve damage and lead to formication
  • Multiple sclerosis, which can cause nerve damage and lead to formication Treatment for formication typically focuses on addressing the underlying cause of the symptom, rather than just the symptom itself. For example:
  • For medication-induced formication, adjusting or changing medications under medical supervision may help
  • For substance withdrawal, medical detoxification programs are recommended
  • Symptomatic relief may include topical treatments like menthol creams or capsaicin, antihistamines for itching, or in some cases, antipsychotic medications if the sensation is causing significant distress
  • Cognitive behavioral therapy can help patients manage their response to these sensations It's essential to seek medical evaluation for persistent formication, as it may indicate an underlying condition requiring specific treatment, as highlighted in the study 1, which emphasizes the importance of early diagnosis and treatment of perineural spread of head and neck cutaneous squamous cell carcinoma, a condition that can cause formication.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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