Can fibromyalgia cause itching all over? Yes, it absolutely can. It’s not one of the fibromyalgia symptoms we hear about very often, but it’s one that can drive you crazy if you have it.
Fibromyalgia itching, also called pruritus, is actually more common than most people realize. According to a 2016 Turkish study, “We found pruritus as a symptom in 69.5% of the FMS patients in our study.”
It should be noted that a 2014 Mayo Clinic study only reported finding itching as symptom in 3.3% of fibromyalgia patients. However, that study did not talk to or even survey FM patients. Instead, it simply reviewed the charts of 845 patients with a fibromyalgia diagnosis to determine common dermatologic manifestations. Since itching is not one of the primary fibromyalgia symptoms most people see their doctor about or even mention during a regular visit, the results are not surprising. I suspect if the patients had been asked specifically about itching, the final tally would have resulted in a much higher percentage.
Despite the fact that we don’t hear a lot about fibromyalgia itching, you might be surprised to learn that itching is actually one in a very long list of possible “general” fibromyalgia symptoms included in the 2010 Fibromyalgia Diagnostic Criteria proposed by the American College of Rheumatology.
What Causes Fibromyalgia Itching?
A single cause for the itching many fibromyalgia patients experience has yet to be identified. There are, however, a few possibilities:
• Hypersensitivity (central sensitization) – It is well known that fibromyalgia causes a sensitization of the central nervous system, resulting in a hypersensitivity to pain. In addition to being hypersensitive to pain, most fibromyalgia patients find themselves to be hypersensitive to other stimuli as well, such as smells, noise, light, chemicals, and even foods. (Hence the large number of people with fibromyalgia who suffer with a variety of allergies.) It’s possible that hyperactive nerve fibers could be causing an itching sensation in some fibromyalgia patients.
• Serotonin – A 2014 study, published in the journal Neuron, found that abnormal levels of the neurotransmitter serotonin caused mice to itch. They also discovered that the release of serotonin in response to pain activates receptors that cause itchiness. Therefore, when the body releases serotonin in response to fibromyalgia pain, it could be activating receptors that result in itching.
• Medication side effects – Unfortunately, many of the medications most frequently used to treat fibromyalgia have itching as a common side effect. Some of those medications include:
- All three FDA-approved medications for fibromyalgia treatment: Lyrica (pregabalin), Cymbalta (duloxetine) and Savella (milnacipran).
- OTC pain relievers like ibuprofen, naproxen sodium and sometimes even acetaminophen.
- Tramadol and other opioid pain relievers.
How to Make the Itching Stop
Regardless what’s causing the itching, all you really want is to make it stop. If you think your itching may be caused by one of the possibilities discussed above, here are some suggestions to talk to your doctor about:
- If hypersensitivity and activated nerve fibers are the problem, an anti-seizure drug like gabapentin or pregabalin may be helpful. However, keep in mind that pregabalin does have itching as a possible side effect.
- If you think abnormal serotonin levels are causing your problem, a selective serotonin reuptake inhibitor (SSRI) may help. Some commonly prescribed SSRIs include fluoxetine (Prozac), sertraline (Zoloft) paroxetine (Paxil), escitalopram (Lexapro), fluvoxamine (Luvox) and citalopram (Celexa).
- If you’re taking one of the drugs for which itching is a common side effect, the obvious solution would be to stop taking it. But if the medication is helping to improve your other fibromyalgia symptoms, that may not be a trade-off you’re willing to make. Warning: if you’re taking one of the three FDA-approved drugs for fibromyalgia, tramadol or another opioid, DO NOT suddenly stop taking it. Abrupt discontinuation of these medications can result in severe withdrawal symptoms. If you want to quit taking any of those drugs, talk to your doctor first and work out a plan to gradually taper off.
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OTC Medications and Natural Remedies for Itching
Additionally there are a number of OTC medications and natural remedies that can help reduce and even eliminate itching.
- Antihistamines – OTC antihistamines like Benadryl, Claritan and Zyrtec can often help relieve itching.
- Anti-itch creams – Topical anti-itch creams or lotions containing at least 1% hydrocortisone, calamine or capsaicin are often recommended. Personally I’ve found Florazone cream, a homeopathic anti-itch cream, to be even more effective at relieving itching.
- Oatmeal bath – Grind plain, unflavored oatmeal into a powder or purchase colloidal oatmeal, and add one cup to lukewarm bath water. Make sure the oatmeal is mixed in well, then soak in the tub for 15 or 20 minutes.
- Ice packs – Since scratching can make itching worse, sometimes temporarily numbing the area that itches can ease the itch and help break the vicious scratch/itch cycle.
- Leaf gels and oils – Aloe vera gel or diluted peppermint essential oil may help bring some cooling itch relief.
Preventing Fibromyalgia Itching
In addition to treating the itch once it begins, there are some preventive measures you can take to help minimize the changes of it starting at all.
- Drink lots of water to keep your skin well-hydrated. Dry skin is more likely to be itchy.
- Avoid taking steaming hot baths or showers as they will dry out your skin and make the itching worse.
- Use only unscented skin care products and detergents to prevent skin irritations and sensitivities.
- Moisturize your skin at least once a day with an unscented lotion or a natural oil like coconut, argon or jojoba.
When Itching Becomes a Serious Problem
If you are experiencing extreme itching to the point that it interferes with your sleep or causes you to scratch so hard that your skin bleeds and/or becomes infected, it’s important to discuss it with your doctor.
Karen Lee Richards is ProHealth’s Editor-in-Chief. A fibromyalgia patient herself, she co-founded the nonprofit organization now known as the National Fibromyalgia Association (NFA) in 1997 and served as its vice-president for eight years. She was also the executive editor of Fibromyalgia AWARE magazine. After leaving the NFA, Karen served as the Guide to Fibromyalgia and Chronic Fatigue Syndrome for the New York Times website About.com, then worked for eight years as the Chronic Pain Health Guide for The HealthCentral Network before coming to ProHealth. To learn more about Karen, see “Meet Karen Lee Richards.”
Erdogan HK, Sas S, Acer E, Bulur I, Altunay IK, Erdem HR. Cutaneous findings in fibromyalgia syndrome and their effect on quality of life. Dermatologica Sinica. 2016 September;34(3):131-134. https://www.sciencedirect.com/science/article/pii/S1027811716000070
Laniosz V, Wetter DA, Godar DA. Dermatologic manifestations of fibromyalgia. Clin Rheumatol. 2014 Jul;33(7):1009-13. doi: 10.1007/s10067-014-2488-3.
Wolfe F, Clauw DJ, Fitzcharles MA, et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res (Hoboken). 2010 May;62(5):600-10. doi: 10.1002/acr.20140.
Zhao ZQ, Liu XY, Jeffry J, et al. Descending control of itch transmission by the serotonergic system via 5-HT1A-facilitated GRP-GRPR signaling. Neuron. 2014 Nov 19;84(4):821-34. doi: 10.1016/j.neuron.2014.10.003.