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That Strange Skin Crawling Sensation Can Have Hidden Causes. Here's What to Do.

An image of a woman looking at and feeling her elbowThe body is a miraculous machine, capable of a lot of amazing things. But when things go wrong, it can also experience a lot of strange symptoms. If you’ve ever experienced a sensation like your skin crawling, then you aren’t imagining it. This is a common sensation that can be associated with several different health issues, including Adrenal Fatigue Syndrome (AFS). So, if you've experienced this peculiar feeling, here’s what you need to know.

What Is Skin Crawling?

First of all, you need to know what the sensation of skin crawling is. Different people often experience or describe these sensations differently. Doctors have called these sensations paresthesia, which describes odd feelings that can include:

  • Tingling
  • Itching
  • Numbness
  • Crawling
  • Tickling

Paresthesia is usually just annoying or uncomfortable but can be painful when it’s caused by certain conditions. The feelings come and go without an apparent cause and can occur throughout the body, though they’re more common in the arms, legs, and face.

If you experience this sensation regularly, then it’s important that you talk to your doctor, no matter how silly you may feel, because it can be a sign of a deeper health problem.

Common Causes of Paresthesia

Damage to or pressure on the peripheral nerves is the most common cause of the skin crawling sensation. These are the nerves found in the arms and legs. At this stage, doctors aren’t entirely certain what causes this kind of damage, though some suspected causes are:

  • Inflammation
  • Injury
  • Chemotherapy drugs
  • Diabetes
  • Vitamin deficiencies

There are also some conditions that are associated with nerve damage and skin crawling sensations.

Hormonal Imbalances

The sensation of skin crawling is quite common in women who have hormonal imbalances. This may be caused by changes in estrogen levels, which is why it’s particularly common during menopause. However, estrogen level fluctuations can occur during any time of life, particularly if you have AFS or other conditions associated with hormonal imbalances.

Chronic Fatigue Syndrome (CFS)

CFS is a mysterious disorder that causes a whole host of unusual symptoms including the sensation of skin crawling. This may be because CFS causes heightened nerve sensibility and exaggerates the pain response in the brain. However, at this stage, there isn’t enough research to support this idea.

When you have CFS, it also causes widespread inflammation throughout the body, which may bring on these sensations.


Fibromyalgia is another condition that can cause skin crawling because it increases nerve sensitivity and the pain response. It’s also associated with low levels of inflammation in the connective tissue, the fascia. This could also bring on paresthesia.

Small Fiber Neuropathy

There are small nerve fibers throughout your skin, organs, arms, and legs. These fibers sense when you're touched and are also linked to the control of your autonomic nervous system. This system regulates your heart rate, body temperature, and breathing.

These small nerve fibers can become damaged in the arms and legs. This is known as peripheral neuropathy and may make you feel as if your skin is crawling. This damage can also extend to the small nerve fibers in the organs and disrupt the autonomic functions, which can be very dangerous. So, make sure you get expert help and a diagnosis if you believe that this may be your issue.

Adrenal Fatigue Syndrome (AFS)

Adrenal fatigue causes several issues that may bring on skin crawling sensations. This stress-related disorder can cause widespread inflammation throughout the body as the adrenal glands break down due to overwork and fatigue and the various circuits in the body become unbalanced.

AFS is caused by the overuse of the NeuroEndoMetabolic (NEM) stress response, which is designed to activate during times of stress to help you cope and survive that stress. It causes the release of cortisol from your adrenal glands, preparing you to fight or run from the cause of the stress, and also makes changes in every organ and system in your body to prepare you for injury or recovery.

The NEM stress response is often overused in the modern world. Psychological, lifestyle, emotional, and mental stresses can be just as damaging as physical stressors, and they’re often ongoing. This can create imbalances throughout your body and fatigue your adrenal glands. And when your NEM stress response is active on an ongoing basis, the circuits are not allowed to return to their pre-stress balance, which causes ongoing and worsening malfunctions. This can be a very dangerous situation, causing a range of symptoms and problems including body-wide, chronic inflammation, which is very damaging.

If you have AFS, this inflammation and other issues may cause damage to nerve fibers and bring on the skin crawling sensation. It may also cause problems with your Neuroaffect circuit that may be more directly linked to paresthesia.

The Neuroaffect Circuit and Nerve Damage

The Neuroaffect circuit can become very unbalanced and unhealthy when you have AFS. It includes the biological aspects of the brain, the autonomic nervous system, and the microbiome, all of which can be connected to the sensation of skin crawling.

When you’re healthy, these three systems work in harmony to perform their regular duties and to help resolve stress. But when you’re unhealthy, the balance between this triad can break down, each of the components declining in health and affecting the health of the other parts and of the system as a whole. In turn, this will also cause additional stress and worsen your AFS symptoms and problems. It may also cause issues that are directly related to paresthesia including the following.

Autonomic Nervous System (ANS) Disruptions

An image of an adrenal gland highlighting an example of cortisolWhen you’re under stress, your body will produce more cortisol, which also increases epinephrine levels. This Neurotransmitter (NT) is responsible for keeping you awake and alert, and it’s essential in stressful situations. However, if you’re always stressed, NT and cortisol levels will remain unnaturally high, causing disruptions and problems with the autonomic nervous system.

Because nerve fibers are so strongly connected to the ANS, this could cause damage to the delicate fibers, resulting in unusual sensations in different parts of the body.

Brain Imbalances

Imbalances in the brain are also very common when you have AFS. This can cause NT imbalances or hormonal imbalances, both of which can bring on the feeling that your skin is crawling. It may also cause issues with the pain centers of your brain, making you more sensitive to the signals from your body. This may result in greater sensitivity to the feeling that your skin is crawling or even sensations of pain when it occurs.

Microbiome Imbalances

You might think that the bacterial balance in your body has nothing to do with your nerves, but you’d be wrong. The balance of bacteria in your gut is strongly linked to your brain through the vagus nerve. As the bad bacteria start to overwhelm the good bacteria in your gut, its health will decline, and your brain health will follow suit. This can bring on all sorts of problems including neurodegeneration, where the neurons in your brain start to degrade and die. This could cause changes in the pain centers of your brain, bringing on the sensation that your skin is crawling.

The gut is also strongly connected to the amount of inflammation in your body. When your gut is unhealthy, inflammation can run rampant and become dangerous, damaging cells throughout your body. This includes nerve cells, which may bring on the skin crawling sensation.

Addressing the Skin Crawling Sensation

If you experience the skin crawling sensation regularly, then it’s important that you see your doctor to identify any underlying causes or problems. Addressing any underlying problems is the best way to reduce or eliminate the strange crawling sensation. Also, because this sensation can be linked to some serious health threats, you need to find out what’s causing the feeling and work out what can be done about it.

Once your doctor has identified a potential cause, they probably won’t address these symptoms directly as long as they aren’t painful. If you do experience painful skin crawling, then talk to your doctor about a referral to an expert neurologist or rheumatologist. They will have the most experience in dealing with these symptoms and can offer certain medications that may help.

The Takeaway

The sensation of your skin crawling can be quite disconcerting. But it’s also a warning sign that there might be something deeper going on with your body. Whether you have AFS or other related conditions, you need to take it seriously if you experience it regularly. Here’s what you should do:

  1. An image of an older woman talking to her doctorTalk to your doctor to determine if there are any underlying health issues that may be causing the sensations.
  2. Evaluate your stress levels to determine if they’re a factor.
  3. Consider taking medications if the sensations are severe or painful.

For more information on this or other unusual symptoms, our team at Dr. Lam can help. You can contact us through our Ask the Doctor system here or call us on +1 (626) 571-1234.

© Copyright 2021 Michael Lam, M.D. All Rights Reserved.

Dr. Lam's Key Question

It isn’t unusual to feel the sensation of your skin crawling. If it occurs regularly, however, then it might be a sign that something deeper is going on with your body, so make sure you pay attention and get it checked out.

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