Paresthesia

What is it?

Paresthesia refers to abnormal skin sensations that occur without any external cause, commonly described as tingling, "pins and needles," numbness, prickling, or feeling like insects crawling on the skin. These sensations result from nerve irritation or damage anywhere along the pathway from the skin to the brain. While everyone occasionally experiences temporary paresthesia (like when a foot "falls asleep"), persistent paresthesia may indicate an underlying nerve or spine problem.

What does it look like?

Paresthesia itself is invisible, but you may notice:

• Areas of darker skin (hyperpigmentation) from chronic rubbing or scratching
• Scratch marks in areas where tingling causes an urge to scratch
• Dry, thickened skin patches in chronically affected areas
• No visible changes in many cases - the sensation occurs in normal-appearing skin
• Possible muscle wasting if severe nerve damage is present

Where does it appear?

Common locations for paresthesia include:

• Back: Between the shoulder blades (notalgia paresthetica) - often one-sided
• Arms: Outer forearms (brachioradial pruritus) or hands and fingers
• Face: Along the path of facial nerves, especially after shingles
• Legs and feet: Often from diabetes or lower back problems
• Scalp: Tingling or crawling sensations, sometimes with hair loss concerns

Associated features

Paresthesia often occurs with:

• Itching that doesn't improve with scratching
• Burning or stinging sensations
• Numbness or reduced sensation in the same area
• Pain that may be sharp, shooting, or electric-like
• Sensitivity to temperature changes
• Symptoms that worsen with certain positions or movements

When to see a doctor

Seek medical attention for:

• Paresthesia lasting more than a few days
• Symptoms that progressively worsen or spread
• Weakness or difficulty moving the affected area
• Paresthesia following an injury or trauma
• Symptoms affecting both sides of your body
• Associated back or neck pain
• Signs of skin infection from scratching