Do you ever feel like there are ants or other tiny insects crawling all over your skin? Does this feeling freak you out? Do you think you’re going crazy? Well, you’re not crazy. Some women in perimenopause and menopause report having crawling sensations. Here’s what we know about this symptom and what you can do about it.

What are crawling sensations?

The scientific name for crawling sensations on, in, or under the skin is formication or tactile hallucinations. It is one of several types of altered skin sensations, such as pins and needles, itchy skin, burning feeling on the hands and feet, and loss of skin sensation. 

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Specific areas in the brain work together to process signals from your sense of touch. When formication occurs, those areas of the brain act like they are processing signals even though no signals are being sent. Since the brain is acting like signals are being sent to it, the crawling sensations feel real even though they are not happening. The feeling can cause you to scratch or pick at your skin.

In addition to perimenopause and menopause, other possible causes of formication include substance use or withdrawal from them (e.g., amphetamines, antidepressants, anti-seizure medications, antibiotics, antifungals), anxiety disorders, obsessive-compulsive disorder, concussions, migraines, bipolar disorder, thyroid conditions, anemia, stroke, multiple sclerosis, and deficiency of folate or vitamin B12.

How are crawling sensations associated with menopause?

For women in perimenopause and menopause, crawling sensations can be linked to hormone imbalances, especially the decline in estrogen levels. Although the exact cause is uncertain, it’s been suggested that the crawling sensations are linked to changes in how the nerves send signals or alterations in blood circulation. 

The feeling that insects are crawling on your skin may also be accompanied by itchy or dry skin. One reason for these accompanying symptoms is that collagen levels decline in the skin in perimenopause and menopause. This causes the skin to be less hydrated and drier.

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How can you manage crawling sensations naturally?

You can make some lifestyle changes and use various natural remedies that may help relieve the crawling sensations. Here are some tips to consider.

• Keep moving. Regular exercise supports and promotes healthy blood circulation, which can help stabilize blood flow. Try a variety of physical activities, such as pilates, stretching, yoga, walking, strength training, and swimming.
• Don’t smoke. Smoking inhibits blood circulation.
• Practice deep breathing. Healthy respiration supports nerve health. Try deep breathing exercises several times a day. One example is boxed breathing: Inhale through your nose to a count of four, hold the breath for four, release through your mouth for four, and rest for four. Repeat this sequence four to six times each session. Box breathing is also good for relieving stress.
• Get enough Bs. The B vitamins are especially supportive of nervous system health. The ones that can be most helpful are vitamin B1 (thiamine), B6 (pyridoxine), and B12 (cobalamin). Review your diet, and if you are not getting enough B vitamins, consider a high-quality B complex supplement.
• Review your diet. Optimal nutrition is essential to support a healthy nervous system. Fresh fruits and vegetables, seeds and nuts, complex carbs from root vegetables, whole grains, and beans, healthy fats, and organic protein are recommended.
• Get your Zzzzzzs. Aim for eight hours of quality sleep every night. Sleep problems are common in menopause, so be sure to check out our sleeping tips for help in this area. 
• Get a massage. Massage can be helpful in improving circulation. If your skin is dry, use gentle, natural massage lotions such as shea butter or coconut or almond oils. 

When to contact your doctor

Experiencing crawling sensations associated with perimenopause and menopause typically doesn’t require a doctor’s care. However, if you believe there may be other causes for formication, contact your doctor as soon as possible. 

Bottom line

Crawling sensations in perimenopause and menopause are associated with declining estrogen levels. They are not common, but if they do occur, don’t panic. Try to manage them naturally and seek medical attention if they persist or seem to be associated with another cause.