Formication (Tactile Hallucinations)

Formication is a form of tactile hallucination. Tactile means the sense of touch. Hallucination means experiencing something that isn't really there. This can be upsetting and frustrating. Formication may be linked to:

• Mental health conditions, such as anxiety, depression, bipolar disorder, obsessive-compulsive disorder, or schizophrenia.
• Neurological conditions, such as stroke, dementia, encephalitis, meningitis, or Parkinson disease.
• Substance use or withdrawal. This includes methamphetamine use, alcohol withdrawal, and acute cocaine use (known as cocaine bugs).
• Use of certain medicines or withdrawal of some medicines.
• Medical conditions, like vitamin deficiencies or anemia.

People who have formication report a feeling that insects are crawling on or under the skin when there are none present. It may be described as crawling, itching, tingling, or prickly. It causes a strong urge to scratch the skin. This can often lead to skin damage or infection.

Treatment depends on the cause. This may include:

• Treating the medical condition that may be causing the tactile hallucinations.
• Stopping or changing prescribed medicines. These may include antipsychotics or antidepressants, or a change in medicines.
• Stopping illegal drugs, if substance use is the cause.
• Substance use treatment. If formication is related to substance abuse or withdrawal, professional treatment can help.
• Cognitive behavioral therapy if formication is caused by a mental health issue. Talk to a therapist or counselor to help you change negative thought patterns and behaviors to help cope with this condition.

It's important to try to avoid scratching. To do this:

• Try gently massaging or tapping the area instead.
• Consider wearing a light compression garment over the affected area. This can provide a constant, gentle pressure.
• Keep your skin clean and moisturized using gentle unscented soaps and lotions. Use warm, not hot, water.
• Keep your nails short to reduce skin damage.
• Use distraction to manage symptoms. Read, listen to music, or watch a movie to take your mind off it.

Make lifestyle changes including stress management, good sleep hygiene, eating healthy, and other efforts to reduce stress and improve your overall well-being.

Call 911 if any of these occur:

• Sudden new problems with:
  • Speech
  • Confusion
  • Vision
  • Walking
  • Coordination
  • Facial droop
  • Weakness or numbness on one side of your body
• Severe headache, fainting spell, dizziness, or seizure
• Chest pain or shortness of breath

Call your doctor right away if any of these occur:

• Your symptoms get worse
• Your skin becomes damaged or infected
• You feel anxious or depressed because of your symptoms

Formication can be a sign of an underlying problem. So you may need testing to rule out causes.

Call 988 if you have thoughts of harming yourself or others. When you call or text 988, you will be connected to trained crisis counselors. An online chat option is also available. 988 Suicide & Crisis Lifeline is free and available 24/7.

Call 988 if you:

• Have suicidal thoughts, a suicide plan, and a way to carry out the plan.
• Have serious thoughts of hurting someone else.
• Have serious emotional distress.