Dysesthesia

What is dysesthesia?

Dysesthesia is a set of symptoms that revolve around unusual touch-based sensations. It can refer to sensations that are unexpected or feel unpleasant, painful or just strange. You might feel these sensations for an obvious reason or it may be hard to point to a specific cause.

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Dysesthesia can be elusive to diagnose and difficult to treat. If you have it, you may feel anxious or scared when trying to get answers. Many people with it worry that their loved ones or healthcare providers won’t believe them because it’s not a symptom someone else can see. Even worse, many fear they’ll face accusations of faking their symptoms. But this set of symptoms is real, and it can be very disruptive and have severe negative effects on your life.

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Some types of dysesthesia are normal and healthy. An example of normal dysesthesia is feeling an itch or a tickle because something irritates your skin. But this can also be a symptom of a skin or neurological (nervous system-related) condition like nerve pain (neuropathic pain).

How your sense of touch works and how it relates to dysesthesia

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Your tactile (touch) sense starts with nerve receptors throughout your body, most just below the surface of your skin. Those nerve endings are like sensors. They can detect a variety of properties, including:

Texture: Does it feel smooth or rough?
Temperature: Does it feel warm, hot, cool or cold?
Pressure: This is how strongly something presses against your skin.
Proprioception: This is your ability to feel the location of a body part in relation to the rest of your body. Imagine that you’re in a dark room and holding your hand right in front of — but not touching — your face. You can’t see your hand or feel it directly, but you still know it’s there.
Nociception: This is the ability to detect imminent or ongoing damage to your body. An example is the pain one feels with a paper cut. The signals that happen because of it are what your brain processes into feelings of pain.

The nerve receptors send messages to your brain describing what they pick up. Your brain receives those signals and processes those into the sensations you feel.

But your nerve receptors can’t feel certain things. For example, humans don’t have skin hygroreceptors, a type of nerve receptor that detects moisture. That means you can’t actually feel if something is wet. Your brain processes temperature and texture into what you know as the feeling of wetness.

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This ability to process sensations and fill in some of the gaps is generally useful. But it can also cause certain issues. Your brain may process signals from your nerves incorrectly. Your brain can also spontaneously generate dysesthesia sensations without nerve input.

Your brain’s ability “fill in the gaps” may also explain why mental health conditions can contribute to dysesthesia and similar concerns. Anxiety and depression can increase your worries about the cause of dysesthesia. But that doesn’t mean it’s an imaginary or “all-in-your-head” symptom set. These sensations feel every bit as real as they would if there were an obvious cause, but it’s real for a different reason.

What does dysesthesia feel like?

Dysesthesia is a positive sensation. In this context, positive and negative don’t mean good or bad. They’re an answer to the question, “Do you feel that?” A positive sensation is something you can feel. A negative sensation is one you can’t feel as strongly or don’t feel at all. Dysesthesia doesn’t involve negative sensation, so it’s not about numbness or the loss of sensation.

Dysesthesia can cause a wide range of sensations. Most people describe what they feel using the following words:

Biting.
Burning.
Cool/cold.
Crawling.
Electric.
Itching.
Piercing.
Pins-and-needles (the medical term for this, paresthesia, is a type of dysesthesia).
Prickling.
Pulling.
Sharp.
Tickling.
Tingling.
Warm/hot.
Wet.