It might seem like fibromyalgia pain extends to your skin, making it ultrasensitive to the slightest touch. Try these If you have fibromyalgia, you may know exactly what it means to not feel comfortable in your own skin. Fibromyalgia pain seems to be intimately connected to your skin.”The pain and discomfort felt in the skin are probably part of the pain ‘disregulation’ of fibromyalgia,” explains fibromyalgia researcher Benjamin Natelson, MD. He notes that people with fibromyalgia seem to process sensations differently than other people. For example, “if I were to prick your finger five times with a pin, after the first few you wouldn’t feel it anymore,” he says. “Your body would become accustomed to it, but fibromyalgia patients continue to feel it intensely.”
Dermatologists are equally challenged by the connection between fibromyalgia pain and skin care, in part because people with fibromyalgia may also have chronic skin conditions, such as rosacea.
“The relationship between fibromyalgia and skin conditions is not well-understood,” says David E. Geist, MD, a dermatologist at the University of Massachusetts Memorial Medical Center in Worcester. “Fibromyalgia syndrome may involve dysfunctional [nerve] signaling leading to pain.”
Basically, we itch because our nerves — and, in fact, our entire nervous systems — aren’t normal. Many of us with these conditions have a symptom called paresthesia, which is abnormal nerve sensation. That’s also why we get pin pricks, burning, tingling, numbness, etc. It’s usually caused by neuropathy, which means damaged nerves.
For a long time, researchers were perplexed by this, because it didn’t appear that we actually had damaged nerves. Now, however, there’s some evidence that we do.
There’s something else to consider, though: narcotic painkillers, such as hydrocodone and oxycodone. Itchiness is a known side effect of these medications, so if you take them for pain, be aware that they could be the cause of your itch.
Dr. Geist points out that although there are no hard data showing a higher prevalence of skin disorders in people with fibromyalgia, there may be some overlap in these conditions. Areas of consideration include:
- Nerve-based conditions. Fibromyalgia seems to have its roots in an unusual response to pain, probably because of atypical nerve signaling. “Urticaria (hives), dermatographism, and notalgia paresthetica (itchy areas on the back) may have underlying neural causes” as well, says Geist. Researchers from the University of Parma in Italy looked at 126 people with chronic hives and found that a surprisingly high proportion – 70 percent – also had fibromyalgia, a link they theorize may be due to nerve dysfunction.
- Overlapping diagnoses. “Studies have shown that female psoriasis and lupuspatients may more frequently meet the diagnostic criteria for fibromyalgia,” Geist notes.
- Chronic inflammation. When researchers tested skin samples from 63 people living with fibromyalgia and compared them with samples from 49 people who did not have the condition, they found elevated levels of inflammatory markers in the skin of those with fibromyalgia. Their report, published in Clinical Rheumatology, suggests that inflammation could explain why people with fibromyalgia report such sensitive skin.
- Patient profile. Many people with fibromyalgia also have rosacea, but there’s no evidence directly linking the two, says Geist. Since rosacea and fibromyalgia are each most prevalent in women 30 to 50 years old, their coexistence seems more related to patient profile than to a physiologic connection.
Though everyone could benefit from a pampering, healthy skin care routine, when you have fibromyalgia pain, a little extra tender loving care just makes sense. “For fibromyalgia patients, the best approach is to use good skin practices,” Geist advises. He offers these suggestions:
“Avoid excessive sun exposure and sunburns, which can be that much more painful in fibromyalgia patients,” he says. Always wear sunscreen with a minimum of SPF 30, and try to stay out of the sun between 10 a.m. and 4 p.m., when the sun’s rays are most direct.
Use cleansers designed for sensitive skin and avoid abrasive scrubs.
Hot water – even if it feels good at times – is actually very harsh and drying to the skin. “Bathe in lukewarm water and apply minimal soap with a soft cloth only to those areas that get dirty,” advises Geist. You don’t need to scrub every inch of skin every day. Pat dry after a bath or shower instead of rubbing.
“Use moisturizers right after bathing, when you are still damp, in order to trap moisture in the skin,” says Geist. Go fragrance-free if you really want to avoid all possible irritants.
Minimize your use of cosmetic products if your skin feels irritated. Geist suggests picking products that work well but don’t contain too many harsh ingredients.
Ongoing pain, rash, irritation, and changes in your skin all call for a trip to the dermatologist. Just as you work with your fibromyalgia doctor to manage pain and other fibromyalgia symptoms, talk with a dermatologist if you’re concerned about a skin condition in addition to fibromyalgia.