Good evening doctor, for the past few days, I've been feeling like something is crawling under my skin, almost like bugs or insects. It happens throughout the day, but especially at night, and it wakes me up. Im really scared and cant sleep because of it, but I cant see anything on my skin. Could you help me understand what might be going on and how to fix this?

The sensation you're describing, feeling like something is crawling on your skin from the inside, is known as formication. This can be a distressing and disruptive symptom.Possible Causes:1. Anxiety or stress: High levels of anxiety or stress can cause formication.2. Neurological conditions: Certain conditions like multiple sclerosis, Parkinson's disease, or peripheral neuropathy can cause formication.3. Skin conditions: Conditions like eczema, psoriasis, or dermatitis can cause formication.4. Nutritional deficiencies: Deficiencies in vitamins like B12 or magnesium can cause formication.5. Medication side effects: Certain medications, such as antidepressants or antihistamines, can cause formication as a side effect.What to Do:1. Consult a doctor: Schedule an appointment with your primary care physician or a dermatologist to rule out any underlying medical conditions.2. Keep a symptom journal: Track when the sensations occur, how long they last, and any potential triggers.3. Practice stress-reducing techniques: Engage in activities like meditation, deep breathing, or yoga to help manage stress and anxiety.4. Get enough sleep: Establish a consistent sleep schedule and create a relaxing bedtime routine to improve sleep quality.5. Avoid stimulants: Reduce or avoid consumption of caffeine, nicotine, and other stimulants that can exacerbate anxiety and formication.Additional Tips:1. Keep your skin moisturized: Use gentle, fragrance-free moisturizers to keep your skin hydrated and comfortable.2. Avoid scratching: Try to resist the urge to scratch, as this can further irritate your skin and worsen the sensation.3. Consider cognitive-behavioral therapy (CBT): A therapist can help you address underlying anxiety or stress contributing to your formication.