For the last 15 years, Ive been experiencing this intense sensation, like numerous needles poking out of my skin, especially in the winter. It happens when Im outside in the sun or doing any physical activity, and it gets so bad that the only way I can stop it is by scratching or cooling down my body. Ive noticed that red patches appear where the sensation happens. Over time, its gotten worse, and now even a short time outside causes it to flare up. Its really affecting my day-to-day life and work, and Im struggling to cope. I try to bathe with cold water to reduce it, but Im looking for a more permanent solution. What could be causing this, and what treatment options do you recommend?

I understand that you're experiencing a distressing and debilitating sensation, often referred to as "pins and needles" or paresthesia. This sensation can be intense and disrupt daily life.Potential CausesConsidering your symptoms, here are some potential causes:1. Cholinergic Urticaria: A skin condition characterized by hives, itching, and a burning sensation, often triggered by heat, stress, or physical activity.2. Solar Urticaria: A rare condition where exposure to sunlight triggers an allergic reaction, leading to hives, itching, and redness.3. Heat Urticaria: A condition where heat triggers an allergic reaction, leading to hives, itching, and redness.4. Dry Skin: Dry skin can cause itching, irritation, and a prickling sensation, especially in cold weather.5. Nerve Disorders: Certain nerve disorders, such as neuropathy, can cause paresthesia, numbness, or tingling sensations.Recommended StepsTo better understand and address your condition:1. Consult a Dermatologist: Schedule an appointment with a dermatologist to discuss your symptoms and undergo a thorough examination.