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Feeling bugs under the skin, or sores from picking

Also called: Formication, delusional parasitosis, crawling skin

Feeling like bugs are crawling under your skin can come from dry skin, nerve problems, alcohol or drug withdrawal, stimulant use, or some medicines. When someone strongly believes they're infested despite no bugs being found, it may be a condition called delusional infestation. Picking at the skin can cause sores and infections, so a checkup helps.

Common causesDry skin, nerve problems, stimulants, withdrawal, medicines
Usually serious?Can be
Get checked ifIt lasts, causes sores, or affects daily life
If you think it's an emergency, call 911.Thinking about suicide? Call or text 988.

Overview

The sensation of insects crawling on or under the skin is called formication. It's common with menopause, dry skin, diabetes nerve damage, and use of or withdrawal from alcohol, methamphetamine, cocaine, and some medicines.

In delusional infestation, the belief in bugs persists even after tests find none, and people may bring samples and pick their skin. It's a real condition, and treatment can help.

When to get medical care

Call 911Seeing or hearing things others don't with confusion, shaking, or seizures, especially after stopping alcohol. Thoughts of harming yourself or others: call or text 988, or call 911 if you're in danger.
Get care todayInfected sores: redness, warmth, pus, or fever. Crawling feelings with confusion or after stopping alcohol or drugs.
See a doctor soonCrawling sensations lasting weeks. Sores from picking. A strong belief in infestation others can't confirm.

Causes

Causes include dry skin, menopause, nerve damage (diabetes, B12 deficiency), scabies or lice (which can be found), stimulant use, alcohol withdrawal, some medicines, delusional infestation, and other mental health conditions.

OwieClear has pages on 2 conditions that can cause feeling bugs under the skin, or sores from picking. Each shows how soon to get care.

Common causes

  • Stimulant use (meth or cocaine)See a doctor if it doesn't get better

    Regular use of meth, cocaine, or other stimulants can cause severe tooth decay and dry mouth, picking sores from feeling bugs under the skin, weight loss, days…

Less likely causes

What you can do at home

  • Moisturize dry skin.
  • Keep nails short and cover sores.
  • Wash sores gently with soap and water.
  • Avoid stimulants and alcohol.

Medicines

Treatment depends on the cause: treating scabies, dry skin, or nerve problems, or medicines that help delusional infestation, along with care for skin sores.

At the doctor

The provider will look for skin, nerve, or other causes.

Questions you may be asked

  • When it started
  • Samples or bugs found
  • Alcohol, drugs, and medicines
  • Others with symptoms

The exam

A skin exam.

Tests

  • Skin scraping
  • Blood tests for nerve and thyroid problems
  • Drug screening if needed

Prevention

Early care helps.

  • Moisturize
  • Avoid stimulants
  • Get help early

Check your symptoms

Most symptoms have more than one possible cause. The symptom checker looks at all of your symptoms together, plus your age, and shows how soon to get care.

Start the symptom checker

Sources

Last updated 2026-11-13.