Morgellons disease

• ANATOMY OR SYSTEM AFFECTED: Psychic-emotional system, skin
• CAUSES: Unknown; under investigation
• SYMPTOMS: Insectlike skin sensations of stinging, persisting itching, biting, pricking, burning, and crawling; minor to disfiguring skin lesions; disabling fatigue; joint pain; psychosomatic and neurological symptoms
• DURATION: Chronic
• TREATMENTS: Symptomatic and supportive skin care, antipsychotic medications

DEFINITION: A skin disorder characterized by a pattern of dermatologic symptoms described as insectlike sensations, with skin lesions varying from very minor to disfiguring, and associated with disabling fatigue, joint pain, and various neuropsychiatric symptoms

Causes and Symptoms

Morgellons disease is a pattern of dermatologic symptoms first described several centuries ago. Patients typically complain of insectlike sensations, such as persisting itching, stinging, biting, pricking, burning, and crawling. They often have skin lesions that can vary from very minor to disfiguring. Some patients, however, have no visible changes in the skin. In some cases, fiberlike material can be obtained from skin lesions; patients describe this material as “fibers,” “fiber balls,” and “fuzz balls.” In other cases, “granules” can be removed from the skin, described by the patients as “seeds,” “eggs,” and “sands.” The majority of patients report disabling fatigue, reduced capacity to exercise, joint pain, and sleep disturbances. Additional symptoms may include hair loss, neurological symptoms, weight gain, recurrent fever, orthostatic intolerance, tachycardia, decline in vision, memory loss, and endocrine abnormalities (such as type 2 diabetes, Hashimoto’s thyroiditis, hyperparathyroidism, or adrenal hypofunction).

The disease may occur at any age and has a large geographic distribution. It occurs in both males and females. Cases of older women living alone seem to be reported more frequently. Physical stress was reported to be a common precursor. Rural residence and exposure to unhygienic conditions (contact with soil or waste products) are often described. Results from routine laboratory tests are often variable and inconsistent.

The vast majority of these patients have been diagnosed with psychosomatic illness. Prior psychiatric diagnosis (such as bipolar disorder, paranoia, schizophrenia, depression, and substance use disorder) has been recorded in more than 50 percent of patients. Patients are obsessively focused on the skin symptoms in terms of complaints and measures to eradicate the disease and prevent contagion. They usually seek help from between ten and forty physicians and complain of not being understood or taken seriously. Usually, patients are intensely anxious and not open to the idea that they may have a psychological or neurological pathology. They often experience extreme frustration.

Morgellons disease has also been reported in association with conditions that are characterized by itching, such as renal disease, malignant lymphoma, or hepatic disease.

The etiology of Morgellons disease remains under investigation. So far, no examinations, biopsies, and tests have been able to provide evidence supporting any possible cause. Skin biopsies from patients with Morgellons disease typically reveal nonspecific pathology or inflammatory process/reaction with no observable pathogen. In a 2012 study by the US Centers for Disease Control and Prevention (CDC), researchers found no evidence that Morgellons is caused by either an environmental substance or an infectious agent.

Treatment and Therapy

The management of patients with Morgellons disease may include skin care, such as baths, topical ointments, and emollients. It is essential for the treating physician (typically a dermatologist) to refer the patient to a psychiatrist or to prescribe suitable psychoactive medication. Long-term treatment with low-dose antipsychotics (0.5 to 2 milligrams once daily), including pimozid, aripiprazole, and risperidone, has been suggested. Patients should be convinced that the medication may be needed for months or years.

Perspective and Prospects

Morgellons disease was initially described in France in 1674 by Sir Thomas Browne. “The Morgellons” was the term used to describe dermal complaints such as hairlike extrusions and sensations of movement beneath the skin reported by children. By the early seventeenth century, this condition was thought to be caused by the parasite Dranculus (later called Dracontia), and the suggested treatment consisted of filament removal from the skin. Michel Ettmuller produced the only known drawing dating from 1682 of “The Morgellons,” the objects associated with what was then believed to be a parasitic infestation in children.

The name “Morgellons disease” was created in 2002 to describe patients presenting with this clinical set of symptoms and to provide an alternative to “delusion of parasitosis.” There is still a discussion whether Morgellons disease is very similar, if not identical, to “delusion of parasitosis.” Research about Morgellons is sparse and limited. General practitioners, mental health professionals, and the general public need to be aware of the signs and symptoms of this condition. Some authors suggest the term “syndrome” instead of “disease.”

Bibliography

Bewley, Anthony, et al. Practical Psychodermatology. Wiley, 2014.

Cutlip, Hunter A., et al. "Morgellons Disease Treated as a Psychosomatic Condition." Cureus, 23 May 2022, vol. 14, no. 5, doi:10.7759/cureus.25236. Accessed 29 Aug. 2025.

"Delusional Parasitosis ." Mayo Clinic, 9 Apr. 2024, www.mayoclinic.org/diseases-conditions/mental-illness/in-depth/delusional-parasitosis/art-20044996. Accessed 29 Aug. 2025.

Eske, Jamie. "What Does Morgellons Disease Look Like, and What Are the Treatments? " Medical News Today, 23 Jan. 2024, www.medicalnewstoday.com/articles/morgellons-disease. Accessed 29 Aug. 2025.

Fair, Brian. “Morgellons: Contested Illness, Diagnostic Compromise and Medicalisation.” Sociology of Health & Illness, vol. 32, no. 4, 2010, pp. 597–612, doi:10.1111/j.1467-9566.2009.01227.x. Accessed 29 Aug. 2025.

Harvey, William T., et al. “Morgellons Disease, Illuminating an Undefined Illness: A Case Series.” Journal of Medical Case Reports, vol. 3, no. 1, 2009, pp. 1–8, doi:10.4076/1752-1947-3-8243. Accessed 29 Aug. 2025.

Jalbout, Jana Dib El, et al. "Morgellons Disease: A Narrative Review." Neurological Sciences, 6 Feb. 2024, doi:10.1007/s10072-024-07361-7. Accessed 29 Aug. 2025.