Morgellons syndrome - a rare cause of itchy skin

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[UPDATED JUNE 2022]

Introduction

This page is an overview of a presentation to the British Society for Ecological Medicine by Dr Damien Downing.
[The more recent studies have been added to further support Dr Downing's ideas.]

Morgellons syndrome is an example of what happens when doctors do not ask the question why and ascribe problems to psychological factors such as Munchausen syndrome.

See Wikipedia - Morgellons and you will see what I mean! Morgellons is referred to there as a delusional disorder - delusional parasitosis to be precise! How wrong!

What is it?

Morgellons syndrome is characterised by intense itching which drives people nuts! Often the skin is very damaged because of scratching. There is now very good evidence that Morgellons syndrome is a little bit like sweet itch in horses. Sweet itch is allergy to insect bites. Wikipedia is better on this - see Wikipedia - Sweet itch

There is good evidence to suggest that Morgellons is caused by a very tiny burrowing fly which gets into the skin, happily feeds on the host's skin cells, produces a larva, then erupts through the skin and flies away. Symptoms arise from allergy to insect parts. We do not see the insect because it is so small but it is thought to be a minuscule fungus gnat.

Many sufferers of Morgellons notice tiny threads coming out of their skin which are typically described as black, red or blue; many also notice there are often very tiny flies around them. These flies reproduce in any cavity where there is oxygen, so obviously the skin, probably also the gut and the lungs.

See History of Morgellons disease: from delusion to definition, Clin Cosmet Investig Dermatol. 2018; 11: 71–90. which states that: 

..rigorous experimental investigations show that this skin affliction results from a physiological response to the presence of an infectious agent.

It has been suggested that there is a co-morbidity with Lyme disease and possibly Chlamydia pneumonia. See Lyme Disease and other Co-infections See Morgellons disease: a filamentous borrelial dermatitis, Int J Gen Med. 2016; 9: 349–354. which concludes that: 

Although MD was initially considered to be a delusional disorder, recent studies have demonstrated that the dermopathy is associated with tickborne infection, that the filaments are composed of keratin and collagen, and that they result from proliferation of keratinocytes and fibroblasts in epithelial tissue. Culture, histopathological and molecular evidence of spirochetal infection associated with MD has been presented in several published studies using a variety of techniques. Spirochetes genetically identified as Borrelia burgdorferi sensu stricto predominate as the infective agent in most of the Morgellons skin specimens studied so far. Other species of Borrelia including Borrelia garinii, Borrelia miyamotoi, and Borrelia hermsii have also been detected in skin specimens taken from MD patients.

The diagnosis of Morgellons syndrome is currently made on clinical suspicion, together with the finding of suspicious foreign material.

Treatment

There is no currently defined treatment plan because this syndrome is at a very early stage of being diagnosed and described. However, there are some interventions that can do no harm and are well worth trying.

  • Salt baths – either one could use ordinary salt, sea salt, or possibly Epsom salts – I would suggest half a kg (one pound) per 15 gallons of bath water – soak in the solution for at least 15 minutes, or longer.
  • Thiamine – one gram daily is thought to be unpleasant to biting insects.
  • Ultraviolet light – i.e. sunshine is often toxic to micro-organisms and possibly small flies.
  • Neem oil
She was subsequently treated with a course of Doxycycline and found on two‐week follow‐up to have complete remission of her symptoms. This case report further supports the theory for an infectious etiology of MD and encourages future studies into its pathophysiology.
  • Ivermectin – again, this is a drug widely used in the veterinary world for external parasites – it is available on the named patient basis for human use.

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