Is My Skin Pain Linked to Endometriosis?
My skin gets really sensitive sometimes. A light touch can feel like a burn. Even brushing my hair will hurt. Normally, these activities create a sensation, not pain. This kind of sensitivity tends to happen during my luteal phase — the 10-12 days before my period starts — or if I'm stressed out, have a migraine, or I'm really cold.
It turns out this symptom has a name, but not one my doctors ever mentioned. It's called allodynia, and it tends to show up in health conditions like:1
- Nerve pain from diabetes
- Trigeminal neuralgia (That's a problem with your trigeminal nerve, a big nerve that sends signals to your face and jaw.)
And not surprisingly, research also links this symptom to chronic pelvic pain.2
What is allodynia?
It means "pain due to a stimulus that does not normally provoke pain," according to the International Association for the Study of Pain. Allodynia is different than hyperalgesia. That's when you have an amplified response to something that is normally a little painful.3
What does it feel like?
There are three types of allodynia3, and I get all of them:
- Tactile: Touch or pressure can hurt.
- Thermal: Your pain is related to temperature changes.
- Dynamic: It'll hurt when something moves across your skin.
My symptoms come and go with certain triggers: physical or emotional stress, cold temperatures, serious headaches, my impending period. Here are some examples of what a flare feels like to me:
- The pressure from the shower makes my skin feel bruised.
- My scalp hurts when I run a comb through my hair.
- Putting on a shirt can feel kind of like I’m rubbing a big piece of sharp ice on my skin.
- A light touch on my back, belly, or vulva — the area around the outside of the vagina, which is where the clitoris is — can feel like a cut or burn.
Can your doctor check for it?
I've never had it done, but supposedly there’s a test for this kind of pain sensitivity. During a physical exam, your doctor will lightly rub a cotton swab down certain parts of your body. That includes your abdomen — under your ribs down to your pubic bone — or your vulva or perineum (the area between your vagina and anus). That kind of thing usually doesn't hurt the skin.4
They can also just ask you questions about your pain symptoms.
How is it linked to endo?
If you have endometriosis, you're more likely to have other conditions where allodynia shows up. That includes fibromyalgia, migraine, and chronic pelvic pain.5,6 I definitely have those last two. My doctor also thinks I have central sensitization. That's when your pain signals are more intense than they should be. While not all of my pain is an overreaction, research backs her up that sensitization is common in people who have endo or chronic pain.7
Can you treat it?
There are a several things you can try. Your doctor might give you antidepressants, nerve pain drugs, topical numbing cream, or suggest some lifestyle changes. Your symptoms might get better if you treat any underlying health conditions. But, as endo warriors know, that's easier said than done.
Here's what I do to lessen my allodynia symptoms:
Take migraine medicine. These serious headaches always trigger pain sensitivity, especially in my face and scalp. Thankfully, I have a medicine that helps treat an acute attack. I'll take a pill as soon as I feel a migraine coming. There are a variety of meds that treat migraine, but I take a class of drugs called triptans.
Take an antidepressant. Research shows selective serotonin reuptake inhibitors (SSRIs) are an effective way to manage some of the conditions that worsen my allodynia. That includes premenstrual dysphoric disorder (PMDD), migraines and chronic pain.8-9 While SSRIs might not work for everyone, I've definitely noticed improvement in my PMDD since I started taking one. And I've gone three months without a migraine.
Use meditation to de-stress. I have friends who can't stand sitting with their thoughts. But mediation — I use the Headspace app — really helps manage my depression and anxiety. When those are under control, I feel less pain in general.
Get warm. I have a very low cold pain threshold (CPT). During winter, my pain levels are always higher; my friends with arthritis say the same thing. Research shows people with moderate to serious menstrual pain, central sensitization, low back pain, or other chronic pain have a lower CPT.10-12
When I can't get warm enough with blankets or a space heater, I'll submerge myself in warm water. I won't take a shower because it'll hurt, but soaking in the bathe almost instantly makes my skin feel better.
Sometimes, I'll actually work in the bathtub. But thankfully it's summer, so I got to write this one outside.
Has insurance ever slowed or stopped your endometriosis healthcare journey?