Morgellons Disease (MD) is a poorly understood condition characterized by a distressing combination of skin and systemic symptoms. Individuals report persistent sensations of crawling, biting, or stinging on and under the skin, known as formication. These sensations are often accompanied by non-healing skin lesions from which patients report removing or observing fibers or filaments. Medical consensus on the origin of MD remains divided, making the condition controversial.
Is Morgellons Disease Contagious?
Morgellons Disease is not considered contagious or transmissible from person to person through typical contact, air, or environmental exposure. A comprehensive 2012 study by the U.S. Centers for Disease Control and Prevention (CDC) examined over a hundred cases. The investigation found no evidence of an infectious agent or environmental link, concluding the condition was not a widespread transmissible disease.
The visible symptoms, such as skin lesions and the presence of fibers, do not spread like those of a typical communicable illness. The CDC analysis of the fibers presented by patients revealed they were mostly composed of cellulose, consistent with cotton fibers likely embedded in the lesions from clothing. Since there is no confirmed pathogen or environmental cause, there is no known mechanism for the condition to spread between individuals.
Scientific Theories Regarding Etiology
The cause of Morgellons Disease is still the subject of significant debate, leading to two competing hypotheses. One major viewpoint classifies the condition as a form of Delusional Infestation (DI), specifically a subtype of Delusional Parasitosis (DP). This psychological hypothesis suggests that physical symptoms are interpreted through a fixed, false belief that the individual is infested by non-living organisms, such as the fibers.
Many dermatologists and psychiatrists view the skin lesions as the result of chronic scratching and picking, a behavioral response to the persistent skin sensations. Consistent with this, the CDC study found that a high percentage of participants had co-existing psychiatric illnesses, suggesting a potential underlying mental health component. This perspective frames the cause as primarily psychosomatic.
The opposing view, known as the infectious hypothesis, suggests that MD is a physical disorder caused by an underlying bacterial infection. Some research suggests a link between MD and spirochetes, particularly Borrelia burgdorferi, the bacterium responsible for Lyme disease. Proponents suggest the presence of these bacteria activates skin cells to overproduce proteins like keratin and collagen, which form the characteristic filaments.
Studies supporting this organic cause have found evidence of spirochetal infection in skin samples from some MD patients, suggesting the symptoms are a physiological response to the infection. However, larger, independent investigations, including the CDC’s, have failed to replicate these findings or establish a definitive link between the condition and an infectious organism. The precise origin of the condition remains unresolved, making it difficult to establish a single, universally accepted treatment protocol.
Diagnosis and Patient Management
Because of the lack of consensus on the cause, diagnosing Morgellons Disease is often a process of exclusion, where other skin conditions like scabies are first ruled out. Healthcare providers conduct a thorough medical history and physical examination, often including microscopic analysis of the skin and any fibers presented. The clinical approach must recognize the significant distress experienced by the patient, regardless of the ultimate classification of the disorder.
Management typically requires a multidisciplinary approach involving both dermatological and psychological care to address the complex nature of the symptoms. Dermatological care focuses on treating skin lesions, managing intense itching (pruritus), and addressing secondary infections resulting from scratching. Topical treatments and antiseptic emollients may be used to soothe the skin and promote healing.
Psychological support is a necessary component of management, even when an underlying infectious cause is suspected or treated. Treatment often involves psychiatric evaluation and the use of medications, such as antipsychotics, which can relieve delusional symptoms and associated distress. Building a strong, trusting relationship between the patient and the healthcare provider is paramount to encourage treatment adherence and improve quality of life.