People may develop a condition described as having fibers or parasites live in skin. Sometimes it is simply the sensation that these exist. People may develop symptoms of crawling, biting, itching or other reactions to fibers or small bugs. They may be able to show proof of this by carrying a small collection of these fibers or mites. When the evidence shows that there is no infestation, the diagnosis is delusions of parasitosis (also known as Morgellons syndrome).
In this situation it is important to address the possibility that people with these symptoms may be correct. Examination of their skin and the evidence they provide should give the diagnosis. People who genuinely have mites on their skin (such as scabies) can be treated effectively. People who do not show evidence of infestation may improve with counseling or medications that suppress their sensation, such as risperidone.
The prognosis for this condition is favorable. Some people improve with a thorough examination and discussion.