Goose Bumps (Goose Flesh) – Normal and Abnormal Causes

Everyone at some time or the other has experienced goosebumps, which refer to the appearance of tiny bumps on the surface of the skin under conditions such as cold weather or sudden fright. The name “goosebumps” or “goose flesh” derives from the appearance of the skin of a goose when its feathers are plucked. It may appear more prominent in some people and varies based on individual sensitivity to cold.

The goosebumps are a normal physiological reaction of the skin, and usually resolve on their own within a short time. They are not really a cause for any concern. However, not all goosebumps are normal. A variety of hormonal, neurological and infectious diseases can also cause the appearance of goosebumps. In such cases, the underlying disease must be identified and treated.

Why do goosebumps appear?

Goosebumps that appear as a normal physiological reaction of the skin (to conditions such as cold) are technically referred to as cutis anserina. Earlier, the goosebumps were also referred to as horripilation. However, this term is not used very frequently now-a-days. Goosebumps appear when the muscles within the skin contract to erect the hairs present on the surface of the skin.

The hair follicles in the skin have smooth muscles attached to them. These smooth muscles are technically referred to as erector (or arrector) pili. The contraction and relaxation of these tiny smooth muscles in the skin is controlled by sympathetic nervous stimulation from the autonomic nervous system. Contraction of these erector pili muscles makes the hairs stand up, whereas relaxation of these muscles makes the hairs lie flat on the surface of the skin.

When the hair stands up during cold weather conditions, the flow of air over the surface of the skin is slowed down. This reduces the loss of heat from the peripheral areas of the body. The hairs also stand up when the sympathetic branch of the autonomic nervous system responds to emotional arousal states caused by intense pleasure, anger, fear, and euphoria.

The goosebumps are visible even when the hair is absent from the affected skin area. This is because the erector pili muscles in the skin still contract in response to the sympathetic nervous stimulation. Goosebumps are most commonly seen on the skin on the arms and the legs.

Since the contraction of the muscles that make the hair on the skin stand up is under the control of the autonomic nervous system, we cannot voluntary control the appearance of goosebumps. Under conditions such as cold weather, or intense emotions such as sudden fright, sexual arousal or euphoria, the autonomic nervous system gets stimulated and causes the formation of goosebumps. When the inputs from the autonomic nervous system cease, the goosebumps disappear and the hairs fall back into their normal lying position.

Sometimes, dysfunction of the autonomic nervous system can cause the formation of abnormal goosebumps. Other involuntary reactions such as sweating, flushing, and changes in heart rate also occur along with the goosebumps. Such an abnormal reaction of the autonomic nervous system is termed as autonomic dysreflexia or autonomic hyperreflexia.

Abnormal Goosebumps

Goosebumps can occur in people with all kinds of skin colors, textures, and appearances. When goosebumps are caused by well known trigger factors (such as cold temperatures and heightened emotions) and resolve on their own within a short time, there is no cause for concern.

To distinguish between normal and abnormal goosebumps, one can take simple measures such as turning up the heat in the room, wearing warm clothes, and relaxing to see if the goosebumps disappear. If these measures are unable to reverse the goosebumps, then the possibility of some underlying abnormality should be considered.

The following signs and symptoms may also be present alongside abnormal goosebumps:

  • A general feeling of malaise (not feeling well)
  • Changes in body temperature
  • Changes in normal appetite
  • Profuse sweating
  • Changes in blood pressure
  • Changes in heart rate
  • Paleness or redness of skin
  • Alterations in mental state
  • Dizziness or lightheadedness

Read more on how to reduce a fever.

Causes of Abnormal Goosebumps

Chills and autonomic hyperreflexia are the two main causes of abnormal goosebumps. However, it is important to note that chills and autonomic hyperreflexia do not cause abnormal goosebumps in all cases.


Chills commonly occur during feverish conditions. Infections are often associated with feverish conditions that cause chills. During these states, an abnormal rise is body temperature is accompanied by involuntary shaking. The shaking associated with chills may either precede the onset of fever or may occur alongside the fever. Even though chills occur commonly with fever, this is not always the case.

Chills may also occur without fever. Some of the conditions associated with chills and abnormal goosebumps include cellulitis, common cold, infectious mononucleosis, influenza, malaria, pneumonia, meningitis, gastroenteritis, tuberculosis, septicemia, urinary tract infections (commonly abbreviated as UTIs), and tonsillitis.

Autonomic hyperreflexia

A variety of factors stimulate the autonomic nervous system. These inputs enable the autonomic nervous system to regulate events in different parts of the body. Sometimes, the autonomic nervous system overreacts or reacts abnormally to the inputs it receives, causing signs and symptoms such as increased blood pressure, rapid heart rate, change in skin color, profuse sweating and abnormal goosebumps. However, it is important to note that these physiologic changes can also occur during a normal responses of the autonomic nervous system.

Autonomic hyperreflexia may occur in conditions such as spinal cord injury, Guillain-Barre syndrome, traumatic brain injury, intake of certain drugs and illicit substances, and withdrawal from addictive substances. Hormonal disorders such as pheochromocytoma, carcinoid syndrome, thyrotoxicosis, and serotonin syndrome can also cause autonomic hyperreflexia.


Goosebumps also occur in corpses. Even though this may seem abnormal, the appearance of goosebumps in corpses is caused by the normal phenomenon of rigor mortis. In fact, goosebumps are an early sign of rigor mortis in which the muscles of the body undergo contraction after death.

Hair Removal

Hair removal, especially through waxing, may also cause the appearance of goosebumps. However, these goosebumps are temporary and go away within a few minutes.

Stress and goosebumps

Stress triggers the same pathways in the nervous system as fright. The well known fight-or-flight response of the autonomic nervous system is an acute stress response that prepares an individual for a rapid action in the face of danger. Goosebumps do occur during this state.

Even in the absence of any clear physical danger, a person may experience mental stress such as anger, anxiety, fear and worry due to various events in daily life. The psychological stress associated with these situations triggers the same neural and hormonal pathways as the fight-or-flight response, and can cause the appearance of goosebumps.

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