Trigeminal trophic syndrome (TTS) is a complication of damage to the trigeminal sensory nerve or sensory nuclei resulting in self-induced excoriations of the skin on the central face. Typically, iatrogenic following therapeutic ablation of the trigeminal nerve, facial dysesthesia or hyperesthesia develops, classically involving the nasal ala. This can also occur on the upper lip, paranasal area, scalp, medial forehead, or ear. Patients may describe pain, itch, picking, or scratching sensations in the region and, as a result, manipulate or excoriate their skin.

Most cases of trigeminal trophic syndrome are a complication of neurosurgical removal of the Gasserian ganglion, which is typically performed to treat intractable trigeminal neuralgia. Additional predisposing conditions include stroke, central nervous system (CNS) tumors (ie, astrocytoma or meningioma), infections (ie, herpes simplex virus [HSV], varicella-zoster virus [VZV], or leprosy), syringobulbia, vestibular schwannoma, postencephalitic parkinsonism, and vertebrobasilar insufficiency.

Trigeminal trophic syndrome can occur weeks or years after injury to the trigeminal nerve or sensory nuclei. It occurs more commonly in elderly patients and women.