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Can MS Affect the Skin? Dryness, Lesions, and More

Posted on May 13, 2022
Medically reviewed by
Joseph V. Campellone, M.D.
Article written by
Jodie Rothschild

Many symptoms can go along with an autoimmune disease like multiple sclerosis (MS). Everyone’s MS experience is different, and you may have had to deal with some new sensations and changes to your skin — most of them unpleasant or uncomfortable.

Some of the skin changes you might experience are MS symptoms. Others are side effects of disease modifying treatments (DMTs) used to treat MS. Fortunately, health care professionals can usually tell the difference, depending on your symptoms. Figuring out the causes behind your skin changes can help you find ways to manage them.

Itching, Pain, and Other Sensations

Nerves send signals to your brain to tell it what you’re feeling. If you have MS, your immune system starts to attack your central nervous system (your brain and spinal cord), which causes damage to the nerves’ protective coating (or myelin sheath). This is called demyelination. Demyelination causes the wrong messages to get sent to the brain, and you may start feeling strange – and often painful – sensations. Demyelination is also responsible for other common symptoms of MS, like muscle weakness or double vision.

Following are some of the words you might hear your neurologist use when talking about skin symptoms of multiple sclerosis.

Paresthesia

Paresthesia is an abnormal sensation of the skin, but not usually a painful one. An example is the pins and needles or numbness you feel if you fall asleep on your arm. Sometimes there’s a cause, like something touching your skin. But, especially with MS, these feelings can seem to come out of the blue.

Dysesthesia

Dysesthesia is a kind of neuropathic pain. “Neuro” means “nerve,” and “pathic” means “diseased,” so “neuropathic” pain means “pain caused by nerve damage.”

Dysesthesia is similar to paresthesia, except dysesthesia is definitely uncomfortable. You may experience itching, burning (especially your feet), electric shock, or other types of pain. Often it will be stimulated by something touching your skin. Sometimes dysesthesia might seem out of the blue, just like paresthesia.

Pruritus

Pruritus” is the technical term for itching. MS itching is a common kind of dysesthesia. One MyMSTeam member said, “I just about tear my skin off trying to relieve the itching.”

The big difference between this kind of itching and other kinds of itching is, there’s no rash or bug bite with pruritus. It’s nerve dysfunction. You’ll also probably experience the itching in the same spot on both sides of your body.

Learn more about causes and treatments for itching with MS.

Allodynia

Allodynia is another kind of dysesthesia, which happens when a stimulus that shouldn’t cause pain does cause pain.

For example, one MyMSTeam member said that water droplets in the shower feel like hundreds of little needles. Other members talk about how uncomfortable even their softest clothes feel against their skin.

Hyperalgesia

Hyperalgesia is also a kind of dysesthesia. Hyperalgesia happens when a painful stimulus causes more pain than it should. Touching hot water might cause discomfort for someone without MS, but for someone with MS, it can be extremely painful.

Managing Itching, Pain and Other Sensations

If you experience any of these skin issues, talk to your neurology team. They can help you figure out if it’s due to your MS, a side effect of a medication, or some other medical condition.

You can’t get rid of the itching and strange sensations caused by your MS, but there are treatment options for symptom management. The good news is that these symptoms aren’t usually a sign that your MS is relapsing (also known as a flare-up). Talk to your doctor for medical advice before trying any of these remedies.

Drug-Free Therapies

Some drug-free therapies — most of which are recommended by MyMSTeam members — include the following:

  • Applying ice packs to numb the nerves or cool burning feet
  • Undergoing acupuncture
  • Distracting yourself
  • Distracting your nerves, such as by pressing on or gently squeezing the area or using a transcutaneous electrical nerve stimulation unit
  • Applying oils, lotions, and creams

Medications

There are a few kinds of medications that might help with the chronic pain and discomfort of dysesthesia:

  • Some anti-seizure medications, like phenytoin (Dilantin), carbamazepine (Tegretol), gabapentin (Neurontin), or pregabalin (Lyrica)
  • Some antidepressants, including amitriptyline (Elavil), nortriptyline (Pamelor), or desipramine (Norpramin)
  • Some anti-anxiety medications, such as clonazepam (Klonopin)
  • Some topical (applied to the skin) medications, like capsaicin or lidocaine

Notably, topical antihistamines probably won’t help, since the problem isn’t actually on your skin.

Changes in Skin Color

Some people with MS may experience changes in color in their feet or hands or facial flushing. These changes may be associated with a related health condition or with side effects from medications.

Raynaud’s Syndrome

Many MyMSTeam members have noticed that their feet change color to bluish-purple or white and become ice-cold and numb. This is probably the result of Raynaud’s disease. With Raynaud’s, blood vessels constrict so not enough blood flows into your feet (or hands).

Doctors aren’t sure exactly why this happens with MS. One possibility is that MS causes damaged nerves to tell your brain that the temperature is colder than it is — people with MS tend to be more sensitive to temperature. Raynaud’s has also been shown to be a side effect of interferon beta therapies, a type of DMT used for some types of MS.

Raynaud’s syndrome is usually not dangerous, but it can definitely affect your quality of life. MyMSTeam members have found relief with the following:

  • Vicks VapoRub
  • Microwavable pillows
  • Warm blankets
  • Rubbing and massage
  • Thick socks
  • Eucalyptus oil
  • Exercise and stretching

Facial Flushing

You may also experience flushing of the face, where your face turns red and warm to the touch. This is a side effect of many DMTs. Tecfidera (dimethyl fumarate), in particular, is a common culprit.

If you’re on a DMT and notice tiny red, pink, or purple spots on your skin (or have started to bruise easily), let your doctor know as soon as possible. These spots are called petechiae. Your doctor will probably do a blood test to check for an autoimmune response to your medication.

To help with flushing, MyMSTeam members suggest:

  • Taking aspirin 30 minutes to an hour before taking Tecfidera
  • Eating something high in fat (like peanut butter or avocado) before taking Tecfidera
  • Avoiding alcohol

Health experts also recommend taking Tecfidera with food to help reduce flushing.

Lesions and Sores

A lesion is just an abnormal area of the skin. There are many different kinds of lesions you might experience with MS.

Shingles

Since DMTs affect your immune system, you might develop shingles — especially with the following drugs:

Also, if you’ve gotten the shingles vaccine, ocrelizumab (Ocrevus) may prevent the vaccine from working. If you have a painful, tingly rash with fluid-filled blisters, tell your doctor.

Pressure Sores

If you have mobility issues, you may develop pressure sores. This happens when there is constant pressure on the same spot — like when you lie or sit in the same position for a long time. Pressure sores can lead to infection and are harder to treat the worse they get, so it’s important to avoid them and treat them early.

Pressure sores can be prevented by keeping your skin clean and dry, changing positions often, and preventing friction (for example, you can sprinkle baby powder on your sheets).

Hives

MS itself doesn’t cause hives, which appear as red bumps or welts. If you have MS and are experiencing hives or rashes, it might be a side effect of one or more of your medications. You might also see discoloration and welts at the injection site if you take an injected medication.

If you have hives or a rash caused by your DMT, your doctor may suggest antihistamines like hydroxyzine (Atarax) or diphenhydramine (Benadryl), or topical hydrocortisone cream. Ice can also help. If your symptoms are bad enough, you may need to try a different DMT.

Blisters

Blisters are a rare side effect of some DMTs, especially teriflunomide (Aubagio). Blisters may also be caused by bullous pemphigoid, a rare skin condition that might be linked to MS.

Psoriasis

Psoriasis is an autoimmune disease that attacks the skin, causing inflammation and accelerated production of skin cells. It can result in patches of thickened, scaly skin that can crack, bleed, and itch. People with MS are more likely to also have other autoimmune diseases, so some researchers believe psoriasis occurs more frequently in MS. Studies are conflicting, however.

Talk With Others Who Understand

MyMSTeam is the social network for people with both relapse-remitting and progressive MS, and their loved ones. On MyMSTeam, more than 186,000 members come together to ask questions, give advice, and share their stories with others who understand life with MS.

Do you have itching, flushing, or other skin issues related to your MS or MS treatment? Share your experience in the comments below, or start a conversation by posting on your Activities page.

All updates must be accompanied by text or a picture.
Joseph V. Campellone, M.D. is board-certified in neurology, neuromuscular disease, and electrodiagnostic medicine. Review provided by VeriMed Healthcare Network. Learn more about him here.
Jodie Rothschild is principal of Rothschild Biomedical Communications and a proud member of both the American Medical Writers Association and Plain Language Association International. Learn more about her here.

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