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Many symptoms can go along with an autoimmune disease like multiple sclerosis (MS). Everyone’s MS experience is different. You may have had new sensations and changes to your skin, and some may be unpleasant or uncomfortable.
Some of the skin changes you might have are MS symptoms. Others might be side effects of disease-modifying treatments (DMTs) used to treat MS, or conditions more common among people with MS. Fortunately, healthcare professionals can usually tell the difference and recommend appropriate treatment to help you feel better.
Here are some skin changes and problems you might notice with MS.
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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 called the myelin sheath. This is called demyelination.
Demyelination can cause nerve signals to slow down or become blocked, and you may start feeling strange and often painful sensations. Demyelination is also responsible for other common symptoms of MS, such as muscle weakness or vision problems like double vision.
Neuropathic symptoms are common. “Neuro” means “nerve,” and “pathic” means “related to disease,” so neuropathic pain means pain caused by nerve damage.
The following are some of the words you might hear your neurologist use when talking about skin symptoms, including MS skin lesions and unusual sensations related to MS.
Paresthesia Paresthesia is an abnormal sensation of the skin, but it’s usually not painful. An example is the pins and needles 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.
Hypoesthesia This refers to a partial loss of sensation, such as pain, light touch, temperature, or vibration, usually in one body part.
Dysesthesia Dysesthesia is a kind of neuropathic pain that causes burning, tingling, or tightening sensations. Dysesthesia is similar to paresthesia, but dysesthesia is uncomfortable or painful. It can be worse at night and after exercise and may be triggered by changes in temperature.
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 pruritus and other kinds of itching is that there may be no visible cause, such as a rash or bugbite. This type of itching is caused by nerve dysfunction. Neuropathic itching like pruritus can affect one side or both sides of your body, depending on which nerve pathways are involved.
Learn more about causes and treatments for itching with MS. ❯
Allodynia Allodynia is another kind of dysesthesia, in which something that normally wouldn’t hurt causes 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.
If you have any of these abnormal sensations, 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.
Itching and other unusual sensations caused by MS can be difficult to treat, but there are options to help manage these symptoms. These symptoms don’t necessarily mean your MS is relapsing (also known as a flare-up). However, new or worsening symptoms should be discussed with your MS care team.
Some people with MS may have 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 Disease Many MyMSTeam members have noticed that their feet change color to bluish-purple or white and become ice-cold and numb. This may be due to Raynaud’s disease. With Raynaud’s, blood vessels narrow, reducing blood flow to your feet or hands.
Doctors aren’t sure exactly why this happens in people with MS. Some people with MS are sensitive to cold temperatures, and cold temperatures can also trigger Raynaud’s symptoms. 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 disease is usually not dangerous, but it can affect your quality of life. MyMSTeam members report relief with the following:
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. Dimethyl fumarate (Tecfidera), in particular, commonly causes flushing.
If you’re on a DMT and notice tiny red, pink, or purple spots on your skin or start bruising easily, let your doctor know as soon as possible. These spots are called petechiae. Your doctor may order a blood test to look for a low platelet count or another possible cause.
If Tecfidera causes flushing, taking it with food may help reduce this side effect.
MyMSTeam members suggest avoiding alcohol and eating something high in fat, like peanut butter or avocado, before taking Tecfidera to help with flushing.
Taking aspirin 30 minutes before taking Tecfidera may reduce flushing for some people. This should only be done if your healthcare provider recommends it, as aspirin can increase bleeding risk and irritate the stomach.
Dry skin is a common problem. It becomes even more common as we age and among people with diabetes or skin conditions like eczema. In people who lose mobility due to progressive MS, reduced movement may contribute to more severe dry skin and accompanying itching.
If skin dryness makes you uncomfortable, keeping your skin moisturized may help. If moisturizers don’t help, consider talking to your doctor about testing for underlying skin conditions.
A lesion is an abnormal area of the skin. There are many different kinds of lesions you might have with MS.
Shingles Because DMTs affect your immune system, you might develop shingles, a painful rash caused by the same virus that causes chickenpox — especially with the following drugs:
Doctors may recommend getting the shingles vaccine before starting B-cell-depleting therapy, a treatment that lowers the number of B cells, a type of immune cell. If you have a painful, tingly rash with fluid-filled blisters, call your doctor.
Pressure Sores If you have difficulty moving or changing positions, 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 reducing friction.
Hives MS doesn’t cause hives, which appear as red bumps or welts. If you’re experiencing an MS rash or hives, 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 recommend an antihistamine to help relieve symptoms. Depending on the cause and severity of your symptoms, your doctor may also recommend changing your treatment.
Blisters Blisters can be a sign of a serious skin reaction to some DMTs, including teriflunomide (Aubagio). If you develop blisters while taking teriflunomide, stop taking it and call your doctor right away or get emergency medical care. 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.
Certain autoimmune conditions, including psoriasis, are associated with a slightly higher risk of developing MS. Researchers have also studied whether psoriasis is more common in people with MS, but findings have been conflicting.
On MyMSTeam, people share their experiences with multiple sclerosis, get advice, and find support from others who understand.
Do you have itching, flushing, or other skin issues related to your MS or MS treatment? Let others know in the comments below.
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Non healing wounds from eczema or psoriasis related to Ms?
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I do have red bumps, but they don’t itch. I have been diagnosed with MS since 1996.
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