Multiple sclerosis (MS) is a long-term autoimmune disease where the immune system mistakenly attacks the central nervous system, including the brain and spinal cord. MS can cause many different symptoms that vary from person to person. Some people may even notice changes in their toenails.

Although there’s no direct connection between MS and toenail problems, certain MS symptoms can lead to nail changes. For example, trouble moving around or nerve damage from MS might cause difficulty with foot care, leading to fungal infections or trauma to the toenails.

If you see changes in your nails or have new or worsening symptoms, talk to your neurologist or healthcare provider. They can help figure out the cause and suggest safe, effective treatments.

Difficulty Cutting Toenails

Some people with MS struggle to cut their toenails, including several MyMSTeam members. As one wrote, “I got a referral to a podiatrist because I told my doctor that I can no longer cut my toenails. So frustrating, all the stupid things we took for granted!” (A podiatrist is a doctor who specializes in feet.)

Another replied, “I was just struggling with my toenails today. Let me know if there’s a special toenail cutter that is available.”

What Causes Toenail-Cutting Difficulties?

Many people with MS have weakness, stiffness, and numbness in different parts of their bodies due to lesions (damaged areas) in the brain and spinal cord. These symptoms can make bending over or maintaining control difficult or impossible. Additionally, many people with MS have tremors or coordination issues, which can make the precise task of toenail cutting particularly challenging.

Complications of Not Being Able To Cut Toenails

When toenails aren’t properly trimmed, there’s a greater risk of ingrown toenails. An ingrown toenail develops when part of the nail grows into the surrounding skin — rather than remaining properly on the nail bed — leading to pain, swelling, and potential infection. Those with MS are more prone to ingrown toenails due to difficulty trimming their nails accurately, often caused by numbness or tremors.

Treatment for ingrown toenails typically requires the help of a healthcare provider or podiatrist, especially for people with MS who may struggle with foot care on their own. In some cases, a toenail may need to be removed to treat infections that keep coming back.

Several MyMSTeam members have shared similar experiences. “I had one full nail removed and a partially ingrown one on my big toe, too,” one member wrote.

Another explained, “I had a toenail removed due to frequent ingrown toenail infections, so it’s sore. I’m having the other one done in a few weeks.”

A third commented, “I had the toenail on both big toes removed in early December because of ingrown toenails.”

Managing Toenail-Cutting Problems

There are several options for keeping your toenails well trimmed. Some people find extended nail trimmers helpful. “I’ve seen one that’s on a long stick, for lack of a better word,” shared one member. “Those scare me because my feet jump when I touch my toes.”

Regular visits to a podiatrist or nail salon for professional care can also help prevent complications and maintain foot health. Some people with MS may need help from a professional if their symptoms make it hard to take care of their toenails on their own.

Fungal Infections

Fungal infections in toenails, known as onychomycosis, are relatively common among the general population and happen a bit more in people with MS. These infections can lead to nail discoloration, cracking, or other deformities.

If left untreated, toenail fungus can lead to complications such as severe nail thickening, cracking, and even pain and sensitivity in the toes due to deep fissures (deep cracks or splits) in the nail.

What Causes Fungal Infections in People With MS?

People diagnosed with MS take medication that suppresses the immune system to control their disease. However, these medications can increase the risk of infections, including fungal infections. Additionally, some research suggests people with MS may have a genetic predisposition to developing nail fungus, although more research is needed to confirm this link.

Managing Fungal Infections With MS

There are many prescription and over-the-counter (OTC) treatment options for fungal infections. Your podiatrist or dermatologist may recommend:

• Oral medications
• Medicated lotion or cream to rub into your nails and cuticles
• Antifungal nail polish

One member mentioned taking antifungal medication, writing, “They have stronger meds for fungus, too. Better than taking out the nail.”

Another member suggested an OTC remedy: “I cut and file my toenails as short as I can, then run an emery board over the top. After that, I smear Vicks VapoRub on the nail. It takes a few applications, but it’s inexpensive.”

While some people swear by home remedies, these methods may not have been scientifically tested for safety or effectiveness. In fact, some home treatments could make the infection worse. Check with your healthcare provider before trying any at-home or “natural” remedies.

In severe cases, removing the toenail might be the best way to treat the infection. This makes it easier to apply antifungal medicine directly where it’s needed and may help the area heal faster.

Toenail Loss and Other MS Complications

Some MyMSTeam members have reported losing toenails and believe it may be linked to MS symptoms. One explained in detail: “I’ve been referred to get a circulation test for my right foot because my toenails keep falling off for no reason. It’s the foot with nerve damage due to MS. I lost three toenails on my right foot over a month. Two of the three had grown back. Now, four left toenails have fallen off for no reason.”

Other members have experienced this, too. One wrote, “I have NO toenails and barely any fingernails! It’s been three years.”

Another added, “I have killed several toenails within the past six months. Both little toes and both big toes. I am still waiting for big toenails to grow out so dead ones fall off.”

Members have also experienced toenail issues as a side effect of other MS complications. “I found out that for some people with MS, their toes can start to curl. When they curl, it affects the toenails,” explained one member. “Fortunately, I didn’t have to have the toenail removed. I just had to have it ground down. The upkeep is having this done every three months so it doesn’t become a problem again.”

In addition, research suggests that people with MS are also more likely to have type 1 diabetes. Those with diabetes are at higher risk for various toenail problems, including fungal infections, ingrown toenails, thick or misshapen nails, discoloration, and infections, due to high blood sugar and poor circulation. Regular foot checks are essential for monitoring these issues as part of diabetes care.

If you’re losing toenails and don’t know why, be sure to speak with your neurologist or primary care provider and ask for advice. They may have recommendations for treatment or refer you to a dermatologist or podiatrist more familiar with this specific problem.

Find Your Team

On MyMSTeam, the social network for people with multiple sclerosis and their loved ones, members come together to ask questions, give advice, and share their stories with others who understand life with MS.

How does MS affect your toenails and other parts of the body? What medical advice from your healthcare professionals has been most helpful for you? Share your story or what’s worked for you in the comments below or by posting on your Activities page.