Multiple sclerosis (MS) is an autoimmune disease that occurs when the immune system attacks the central nervous system (the brain and spinal cord). Different people with MS experience different symptoms. Some people with MS find that their symptoms include changes to or problems with their toenails.
MS can affect the toenails in a number of ways. Some are directly related to demyelination (damage to the myelin sheathing around nerves), while others are the indirect result of other MS symptoms. If you notice any new or worsened symptoms, including nail changes, talk to your neurologist or another health care provider. They’ll be able to determine the cause and recommend safe and effective treatment options if they are needed.
Some people with MS struggle to cut their own 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!”
Another replied, “I was just struggling with my toenails today. Let me know if there’s a special toenail cutter that is available.”
There are a number of common symptoms of MS that could cause problems when it comes to cutting toenails. Many people with MS experience numbness in different parts of their bodies. This could make it difficult or impossible to bend over far enough to trim toenails.
Other people with MS may experience tremors and a lack of coordination. Since toenail cutting requires precision, this can make it hard to get the job done.
Ingrown toenails occur when part of the toenail grows into your skin and flesh, rather than remaining on the nail bed. When you can’t cut your own toenails, you run a higher risk of experiencing ingrown toenails. This risk is also higher when you cannot cut your toenails precisely.
There are a number of ways to treat ingrown toenails, most of which require visiting a health care provider or podiatrist.
Some people end up having to have toenails removed to deal with the issue. A number of members have experienced this. One shared, “I had one full nail removed and a partially ingrown one on my big toe, too.”
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.”
Yet another added to these comments: “I had the toenail on both big toes removed in early December because of ingrown toenails.”
There are several options for keeping your toenails well-trimmed.
Some people get an extended nail trimmer. These may work for some people, but not others. “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.”
You may need to regularly visit a podiatrist or work with a nail salon to get your nails trimmed frequently and to improve your foot health.
Fungal infections in toenails, known as onychomycosis, are relatively common among the general population — and they’re even more common among people diagnosed with MS. These infections may cause nail discoloration, lead to cracking and breaking, or cause other nail changes or deformities to develop.
There are many possible complications from toenail fungus. Toes can become extremely painful and sensitive if nails crack too deeply or become too badly thickened by fungal growth.
People with MS may have a genetic predisposition to developing nail fungus, though more research is needed to explore this relationship.
There are a number of treatment options for fungal infections. Your podiatrist or dermatologist may give you:
One member mentioned taking antifungal medication, writing, “They have stronger meds for fungus, too. Better than taking out the nail.”
Some people also swear by home remedies. However, these methods may not have been tested for safety and effectiveness, and they may even make things worse. You should always talk to your health care provider before trying at-home remedies, even those said to be “natural.”
Sometimes, removing the toenail is the best way to allow your feet to heal, as it allows for antifungal medication to be applied directly to the infection.
Some MyMSTeam members have reported losing toenails, and they believe it may be tied to multiple sclerosis.
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.”
There has been little to no research on this as a complication of MS. However, if you are losing toenails and you 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.
On MyMSTeam — the social network for people with MS and their loved ones — more than 184,000 people with multiple sclerosis and their loved ones gather to support each other. You can read about their experiences, ask questions, and learn what has worked for others who are living with the same MS symptoms and taking the same MS treatments.
Have you experienced problems with your toenails while living with MS? Share your story or what’s worked for you in comments below or by posting on MyMSTeam.