People who live with multiple sclerosis (MS) can experience a variety of symptoms, not all of which are commonly discussed. These symptoms can lead some people to wonder whether new sensations and experiences may be related to MS.
“I am having a problem with just the left side of my face feeling hot (but not to the touch) and very sensitive to touch,” one MyMSTeam member wrote. “It happens periodically and comes and goes. Does anyone else have something similar?”
If you experience symptoms similar to this, here’s what you need to know about how they may be connected to MS and what you can do about them.
As always, if you’re experiencing new or worsening MS symptoms, talk to your neurologist or primary care doctor. They can help you determine the cause and find a treatment option that works for you.
There are a few reasons why people diagnosed with MS might experience facial heating and/or sensitivity. Some of these are related to MS and some are not.
Trigeminal neuralgia (TN) is a problem with the nerves and often causes facial pain. This pain can be extreme and may make completing daily activities difficult or impossible. The trigeminal nerve branches throughout the forehead and sides of the face. Pressure on or damage to this nerve causes TN.
Individuals with MS may experience TN due to the effects of demyelination. Demyelination occurs when MS causes the body to attack the myelin sheath that protects the nerves in the body’s central nervous system.
People with TN may experience different types of pain. Some find that they have short, recurring bouts of extreme pain that may feel like a sudden electric shock or a burning sensation. Others describe a stabbing sensation that comes on suddenly through daily activities, such as eating or brushing your teeth.
TN doesn’t always cause pain and instead can lead to symptoms like facial heating and sensitivity. Different people have different symptoms, like one MyMSTeam member who wrote, “I did have numbness on one side of my face well before TN appeared.”
There’s a correlation between MS and TN, although scientists don’t yet understand their exact connection. For people with MS and TN, TN typically occurs due to damage to the myelin sheath around the nerve fibers.
In addition, some people may have MS and TN that aren’t connected. In individuals without MS, TN usually occurs when a blood vessel puts pressure on the trigeminal nerve. TN can also be caused by nerve compression by a tumor, or it can be due to inflammation or infection.
TN is approximately 400 times more common in people with MS than in the general population. Between 4 percent and 6 percent of people with MS will also be diagnosed with TN, and one survey study reported that up to 15 percent of people diagnosed with TN first will eventually end up diagnosed with MS as well.
There is some variation in different studies when it comes to how connected these two conditions are. However, the existence of some kind of connection is the best explanation for the evidence currently available.
MS can also cause facial flushing at irregular intervals. It’s one of a set of paroxysmal symptoms of MS — symptoms that usually come on quickly, last only for a few seconds or minutes, and then go away.
No one knows exactly why some people with MS experience facial flushing, but certain side effects of some medications prescribed for MS treatment may be the source of the problem.
One or both sides of your face may feel sensitive for reasons that don’t directly relate to MS. For instance, TN could be caused by pressure from a blood vessel and not from nerve problems.
Facial flushing may also be caused by:
Work with your neurologist to determine the cause of any facial flushing or sensitivity you experience so you can find the best treatment option for your needs.
There are many treatment options and management options for facial pain and heating. The ones you choose depend on what is causing your symptoms.
If you and your doctor believe you are experiencing facial symptoms from TN, it might help to try one or more of the following treatment options.
There are various medications you can take for nerve pain, and these may help with pain and flushing associated with TN. Adding a muscle relaxant may help related tissues that have clenched due to pain.
Some MyMSTeam members swear by these medications. “What helps me is Tegretol,” wrote one member. Another added, “Trileptal has helped me. However, if you stop taking it, the pain returns within a day.”
If your symptoms are difficult to treat and are affecting your quality of life, your sense of wellness, and your mental health, talking to a therapist can help. Finding someone who is trained to work with people in chronic pain can help you process what you’re going through and learn to manage your emotions and life in new and different ways.
Several procedures and surgeries are designed to ease TN pain, either permanently or temporarily. Glycerol injections can be administered to the site of the nerve for pain relief. Gamma-knife radiosurgery is safe and can be effective, although the results don’t last for everyone.
Microvascular decompression can help if your TN is caused by pressure from blood vessels on the trigeminal nerve.
Additionally, some people are candidates for a balloon compression procedure or a rhizotomy (a procedure that selectively destroys problematic nerve roots in the spinal cord).
If you and your doctor think your facial issues are due to MS-related facial flushing, the following interventions may help.
If you’re on medication that may be causing your facial flushing, talk to your doctor about the pros and cons of making changes. You may choose to manage your flushing rather than changing medications, but you should weigh the options with your doctor.
If you don’t want to change your medications, try taking them with food. This works for some MyMSTeam members. “I have found that eating a spoon of peanut butter after you take your Tecfidera helps with the flushing,” one member wrote. “Also, if peanut butter isn’t for you, an egg will help, as well.”
Take note of what you’re doing right before or when your face starts to flush. If it happens during while you’re performing certain activities or eating certain foods, try avoiding them to see if the flushing goes away and doesn’t come back. Over time, you can figure out what triggers your facial symptoms and work to avoid things that make you uncomfortable.
If you’re concerned about how you look when your face flushes and you can’t get itunder control, try wearing makeup that will hide the flush. Concealers, foundations, and other products can help you feel confident, even when you know your face is flushing.
MyMSTeam is the social network for people with multiple sclerosis and their loved ones. On MyMSTeam, more than 193,000 members come together to ask questions, give advice, and share their stories with others who understand life with MS.
Do you struggle with facial heating on one or both sides? Or have you been diagnosed with trigeminal neuralgia alongside MS? Share your experiences and tips in the comments below, or start a conversation on MyMSTeam.