A Guide to Multiple Sclerosis Skin Conditions

Medically Reviewed By Susan W. Lee, DO

Multiple sclerosis (MS) causes damage to spinal cord, brain, and eye nerves. This damage may not directly harm the skin. However, people with MS may experience skin conditions from nerve dysfunction and some MS medications. These conditions include infection, tingling, and rashes. MS is a condition in which the immune system causes inflammation and damage to the central nervous system (CNS). The CNS includes the spinal cord, brain, and eye nerves.

Some people with MS experience skin conditions as symptoms or complications.

This article explains multiple sclerosis skin symptoms and complications, including causes, diagnosis, and treatment. 

How does multiple sclerosis affect the skin?

Someone scratches the back of their wrist.
AndreyPopov/Getty Images

MS damages the nerves and pathways that transmit signals between the brain, spinal cord, and eyes. These signals control Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source how you perceive pain, discomfort, and sensation. 

MS damage in the nerves and brain can cause skin sensations without any physical stimuli on the skin or as an overreaction to a physical stimulus. Examples of stimuli include a scratch or an irritant. However, the absence of physical stimuli does not make the sensations any less significant.

MS medications and the effects of MS on daily life may also increase Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source the risk of certain skin conditions.

Following are skin symptoms that someone with MS might experience. 

Neuropathic itch

Neuropathic itch, or pruritus, is itching that can occur as an overreaction to stimuli or without physical stimuli. This creates a real itch sensation on the skin.

People with MS may experience pruritus in different ways. It can feel like:

  • pins and needles on or inside the skin
  • burning 
  • stabbing sensations
  • the skin is tearing off 

Paresthesia

MS nerve damage can cause paresthesia, or atypical skin sensations.

Paresthesia is most often painless, and can feel like:

  • numbness
  • tickling, tingling, or pins and needles
  • burning
  • prickling
  • skin crawling

These sensations are often felt in the hands, limbs, and feet, but they can affect other body areas.

Numbness and tingling can be early symptoms of MS.

Sensitive skin

The nerve damage of MS can make the skin very sensitive and sometimes painful.

A 2018 review of previous studies suggests that 60–80% Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source of people with MS experience temperature sensitivity. This is an intense reaction to hot or cold temperatures.

Studies in the review also suggested:

  • About 8% of people with MS experience mechanical allodynia, a painful sensation from a light touch to the skin.
  • About 35% of people with MS experience cold allodynia, when the skin touches something cold.

Medication side effects

Some medications and treatments for MS may cause Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source skin irritation, such as Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source :

  • lesions
  • hives
  • pruritus
  • other rashes
  • inflammation of the mucosa, the soft, moist tissues that line the mouth, gut, and other areas

Medications that may cause skin reactions include Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source cladribine (Mavenclad) and monoclonal antibodies, such as ocrelizumab (Ocrevus).

If you use injected medications, you may experience Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source irritation at the injection site, including:

  • swelling, pain, or itching
  • lesions or plaques
  • temporary bumps or nodules
  • fat wasting

Pressure sores

Some people with MS may develop pressure sores, or bedsores. These develop from pressure on the skin. Pressure sores tend to develop on bony parts of the body, such as the heels or tailbone. They can lead to open wounds.

Symptoms of pressure sores include:

  • discolored skin
  • changes in skin texture
  • skin that feels different from the surrounding areas, such as cooler, warmer, harder, or spongier
  • blisters
  • broken skin or open wounds

Contact your doctor if you notice possible symptoms of pressure sores.

Read more about bedsores, including their prevention and treatment.

Skin infections

MS may indirectly increase the risk of skin infections through Trusted Source Centers for Disease Control and Prevention (CDC) Governmental authority Go to source the following:

  • pressure sores, which may cause open wounds that allow pathogens to enter
  • injected medications, which may cause infection from breaking the skin or using improperly sterilized needles
  • scratching from pruritus, which may break Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source the skin
  • immunosuppressant medications, which may lower Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source the immune system and increase the risk of infection, including skin infection

Symptoms of skin infection can include:

  • discoloration or redness
  • painful skin close to a wound
  • rashes
  • pus
  • skin that feels warm to the touch

Contact a doctor promptly if you notice any possible symptoms of skin infection.

Read more about the symptoms of skin infection.

Diagnosis

Contact your doctor if you have persistent or concerning skin symptoms.

To diagnose the cause of your symptoms, your doctor will ask about your symptoms, medical history, and family medical history. They may also conduct a physical exam and order further tests to identify or rule out conditions. Tests may include:

  • blood tests
  • swabbing the skin or a wound
  • taking a small sample of skin

If you already have an MS diagnosis, your medical team may suggest updates to your current treatment plan. For example, they may recommend physiotherapy or occupational therapy to help with physical activity. This will help reduce the risk of pressure sores.

Treatment and management 

Treatment options depend on the specific symptoms or condition, as well as personal health.

In many cases, treating the underlying MS can help alleviate the skin symptoms it causes. Most MS treatment includes a combination of medications to calm the immune response and decrease inflammation. 

Example treatments for MS skin symptoms include:

  • antiseizure or antidepressant medications for pain, itching, or paresthesia
  • medication adjustment to reduce side effects
  • antibiotics or antivirals for skin infection

Learn more about treatment for MS pain and itching.

To relieve pressure and speed up healing of pressure sores, treatment may include:

  • wound cleaning and dressing
  • ointments
  • specially designed cushions, mattresses, or mobility aids
  • regular changing of position

To manage MS skin symptoms at home, ask your doctor about options for caring for your skin.

The National Multiple Sclerosis Society recommends the following self-care strategies for managing MS symptoms:

Read more about self-care approaches and treatment options for MS.

Summary

MS nerve damage, pressure on the skin, and medication side effects may cause skin symptoms and conditions. These include itching, skin sensitivity, and infection.

Treatment for MS skin conditions depends on the symptoms and causes. For example, wound dressing and ointments may improve pressure sores.

If you have MS and experience skin symptoms, talk with your medical team for advice. Contact a doctor promptly for symptoms of skin infection, such as pus leaking from a wound or skin discoloration.

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Medical Reviewer: Susan W. Lee, DO
Last Review Date: 2023 Oct 31
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