While Multiple Sclerosis (MS) doesn’t cause skin lesions, some aspects of MS or MS treatment can be associated with an increased risk of skin lesions, hives, and other skin problems. Treatment options may help.

Multiple sclerosis (MS) is a chronic disease of the nervous system. It can cause a range of symptoms, from fatigue and muscle spasms to itching, numbness, and even vision, bowel, and cognitive problems.

MS may increase the risk of certain skin lesions, usually because of irritation from excessive scratching or as a side effect of some MS medications. Treatments for MS lesions vary and may be different from typical treatments for rashes and hives triggered by other causes.

Learn more about MS.

A skin lesion is a small or large section of skin that differs from the surrounding skin. It could be a dry patch, hives, or other irritation.

An MS skin lesion is one that develops as a result of having MS, as opposed to skin that’s injured by a scrape or burn or that changes because of an acne breakout or a condition such as psoriasis or eczema.

A skin lesion triggered by MS medications may present as hives and as red and swollen bumps, often on the face.

The itching sensation that often accompanies MS also can cause someone to scratch their skin too much in looking for relief. Symptoms may then include raised, thickened areas of skin that can become cracked. Bleeding and infection may follow.

There are several causes of MS skin lesions, including:

Pruritus

For people with MS, itchy skin, also known as pruritus, is a type of dysesthesia, an abnormal sensation triggered by changes in the central nervous system. In addition to itchiness, dysesthesia can feel like pain, numbness, or tingling.

A 2018 study suggests that about 80% of people with MS experience some type of sensory symptoms such as itching, tingling, and abnormal sensitivity to heat and cold.

MS affects the central nervous system by harming the myelin, a fatty sheath that surrounds and protects nerve fibers. As a result, the nerve fibers themselves are changed. Specific nerve fibers affected by MS lead to various MS symptoms, including dysesthesia.

Side effects of oral medications

Medications you take to treat MS may also cause MS skin lesions. MS medications associated with skin lesion side effects include:

  • cladribine
  • alemtuzumab (rarely used because of serious and potentially life threatening side effects)
  • natalizumab (rarely used because of serious and potentially life threatening side effects)

Injection site reaction

Some MS medications are self-injected and can cause bruising or swelling in the area of injection. A site reaction is different from the side effect of systemic rash that’s caused by some MS medications. Site reactions can cause redness or a rash, and the complications can be severe.

Immune system suppression

Most MS treatments, such as maintenance disease-modifying therapy and steroids used during an attack, suppress the immune system.

Skin infections can occur when the immune system is weakened, and these skin infections may cause symptoms such as:

  • changes in skin color
  • itching
  • rash
  • redness
  • sensitivity
  • bleeding

To diagnose MS skin lesions, a doctor or healthcare professional will:

  • examine the affected area of skin
  • discuss other symptoms you have, if any
  • list your current medications
  • review your medical history

A doctor will also investigate other causes for your skin lesions such as:

  • possible injection site infection
  • another autoimmune disease that causes skin changes
  • severe and harmful scratching
  • medications for other conditions

The treatment for MS skin lesions will depend on what’s causing them.

If MS medications are causing skin lesions, the first approach may be to stop the drugs. A doctor may recommend an alternative medication that’s not associated with a high risk of hives or other risks.

If the MS skin lesions are mild, a doctor may prescribe medications to treat the hives or skin reactions. Antihistamines are among the medications that are sometimes used. Histamines are substances the body releases in response to infections and allergies.

Histamines can cause symptoms such as:

  • congestion
  • hives
  • itching
  • skin rashes
  • sneezing
  • watery eyes

Antihistamines blunt the effects of histamines. If an antihistamine isn’t effective, a doctor may then recommend taking a short course of corticosteroids, which reduce inflammation and symptoms such as hives.

Other medications that may help reduce skin lesions include:

  • corticosteroids
  • omalizumab, an injectable medication for chronic hives and other inflammatory conditions
  • topical antifungal
  • medications for specific autoimmune disorders

Because skin lesions can develop in anyone with MS, there’s no single risk factor that makes one person more likely than another to develop them. Likewise, there are no factors that overwhelmingly raise the risk of developing MS.

MS is a disease of the immune system, and scientists are still trying to understand why certain people develop MS. Certain genetic traits may raise the risk of MS, but MS isn’t considered an inheritable condition such as cystic fibrosis or Huntington’s disease.

MS skin lesions won’t affect the course of MS. However, they can cause complications if they’re not treated, so it’s important to respond as soon as possible to the onset of skin lesions or other new MS symptoms.

Does MS itself cause hives or other skin lesions?

Though MS can affect many parts of the body, the disease itself doesn’t cause skin changes. The skin lesions experienced by individuals with MS are usually attributable to excessive itching, medication side effects, or other medical conditions.

Is it possible to reduce itching without medications?

Because the pruritus brought on by MS isn’t a typical skin condition, moisturizers and soothing lotions may not be as effective. However, they may be helpful in easing the irritation caused by a lot of scratching. Learning to manage stress is also associated with MS symptom reduction.

What type of doctors treat MS symptoms?

Because MS affects so many systems in the body, you may be best served by a team of specialists, including:

MS is a challenging disease, but by being proactive about your care and taking your medications as directed, you may be able to reduce symptoms, such as skin lesions, and improve your quality of life.

MS skin lesions are indirect complications of the disease and are usually treatable. Keep in mind that that not all cases of hives, rashes, or other skin problems will be related to MS. Food allergies, sunburn, and many other factors can trigger skin lesions, so be sure to get a thorough medical evaluation if these symptoms appear.