Nail problems are common, and they are not usually serious. If a person has multiple sclerosis (MS), nail problems can cause pain or discomfort. While nail issues are not directly related to the disease, determining the cause may help prevent a person with MS from experiencing further discomfort.

Multiple sclerosis (MS) causes the immune system to attack the myelin sheath, the protective covering around nerve cells. It can affect any part of a person’s body.

There is no clear link between MS and issues with the nails. If a person notices changes in their nails, it may be due to the nail itself or the skin underneath it. Changes in the nails may be due to environmental factors that affect the wider population in the same way, including trauma or prolonged exposure to dyes, such as nail polish.

Nail issues could also be a marker for an underlying systemic disease, such as chronic obstructive pulmonary disease (COPD), so a person should contact a doctor if they feel concerned.

In this article, we look at the possible causes of various nail changes and how to treat them.

Learn how to identify nail diseases using our illustrated chart here.

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MS is an autoimmune disease that causes the immune system to attack healthy cells.

MS can cause weakness and paresthesia. Paresthesia causes unusual sensations that can affect any part of the body, usually on one side or limb. However, it often affects the extremities, such as hands, legs, or feet.

Sometimes, paresthesia can affect the fingers or toes, but having MS does not make this more likely. However, the sensation can make a person feel like there is something wrong with their nails.

It is important to note diminished sensations in the body, particularly in the arms or legs, as they can put a person at risk of an injury they might not notice or be aware has happened.

People with MS can also experience pain more intensely than the general population. Therefore, seemingly insignificant issues, such as hangnails, may cause excessive pain in someone who has MS.

Nail abnormalities can occur for many reasons and are not exclusive to people with MS. Environmental factors, vitamin deficiency, or prescribed medication are usually the cause. Prolonged exposure to water, for example, can soften the nails, making them more susceptible to infections or discoloration.

Learn how MS can affect the body here.

There are many reasons why nails may change color. Some may involve lifestyle choices, such as smoking, staining after wearing dark nail polish, trauma from an injury, or an underlying condition. Discoloration can affect the nail itself or result from changes in the skin underneath the nail.

Yellow, brown, or white

Yellow, brown, or white nails usually indicate a fungal infection. The nails may also thicken, crack or break more easily.

Some fungal infections heal slowly, sometimes taking up to a year. However, once the infection has cleared, the nail usually grows back. A doctor may prescribe oral antifungals if topical treatments do not work.

Learn about yellow nail syndrome here.


Blue nails occur when there is not enough oxygen in the bloodstream. This may result from cold weather when the body restricts the amount of oxygen to the fingertips. People with Raynaud’s disease may experience this sensation. Blue nails will typically return to their usual color when the body warms up.

Contact a doctor for further treatment.

Learn more about blue nails here.


Black nails often develop after trauma to the nail. If something hits the nail with force, the nail or the skin underneath it may turn black.

Other causes of black nails include underlying conditions, such as thyroid disease, although this is extremely rare. Contact a doctor to determine the cause.

Learn about black toenails here.

White spots

White marks on the nails are known as leukonychia. The markings can present as spots or stripes. There are many causes of white spots on the nails, including trauma, some diseases, or a zinc or iron deficiency.

Treatment depends on the cause. Lifestyle changes or taking supplements may cure this problem, but if it persists, contact a doctor.

Learn more about white spots on the nails here.

Brittle nails are usually the result of too much or too little moisture. Repeated washing and drying of the hands can cause the nails to dry out and become hard and brittle, and applying too much moisturizer, for example, can make the nails too soft, causing them to split.

Rarely, brittle nails may signify a vitamin deficiency, including iron deficiency.

There are few treatments available for brittle nails. However, wearing cotton-lined rubber gloves when washing up or using cleaning products, taking supplements to strengthen the nails, or moisturizing hard, brittle nails may help.

Learn more about brittle nails here.

A person may notice horizontal or vertical nail ridges. Horizontal ridges follow the direction of the nail bed, while vertical ridges run along the length of the finger.

Horizontal ridges

Beau’s lines are deep grooves that run horizontally across the width of the nail. These occur when something interrupts or stops the nails from growing.

There are many causes of horizontal nail ridges, including high fever, cold temperatures, or psychological stress.

Vertical ridges

Vertical, or transverse, ridges that run along the length of the nail can develop due to:

  • injury
  • recurrent bouts of illness
  • improper nutrition
  • picking at or pushing back the cuticles

Learn more about ridges in nails here.

If a nail has separated from the nail bed, it may lead to a white block appearing on the nail. Separation from the nail bed may have a common cause, such as trauma or a fungal infection. However, it may also be the result of psoriasis.

Some researchers have suggested there may be a strong link between psoriasis and MS. According to one 2019 study, the incidence of MS in people who have psoriatic arthritis is almost double that of MS in the general population. Psoriasis and psoriatic arthritis can both cause the nail to lift from the nail bed.

Learn the difference between nail psoriasis and a fungal infection here.

Nail loss may be the result of trauma, a rash, or certain MS medications.

Lichen planus causes a recurring itchy rash. When it affects the nails, it can damage the nail bed, causing the nail to become yellow, thinner, and ridged. It can lift the nail off the nail bed in some cases, and the nail may fall off.

Prescribed medicines can cause nail damage, and some people have reported nail damage, although scientists have not fully established this link.

If a person notices nail loss, they should contact their doctor.

Learn more about why a toenail might fall off here.

Nail disorders are not specific to MS. However, as this is a systemic disease affecting every part of the body, some people with MS may experience symptoms. Certain medications may also cause nail issues.

External factors, such as exposure to chemicals or household cleaners, can damage the nails, as can fungal or bacterial infections.

In most instances, nail damage will clear as the nail grows out, but it may be a marker of an underlying condition. Anyone who notices any sudden changes in the texture or appearance of the nails that are not the result of an injury should consult a doctor for advice and diagnosis.