If you have myasthenia gravis (MG), you may be too focused on muscle strength and function to think much about your skin health. Myasthenia gravis isn’t known to cause skin problems directly, but complications, treatment side effects, and conditions related to MG may raise your risk for developing skin rashes or other skin irritations.

Read on to learn about three possible ways myasthenia gravis may affect your skin.

1. Skin Problems Linked to Myasthenia Gravis Complications

Myasthenia gravis is an autoimmune condition. In MG, your body’s immune system attacks the space between nerves and muscles, making it harder for muscles to receive signals.

Because of this communication breakdown, people with MG experience muscle weakness, which affects mobility and control of fine-motor movements. For some people, movement challenges could lead to rubbing, scratching, or pressure on the skin with certain movements. This added friction could cause irritation, rashes, or bruising.

2. Skin Problems as Treatment Side Effects

Myasthenia gravis affects everyone differently. There are many MG treatments to help you manage symptoms and improve your quality of life. All medications, including those sold over the counter, can cause side effects. In the case of treatments for MG, these may include injection site reactions and allergic reactions like itching, burning, and skin discoloration.

The three medication types below can impact your skin in different ways.

Acetylcholinesterase Inhibitors

Many people with myasthenia gravis benefit from a class of drugs called acetylcholinesterase inhibitors. These medications prevent the breakdown of the chemical acetylcholine, promoting better communication between nerves and muscles. However, some acetylcholinesterase inhibitors are associated with a variety of skin irritations.

For example, in one study of the medication pyridostigmine (Mestinon), some participants with MG reported experiencing skin rash, blushing, or hives as a side effect.

Corticosteroids

Your doctor may prescribe corticosteroids (often simply called steroids) to manage MG. While these medications can reduce inflammation and regulate your immune system, they can have side effects. Potential skin problems associated with steroids include:

• Acne — Corticosteroids can cause an overproduction of oil in the skin, which can clog pores and cause acne outbreaks.
• Delayed wound healing — Steroid medications can slow the body’s natural healing process, which means cuts, scrapes, or surgical wounds may take longer to heal.
• Sunburn — Corticosteroids can increase sun sensitivity and the risk of sun damage.
• Skin thinning — Long-term corticosteroid use can cause your skin to become thinner and more fragile. This can lead to bruising and tearing.

One MGteam member asked, “Anyone else bruise real easy with MG?” Another replied, “Look at me sideways, and I will bruise. It started happening before MG, but now it’s 10 times worse. Bruising and thin skin.”

Immunosuppressants

If you have MG, your doctor may prescribe immunosuppressant medications to tamp down your immune system’s response. Immunosuppressants for myasthenia gravis include azathioprine and mycophenolate mofetil. These medications may be effective alternatives to long-term steroid use.

Azathioprine and mycophenolate mofetil both increase sun sensitivity, increasing the risk of sun damage or sunburn. It’s important to use adequate SPF and protect yourself from the sun when taking these medications.

Some studies have found a link between the prolonged use of azathioprine and a low but increased risk for skin cancer. However, other studies have not found the same results. Ask your doctor about skin cancer risk in regard to your medication.

3. Skin Side Effects From Myasthenia Gravis-Associated Conditions

Myasthenia gravis increases the risk for other health conditions, several of which can cause skin problems.

Research has shown that people with MG are at risk for other autoimmune disorders. This includes pemphigus, a rare condition that causes skin blistering. Other autoimmune conditions that can affect the skin include psoriasis, which causes dry plaques to form on the skin, and vitiligo, which causes the gradual loss of skin pigmentation. MG also raises the risk for lupus, which can have skin symptoms as well.

Thyroid disease is another condition associated with myasthenia gravis. Thyroid disease affects 5 percent to 10 percent of people with MG. The American Academy of Dermatology lists several skin-related symptoms of thyroid disease, including:

• Pale, dry skin
• Wounds that take a long time to heal
• Deep cracks in the skin
• Prominent lines on the soles of the feet and palms of the hands
• Rashes that form in the creases of the skin

Hashimoto’s thyroiditis, a thyroid issue which affects some people with myasthenia gravis, also causes dry skin.

Take Care of Your Skin

People with myasthenia gravis face unique challenges when it comes to skin health. However, there are several steps you can take to protect your skin.

Find a Skin Care Routine That Works for You

Use mild, fragrance-free cleansers and moisturizers to keep your skin hydrated and avoid irritation. Stay away from harsh scrubs that can damage thinning skin or make acne worse. If you have sensitive skin, consider using hypoallergenic products. If you are taking medications which can affect your skin, talk to your healthcare team about products or routines that can protect your skin.

Protect Yourself from Bruising

Certain myasthenia gravis medications can make your skin more fragile. Try to avoid activities that can lead to bruising or injury. Be extra cautious during physical activities, and protect your arms and legs.

Seek Quick Help for Skin Infections

If you notice redness or skin discoloration, swelling, pain, or pus, you may have a skin infection. Talk to your doctor right away. Quick treatment can prevent your infection from spreading.

Shield Yourself From Sun Exposure

Some medications (like corticosteroids and azathioprine) increase your sensitivity to light. Take extra precautions when spending time outdoors. The American Academy of Dermatology recommends wearing sunscreen with an SPF of at least 30. Steer clear of the sun between 10 a.m. and 4 p.m., and wear wide-brimmed hats, protective clothing, and sunglasses for added protection.

Talk to Your Healthcare Provider About Medication Side Effects

Your medications may help with your myasthenia gravis symptoms, but you don’t have to accept the skin problems they may bring. Talk to your healthcare provider about medication alternatives or dosage adjustments that may reduce skin irritations.

Know When To Seek Help

How do you know if your skin problem is due to your myasthenia gravis? It may be tough to tell, but MGteam members say you shouldn’t ignore any symptoms. One MGteam member said, “Listen to what your body is telling you.”

Talk with your healthcare provider about skin rashes or other skin-related problems. Make sure they know about every medication you take — including supplements.

Talk With Others Who Understand

MGteam is the social network for people with myasthenia gravis and their loved ones. On MGteam, members come together to ask questions, give advice, and share their stories with others who understand life with MG.

Have you noticed skin problems associated with myasthenia gravis? Have you had a skin reaction to a myasthenia gravis medication? Share your experience in the comments below, or start a conversation by posting on your Activities page.