Lupus and the skin
Lupus affects different people in different ways. Most people with lupus have skin problems, like rashes or sores. Sometimes lupus affects only the skin, and sometimes it affects other parts of the body, too.
How does lupus affect the skin?
People with lupus can have many different skin problems.
Skin problems that only happen to people who have lupus are called cutaneous lupus. There are 3 main types:
- Chronic cutaneous lupus (also called discoid lupus) causes round, disc-shaped sores, usually on the face and scalp. The sores can cause scars or changes in skin color.
- Subacute cutaneous lupus causes a red scaly rash or red ring-shaped sores. It usually happens on skin that gets sunlight, like the neck and arms.
- Acute cutaneous lupus causes a butterfly-shaped rash on the cheeks and nose that looks like a sunburn (called malar rash). Sometimes it affects other body parts, like the arms and legs.
Other lupus skin problems
People with lupus can have other skin-related problems, like:
- Hair loss
- Calcinosis (hard, white lumps under the skin caused by a calcium buildup)
- Mucosal ulcers (sores inside the mouth, nose, or vagina)
People with lupus can also have problems with blood or blood vessels that you can see on the skin. A few examples include:
- Raynaud’s disease (fingers and toes turning white or blue and feeling numb when you’re cold or stressed)
- Livedo reticularis (a blue or purple pattern that showing through the skin that looks like lace or fishnet stockings)
- Palmar erythema (palms of the hands turning red)
- Petechiae (tiny red spots on the skin caused by low platelets in the blood [thrombocytopenia] )
What do lupus skin problems feel like?
Sometimes these skin problems feel itchy or painful, and sometimes they don’t. The symptoms can come and go, and they can feel different from person to person. If you have pain or other symptoms from lupus, talk with your doctor about treatment options.
Lupus skin problems are not contagious — you can’t catch them or give them to someone else.
Take steps to protect your skin
While many skin problems need medical treatment, making lifestyle changes can help prevent or ease some symptoms.
Protect your skin from ultraviolet (UV) light
Most people with lupus are sensitive to UV light — and it can trigger lupus skin problems. Follow these tips to protect yourself:
- Use a broad-spectrum sunscreen with SPF 60 or higher that blocks both UVA and UVB rays. Use a wax-based lip balm with SPF 15 or higher to protect your lips. Apply sunscreen at least 20 minutes before sun exposure and apply throughout the day.
- Wear long sleeves, pants, and wide-brimmed hats made of fabrics that protect you from the sun
- Plan outdoor activities for early in the morning or later in the evening. It’s also important to remember that cloud cover or shade doesn’t fully protect you from UVA rays.
You may be sensitive to indoor lighting, too. If indoor light bothers you, try putting light shields over fluorescent bulbs. You can also buy light bulbs that send out low amounts of UV radiation, like LED lights. If the sunlight bothers you while indoors, it’s possible to get UV-blocking shades for your windows to prevent sunlight from entering the room.
Protect your skin from cold temperatures
If you have Raynaud’s disease, protecting your skin from the cold can help. Try wearing warm gloves and thick socks when you’re outdoors in cold weather. If you’re going from the heat to an air-conditioned building, be sure to carry extra clothing to help prevent flares.
Find the right treatment plan
Because lupus can cause a lot of different skin problems, there are many different kinds of medicine that can treat them. A specialist doctor called a dermatologist can help you find a treatment plan that works for you.
Richard D. Sontheimer, MD
Specialist in the skin changes that occur in autoimmune rheumatic diseases like lupus. Read Bio