Lupus and your skin: Self-care dermatologists recommend

12 self-care tips dermatologists give their patients with cutaneous lupus

When lupus affects your skin, the right self-care when combined with treatment can:

• Reduce flares

• Prevent lupus from getting worse

• Lessen your risk of long-term skin problems and other conditions

Here are 12 self-care tips that dermatologists share with their patients who have cutaneous (skin) lupus:

1. Protect your skin from the sun every day. Lupus can make your skin very sensitive to ultraviolet (UV) light, which can trigger a lupus rash or other skin problems. Sun protection can prevent flare ups and stop lupus from worsening.
   
   To protect your skin from the sun, dermatologists recommend the following:

   • Seek shade when outdoors.
   • Wear sun-protective clothing like pants, long sleeves, a wide-brimmed hat, and sunglasses when possible. For more effective protection, select clothing with an ultraviolet protection factor (UPF) number on the label.
   • Apply sunscreen to all skin that clothing won’t cover, using a sunscreen that offers broad-spectrum protection, SPF 30 or higher, and water resistance.
   To get the protection that you need from sunscreen, be sure to apply it 15 minutes before going outdoors. While outdoors, reapply your sunscreen every two hours and after swimming or sweating.

   If you have a darker skin tone, consider using a tinted sunscreen

   It won’t leave a white cast on your skin. To get the protection you need, a tinted sunscreen must also offer broad-spectrum protection, SPF 30 or higher, and water resistance.

   

2. If you lie in the sun or use tanning beds, stop. Both the sun and tanning beds expose you to harmful UV rays. Whether from the sun or tanning beds, these UV rays can cause lupus to flare.

3. If you smoke, quit. Findings from research studies suggest that smoking can worsen cutaneous (skin) lupus. Smoking may also prevent some medications used to treat lupus like chloroquine and hydroxychloroquine, which are antimalarial medications, from working.
   
   Studies have also shown that when patients quit smoking, medication that failed to clear their rashes and other skin problems starts to work.
   
   For many people, quitting smoking is difficult. The cravings for nicotine can be intense.
   
   To help people quit, the American Lung Association (ALA) has been offering a quit- smoking program for more than 35 years. Today, the ALA says that it’s ranked as one of the most effective programs for helping people quit smoking for good.
   
   Learn more at Freedom from Smoking®.

4. Stop touching the patches and rashes on your skin. When you touch, rub, or pick at the rashes, sores, and patches, new ones can develop.

5. Replace fluorescent, compact fluorescent, and halogen light bulbs. These light bulbs emit some UV light. If you are very light sensitive, this UV light can cause a lupus flare-up or itchy skin. Replacing these bulbs with LED or incandescent bulbs can help.
   
   If you cannot replace the bulbs, a UV light filter or light shield may help. Some people say these products reduce the flare-ups and itching that occur when they spend hours under fluorescent lights, such as at work.
   
   If you cannot replace the bulbs or get a UV filter or shield, you may want to wear a wide-brimmed hat, sunscreen, and sun-protective clothing. These can also protect you from indoor UV light.

6. Before taking a medication, ask if it can increase light sensitivity. Some medications can make your skin more sensitive to light. If your doctor says that a medication can increase light sensitivity, ask if you could take another medication.

7. Ask your dermatologist if you need a vitamin D supplement. Our bodies need vitamin D for healthy bones. If you are not getting enough, you may need to take a supplement. A blood test can tell your dermatologist whether you’re getting enough vitamin D.

8. Protect your skin from the cold if you have Raynaud’s phenomenon. Some people who have cutaneous lupus develop this condition, which makes their fingers and toes extra sensitive to cold.
   
   To protect your skin from the cold, dermatologists recommend that you bundle up when spending time outdoors in the cold. A warm coat, hat, gloves, and socks are essential. When spending time in a heavily air-conditioned space, wear gloves and socks. Hand warmers can also keep your hands warm.
   
   Raynaud’s can also make you very sensitive to caffeine and nicotine. People living with Raynaud’s should avoid anything that contains caffeine or nicotine.

9. Keep all your dermatology appointments. If you have cutaneous lupus, it can take time to diagnose this condition. It can also take time to find a treatment plan that works for you.
   
   Another reason to keep your dermatology appointments: About 20% of people who have cutaneous lupus develop systemic lupus erythematosus (SLE). Called the most serious type of lupus, SLE can affect other organs like the lungs and kidneys. Keeping all your dermatology appointments can help your dermatologist find signs of SLE early when treatment can improve your quality of life.

10. If you see anything on your skin that is different from others, or that changes, itches, or bleeds, see your dermatologist. These can be signs of skin cancer. Some types of cutaneous lupus increase a person’s risk of developing skin cancer. With early detection and treatment, skin cancer is highly treatable.

11. Before trying an herb, vitamin, or other alternative treatment, tell your dermatologist. Some of these may interact with medications that you use to treat lupus on your skin, causing unwanted side effects.

12. Connect with others who have lupus. You can find others who have lupus on Facebook, Twitter, and other social media platforms.

If you’re looking for a lupus support group, you may find one in your area or online at Lupus Foundation of America.

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References
Ezra N, Jorizzo J. “Hydroxychloroquine and smoking in patients with cutaneous lupus erythematosus.” Clin Exp Dermatol. 2012 Jun;37(4):327-34.

Nozile W, Adgerson CN, et al.” Cutaneous lupus erythematosus in skin of color.” J Drugs Dermatol. 2015 Apr;14(4):343-9.

O'Brien JC, Chong BF. “Not just skin deep: Systemic disease involvement in patients with cutaneous lupus.” J Investig Dermatol Symp Proc. 2017;18(2):S69-S74.

Temprano KK. “A review of Raynaud's disease.” Mo Med. 2016 Mar-Apr;113(2):123-6. 

Written by:
Paula Ludmann, MS

Reviewed by:
Brendan Camp, MD, FAAD
Mario J. Sequeira, MD, FAAD

Last updated: 9/23/22