It is common to experience skin problems when you have lupus. You may have lesions or ulcers in your nose or mouth. You can also have rashes that look like butterflies across your facial cheeks and your nose. It can appear faint as a blush or severe and raised and may contain some scaling. The rash will be very sensitive to sunlight and will worsen if exposed to the sun or even certain types of artificial light. The rash may be permanent or may even disappear and then reappear again.
There are three types of lesions you may encounter as a lupus patient; discoid, subacute cutaneous and mucous membrane lesions. Discoid lesions are coin-shaped and occur on the scalp region of the head. These discoid lesions do leave scars and can cause permanent balding at the site of the lesion.
Subacute cutaneous are red, scaly, coin-shaped lesions that are very sensitive to UV light. They appear on any large area of skin and can look like psoriasis. Mucous membrane lesions occur in the mouth, nose and even the vagina. They are also called ulcers. These ulcers or lesions are painless.
Vasculitis is a condition common in lupus patients in which blood vessels become inflamed. Very small blood vessels can become inflamed and break and cause bleeding into the surrounding tissues. This results in tiny, reddish-purple spots called: petechiae. When the spots are larger they are called: purpura.
Blood clots can form, or skin ulcers or even small black areas around the nails of fingers and toes. The blackened skin is a sign of tissue damage and is a very serious condition that needs immediate medical care. Let your doctor know if you notice any black skin.
Raynaud’s phenomenon is a condition where he blood vessels of the fingers become narrowed in cold temperatures causing the fingers or toes to turn whiter (or blue) than the surrounding tissue. When the circulation returns to normal you may feel some tingling or pain.
The color will return to normal, when the skin warms up again. Dress warmly in cold weather and make sure you keep your hands and feet warm. Keep your home thermostat turned up so that your home is warm. Avoid cigarette smoking, caffeine, and as much as possible avoid stress.
Tips on Caring for your Skin
1. Limit your exposure to the sun and artificial light (fluorescent/halogen bulbs).
2. Stay out of the sun during the hours of 10 a.m. and 4 p.m.
3. Apply sunscreen to any exposed areas of skin of SPF 15 or higher. Products that contain zinc oxide or titanium dioxide will block both the UVA and the UVB rays and are good to use. You should wear sunscreen all year, even on cloudy days.
4. Wear protective clothing, and hats with wide brims. Special clothing that is designed to be UV-protective can also be purchased.
Always inform your doctor if a sore or rash gets worse and always take any prescribed medicine.
If you have a mouth ulcer or lesion, rinse your mouth with salt water and eat soft foods until it heals. Your doctor may recommend a treatment or medicine to apply to the ulcer.
Avoid using anything on your skin that may make your skin condition worse like: hair dyes, skin creams, even some drugs can make your skin more sensitive to the sun (talk with your doctor about this). If you must wear makeup, be sure to use the hypoallergenic ones. If available use products that state they have UV protection.