If you’re living with lupus, there’s a good chance you’ve experienced a lupus rash, such as the characteristic malar, or “butterfly,” rash. However, lupus can also cause other types of rashes on different parts of the body. These rashes can change the skin’s color and texture, and may feel itchy, painful, and even hot.

“When I flare, my butterfly rash gets very hot to the touch, and I feel achy all over. Yet, I don’t seem to run a fever,” shared one MyLupusTeam member.

“Yes, that happens to me,” another member replied. “Sometimes my eyes burn too.”

If your lupus rash feels hot, you may be experiencing signs of lupus-related inflammation or sun sensitivity. The warmth could also come from something unrelated, such as menopause, or even an infection that needs treatment. Below are some reasons your rash might feel hot and when you should contact your doctor.

Lupus-Related Causes of Warm Skin

The skin is one of the main organs affected by lupus. Sometimes, this autoimmune disease involves only the skin — a condition known as cutaneous lupus erythematosus, or CLE. More often, it also affects internal organs, in which case it’s called systemic lupus erythematosus (SLE). About 50 percent of people with lupus develop the butterfly rash — named for its shape across the cheeks and bridge of the nose.

Inflammation

Lupus is driven by inflammation, and inflammation can create heat. People with chronic inflammation may get low-grade fevers even when they aren’t sick. Also, parts of the body affected by active inflammation, such as a rash, may look flushed or feel hot. “This happens to me when I have a flare-up. The inflammation in my body makes the muscles hurt and the skin red and warm and sensitive,” shared a MyLupusTeam member.

Other members of MyLupusTeam have noticed they feel the heat first, followed by a rash: “My face rash comes out more when I’m hot and doing housework. I get another rash around my neck, which looks terrible, like a very big heat bump that hurts when touched. They last two or three days,” another member said.

Photosensitivity

Lupus rashes often worsen after sun exposure. Ultraviolet (UV) light can intensify the inflammatory response, making rashes more severe. One MyLupusTeam member shared, “My skin feels warm to the touch and, like a sunburn, it seems tender.”

“My face gets red and hot every evening with a low-grade fever sometimes. The sun is my enemy. My eyes can’t take the sun even with dark glasses and a big-rimmed hat. If I get even a few minutes of sun, I get chills and aches later and need to go to bed,” another member said.

Because lupus rashes are photosensitive, it’s important to use sun protection like sunscreens, wear protective clothing, and use hats or umbrellas when outdoors. Limiting sun exposure can help prevent lupus flares.

Vasculitis and Body Temperature

Another potential symptom of lupus is vasculitis — inflammation of the blood vessels. This condition can raise your overall body temperature or cause heat and pain in specific areas. Skin affected by vasculitis may develop small red or purple dots (which may be harder to see on darker skin tones), itchy or raised rashes, open sores, or black spots.

Other Reasons Your Skin Feels Warm

Warm skin isn’t always caused by lupus. Some people experience hot flashes — sudden waves of heat — due to menopause or, in some cases, premenstrual syndrome. Because lupus most often affects women of reproductive age, these hormonal causes are relatively common. Researchers and doctors believe hot flashes happen when the body overreacts in an effort to release heat.

Feeling overheated can be a side effect of medications, including lupus treatments like corticosteroids (such as prednisone). This side effect can also happen with medications prescribed for other conditions, including:

• Anxiety
• Attention-deficit hyperactivity disorder
• Cancer
• Depression
• Erectile dysfunction
• Thyroid problems

Sometimes lupus itself can lead you to feel overheated. However, it’s important to consider other health conditions that can cause similar sensations, such as diabetes, fibromyalgia, or thyroid disease. These conditions can alter how your body regulates temperature or processes inflammation, leading to sensations of warmth or flushing.

Managing Warm Skin With Lupus

Reducing inflammation is a key part of managing lupus and easing symptoms like rashes that feel warm. In addition to taking your prescribed lupus medications, you can support your health with lifestyle measures such as following an anti-inflammatory diet. This type of diet focuses on healthy fats and plenty of vegetables, and it limits fried or processed foods and added sugar. Avoiding trigger ingredients such as alcohol, caffeine, and spices can also help keep your body temperature from rising.

If you experience photosensitivity, avoiding UV light both outdoors and indoors — including tanning beds — is essential. Apply sunscreen daily, wear long-sleeved, protective clothing, and avoid sitting near bright windows or under high-intensity lighting.

If inflammation from lupus — such as vasculitis — is contributing to making your skin feel warm, your doctor may prescribe steroids or other medications to help bring it under control. To cool off, keep your home slightly cooler, run fans at night, and apply skin-safe gel packs. Always check with your healthcare provider before trying cold therapy to make sure it’s safe for you.

When To Call Your Healthcare Provider

If your lupus rash doesn’t improve after a couple of weeks of treatment, your doctor may need to adjust your regimen. Rashes that spread to your lips or develop into mouth sores should also be evaluated by your rheumatologist or dermatologist.

Sensitive skin that feels hot to the touch could be a sign of infection. Other signs of a skin infection include swelling, pus, and pain. Because immunosuppressive drugs make it harder for your immune system to fight off the infection, infections are especially dangerous for people with autoimmune diseases like lupus.

If you have chronic skin lesions from lupus, be sure to have them monitored regularly by a healthcare provider.

Whenever you notice a new or unexpected symptom with lupus — including rashes or lesions that feel hot — don’t hesitate to contact your healthcare provider for medical advice. Getting treatment quickly and watching for changes are key to managing this lifelong condition and feeling your best while living with lupus.

Join the Conversation

On MyLupusTeam, people share their experiences with lupus, get advice, and find support from others who understand.

Do you experience skin that feels hot as a sign of lupus or lupus flare-ups? What strategies have you used to help keep your body cool? Let others know in the comments below.