A malar rash is an area of discoloration that spreads across the face, usually from one cheek to the other. It’s often called a “butterfly rash” because the shape looks like a butterfly with outspread wings. But what if the rash is only on one side of your face? Is that still considered a malar rash?

Like many members of MyLupusTeam, you may wonder if you have an unusual version of this common lupus symptom.

“The rash I’ve had for several months doesn’t look like a typical butterfly rash because it’s only on my left cheek and left side of my nose,” one member wrote. Another replied, “My rash is always more prominent on one side than the other.”

Read on to learn more about the features of a malar rash, other types of rashes that are symptoms of lupus and may affect your face, and possible treatments.

Malar Rashes Are Symmetrical

A key feature of a malar rash is that it’s symmetrical. It usually spreads across both cheeks and the bridge of the nose. A rash that appears only on one cheek or one side of the face is not considered a malar rash. Other features that are common (but not always present) include:

• Discoloration — Red on lighter skin and dark purple or brown on darker skin tones
• A raised or bumpy texture
• Scaliness
• Itchiness, pain, or burning

A malar rash can look like a sunburn or like you’re blushing across your cheeks and nose. One MyLupusTeam member said, “My malar rash normally is bright red on my cheeks and nose, almost like I used way too much rouge. Sometimes it’s more raised and painful, with a burning sensation.”

Other Features of Malar Rashes

Besides its shape, a malar rash has another unique feature — it doesn’t affect the nasal folds (smile lines) or the underside of your nose, around your nostrils.

Check with your doctor if you have a facial rash and are wondering if it’s a malar rash or a different kind of lupus rash.

How Long Does a Malar Rash Last?

A malar rash may appear suddenly in response to a trigger, such as sun exposure. It’s usually temporary. Depending on the cause, it may fade within a few days or take several weeks to clear. Once it heals, the rash doesn’t leave a scar. For some people, a malar rash can signal that a lupus flare-up is coming.

Who Gets Malar Rashes?

Malar rashes can happen in several conditions, but they’re a common symptom of all types of lupus. About half of all people with lupus develop a malar rash. In a MyLupusTeam survey, 62 percent of members said they had experienced one.

Malar rash can often be the first symptom of systemic lupus erythematosus (SLE), the most common type of lupus. Malar rashes can appear months or even years before other symptoms. Still, not everyone with SLE develops a malar rash. A 2023 study in The Journal of Rheumatology found that 30 percent to 50 percent of people with SLE develop this symptom of lupus.

Why Do I Have a Rash on One Side of My Face?

Aside from a malar rash, there are other types of lupus-related skin conditions that can affect your face and other parts of the body. Other inflammatory or autoimmune diseases can also cause rashes that appear on one side of the face. These rashes are called nonspecific rashes seen in lupus.

In some cases, the rash may not be related to lupus at all. Sun exposure, eczema, and rosacea are other possible causes of one-sided facial rashes.

Discoid Lupus Rashes

Discoid lupus is the most common type of chronic (ongoing) cutaneous lupus erythematosus (CLE), which is lupus that affects the skin. Rashes caused by discoid lupus are usually disc-shaped, which is where the name comes from. They often appear on the scalp, face, or neck. In addition to being round, discoid lupus rashes are usually:

• Red, dark purple, or dark brown (depending on skin tone)
• Raised
• Scaly

Discoid lupus rashes may cause scarring, discoloration, and hair loss in the affected area. If you notice a disc-shaped rash on your face, talk to your doctor. It could be a sign of discoid lupus. Your doctor can help you find ways to manage this chronic condition.

Rashes Around the Eyes

Some people with lupus develop rashes or lesions on the skin around their eyes or on their eyelids. This may be linked to discoid lupus or another form of cutaneous lupus.

Many members of MyLupusTeam have described discoloration and swelling around one or both eyes. One member shared, “It was hard hiding my swollen eye with makeup. I was only able to cover the redness, but the swelling still showed through my makeup. ☹️”

Because the skin around the eyes is delicate, rashes here can be especially difficult to manage. Tell your doctor if you notice these changes. Lupus treatments may help reduce swelling and rashlike symptoms. Since scarring in this area can be permanent, it’s important to seek treatment early to reduce any long-term effects.

Rashes From Light Sensitivity

Lupus can make your skin very sensitive to sunlight and other sources of ultraviolet (UV) light, such as some artificial lighting. This is called photosensitivity, and it affects about half of people with lupus.

Photosensitivity can cause skin rashes on areas exposed to the sun or artificial sources of UV light. Some people develop malar, discoid, or other types of lupus rashes after being in sunlight or under fluorescent lighting. “Sometimes I’ll get a burning rash on one side of my face, especially if it’s a side that is facing the sun or any other source of UV light,” one MyLupusTeam member said.

Talk with your healthcare provider about light sensitivity. Protect your skin by applying sunscreen with a high SPF, wearing sun-protective clothing, and limiting exposure to UV light.

Other Lupus Rashes or Sores That Affect the Face

Lupus rashes can also spread to different parts of the face or body. “My eyes are swollen, and the rash is around my mouth and goes under my chin,” one MyLupusTeam member explained.

If you notice facial rashes but aren’t sure what type they are, check with your doctor. They can explain how lupus affects the skin and help you find the right treatment for your specific symptoms.

Sometimes rashes are not related to lupus at all. Be sure to tell your doctor about when and where rashes appear so they can pinpoint the cause and point you to the right treatment.

How To Treat Rashes

Treating lupus rashes may require seeking medical advice from a dermatologist — ideally, one who is familiar with skin symptoms from lupus. A dermatologist may run tests, such as a skin biopsy (a small sample of tissue for examination under a microscope) or a blood test, to see if your rashes are due to lupus or a different condition.

Treatment for lupus rashes may include:

• Management of photosensitivity, such as using sunscreen and limiting sun exposure when UV rays are high
• Medication, such as a steroid creams, antimalarial drugs, antibiotics, or — in resistant cases — immunosuppressive therapy
• Laser therapy, which may help with scarring or discoloration

You’re not alone in dealing with lupus rashes on your face and the emotional and physical challenges they can bring. Talk with your doctor about malar rashes and other symptoms of lupus rashes. The right treatment can help you feel better and support your journey toward living well with lupus.

Join the Conversation

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

Do you get a malar lupus rash? Do you have a rash on one side of your face? Let others know in the comments below.