Many people with lupus develop rashes on their skin, including their legs. Lupus can affect different parts of the body, like the skin and organs. The most common type is systemic lupus erythematosus (SLE). Cutaneous lupus affects the skin and can happen by itself or along with SLE. Two types that can affect the legs are discoid lupus erythematosus (DLE) and subacute cutaneous lupus erythematosus (SCLE).

In this article, you’ll learn about the types of leg rashes that can happen with lupus, what causes them, and how to manage and treat them.

What Does a Lupus Rash on Your Leg Look Like?

Skin rashes are common among MyLupusTeam members. Not everyone with lupus will have rashes on their legs. When they do happen, they can look different from person to person.

One MyLupusTeam member described their skin symptoms as “little things that look like blood blisters that then break open and start bleeding. When they heal, they leave scars and look horrible.”

Other lupus leg rashes may be described as faint, interlocking networks of red circles. For example, one MyLupusTeam member reported, “I get a rash with red lacy circles on my legs. It kind of looks like a snake pattern. It seems to show up when I’m having a flare and my hip joints and thighs hurt a lot.”

What Do Lupus Leg Rashes Feel Like?

There’s as much variety in how lupus leg rashes feel as in their appearance. As one MyLupusTeam member observed, “There are so many different kinds of skin issues with this disease. We’re all so different but also alike.”

You may experience a painful burning, crawling, or pin-pricking sensation with a lupus leg rash. Some people describe it as feeling like a sunburn. Other MyLupusTeam members report increased sensitivity to either very hot or cold temperatures, which causes itchy or painful hives, chilblains (painful red or purple bumps from cold), blisters, or pimple-like bumps. Some people describe visible skin changes, while others have itching or pain without any rashes or changes in color.

Some lupus-related rashes are intensely itchy. Another MyLupusTeam member wrote, “By the end of the day, my skin feels like I have an army of ants under it, and I am scratching it till it bleeds.”

How Long Do Lupus Leg Rashes Last?

Lupus leg rashes can be hard to predict. Symptoms may come and go, and can change with the time of day, the season, or stress. Some rashes can last for months or longer if they aren’t treated.

How Do Lupus Skin Rashes Affect Daily Life?

It can take a toll on your emotions when skin symptoms affect your physical appearance and when other people have reactions to your skin issues. As one MyLupusTeam member wrote, “Because of the skin lesions, people stare at you… It not only takes a toll on your self-esteem, but it’s so painful as well.”

Living with lupus can be a stressful experience. Stress can make you feel overwhelmed and isolated. Seeking help from a therapist, counselor, or behavioral health provider can help you better cope with the social and emotional struggles of chronic skin problems.

Itching can disrupt sleep, increase mood problems, and lead to scratching and scarring. A MyLupusTeam member commented, “I also get lesions on my lower legs that are so itchy, my scratching breaks the skin or causes bruising.”

What Causes Leg Rashes With Lupus?

Lupus is an autoimmune disease, which means that symptoms happen when a person’s immune system attacks their tissues. This can include symptoms on the skin, like rashes.

The main triggers for rashes on the legs with lupus are:

• Lupus flare-ups
• Exposure to ultraviolet (UV) light or indoor fluorescent light
• Certain medications
• Smoking

Discoid Lupus Erythematosus

DLE can cause round, coin- or disk-shaped red patches that are thick and scaly. It may or may not itch or hurt and can lead to scarring, especially if scratched. Sunlight can also cause lasting discoloration (lighter or darker areas).

If you don’t already have a dermatologist, you can ask your primary healthcare provider for a referral. A dermatologist may perform a biopsy to confirm a DLE diagnosis. A biopsy involves removing a small sample of tissue or cells for examination under a microscope.

Subacute Cutaneous Lupus Erythematosus

SCLE can cause circular red patches with a ring-like border that may be scaly. These rashes often show up on sun-exposed skin, including the legs, and usually don’t itch or cause pain.

Sunlight and taking certain medications can trigger SCLE. Doctors use the word “subacute” to describe this rash because it appears quickly and doesn’t last as long as other lupus rashes. SCLE doesn’t cause scarring like DLE, but can cause permanent skin lightening or darkening.

How Do You Treat Lupus-Related Leg Rashes?

Because there are different kinds of lupus leg rashes, it’s important to see a dermatologist or other healthcare provider to help you get a diagnosis and find the right treatment plan for your rash. Before starting treatment, your healthcare provider may do a biopsy or other tests to find out what type of cutaneous lupus you have.

The main types of treatments for lupus rashes on the legs are:

• Steroids (creams, injections, or pills) for skin inflammation
• Medicines that calm the immune system (creams or pills), like calcineurin inhibitors — Can help reduce skin inflammation
• Antimalarials (pills) to help protect skin from UV light and rashes
• Certain biologics (made from living cells, given as injections) for lupus symptoms, including skin problems

Managing Symptoms

MyLupusTeam members with skin symptoms recommend cool (not cold) baths, sometimes with oatmeal, to help soothe their itchy or painful rashes. Baths can also offer a relaxing way to prepare for a better night’s sleep if your leg rashes keep you awake.

Can You Prevent Leg Rashes With Lupus?

While you can’t prevent cutaneous lupus, you may be able to prevent rashes with some lifestyle changes. Exposure to sunlight often triggers rashes and sores and makes breakouts worse. Avoiding sun exposure can be key.

Learning what triggers your rashes and how to avoid these triggers can help you experience less pain and itching from leg rashes.

Here are some tips for avoiding triggers and protecting your skin:

• Learn which skin and body care products do not irritate your skin. Travel with your own supply of “safe” products.
• Avoid being outdoors when the sun’s rays are strongest — between 10 a.m. and 4 p.m.
• Always wear sunscreen with a sun protection factor (SPF) of 30 or higher that provides broad-spectrum protection, meaning it blocks UVA and UVB rays.
• Wear long pants made of sun-protective material.
• Protect your legs and feet from cold temperatures with layers of clothing, long underwear, and warm socks in the winter.
• Protect yourself from UV rays while indoors by avoiding and replacing fluorescent lights.
• Speak to your healthcare providers about avoiding medications that make your skin more sensitive to light.
• Stop smoking if you smoke — Smoking can make lupus skin symptoms worse. Smoking and other tobacco use can also make lupus medications like antimalarials less effective for treating rashes on the legs.
• Stay healthy by taking your lupus medicines as prescribed, going to regular checkups, eating a healthy diet, and staying active.

Lupus leg rashes can be frustrating, but there are steps that help. Keep track of flare triggers (like sun, cold, or stress) and talk with your care team about treatment options. If you have lupus and skin symptoms, see a dermatologist for regular skin checks. Also consider mental health support if your leg rashes lead to anxiety, depression, feeling isolated, or trouble sleeping. You don’t have to manage this alone. Support from your care team and community can make a real difference.

Join the Conversation

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

How have you managed leg rashes with lupus? Let others know in the comments below.