For many people with lupus, a hot shower can feel good and may help with relaxation. But lupus affects everyone a little differently. In some cases, a hot shower can cause a burning sensation on the skin that can be uncomfortable and bewildering.

“My skin burns to the touch after I take a shower,” one MyLupusTeam member wrote. “I get redness in my neck and chest and burning skin all over that lasts for hours.”

Another member said, “Sometimes, water in the shower stings me. I don’t know why, but it hurts for a while, like an hour, then the sting goes away.”

“Does anyone else experience pain while showering? When the water hits my skin, it feels like pins and needles. It’s painful,” someone else shared.

Lupus is an autoimmune disorder in which antibodies in the immune system mistakenly attack healthy tissue throughout the body. Lupus can cause symptoms on the skin, such as a malar rash (butterfly rash) across the bridge of the nose and cheeks. There are a number of reasons why you may experience burning skin or skin sensitivity after a shower.

It’s important to let your rheumatologist know if you are having new or worsening symptoms. Depending on what may be causing a sensation of burning skin, your doctor can advise you on treatment options to help control symptoms and improve your quality of life.

Here are some possible explanations why you may experience a feeling of burning skin after a shower.

1. You May Have Cutaneous Lupus

There are several types of lupus, one of which primarily affects skin. Cutaneous lupus erythematosus (CLE) — also called skin lupus or cutaneous lupus — makes up about 10 percent of all lupus cases. However, 65 percent of people with systemic lupus erythematosus (SLE) — the most common type of lupus — develop cutaneous lupus at some point during the course of the disease.

Symptoms of CLE can vary depending on the severity of the condition and may include hair loss, a range of different rashes, skin lesions, or scaly patches of skin. Skin can also feel painful, itchy, or like it’s burning. Although cutaneous lupus is especially triggered by sun exposure, highly sensitive skin due to cutaneous lupus could react to other stimuli, such as a hot shower.

2. Some Indoor Lights Can Aggravate Skin in Lupus

People with lupus aren’t only sensitive to the ultraviolet (UV) radiation of sunlight. Fluorescent lights and halogen lights also emit UV radiation and can aggravate skin in people with lupus. Light sensitivity is also known as photosensitivity. If you have these types of lights in the bathroom where you take a shower, it’s possible that your skin may be reacting to light rather than the shower itself.

3. Side Effects From Some Lupus Medications Can Cause Skin Reactions

Some lupus medications can have side effects that may affect the skin. For instance, hydroxychloroquine (Plaquenil) — sometimes used to treat cutaneous lupus manifestations — may cause skin rash as a side effect. A rash can cause a burning sensation in the skin. Corticosteroid (steroid) side effects can also cause skin reactions.

Some medications may increase light sensitivity, which can increase the risk of skin reactions. Talk to your doctor in detail about potential side effects for any medications you may be taking for lupus or for any other condition.

4. You May Be Experiencing a Lupus Flare-Up

When lupus is flaring, the skin may become especially sensitive. Your skin may develop a rash that is accompanied by a burning sensation if the disease activity is getting worse. Always let your doctor know if you think you may be having a lupus flare-up to be sure you receive appropriate treatment.

5. Skin Reactions May Be From a Comorbidity

People with autoimmune diseases such as lupus are at risk of numerous comorbidities — coinciding health conditions — that can cause a wide variety of symptoms. Skin diseases, allergies, and thyroid disorders are some of the comorbidities of lupus that may cause reactions in skin that may feel like a burning sensation. Hyperthyroidism (overactive thyroid) can cause heat intolerance, which could cause a reaction to a hot shower.

Erythromelalgia (or Mitchell’s disease) is a rare comorbidity of lupus. According to health experts, this condition is a type of nerve pain that can cause symptoms in the hands, feet, and skin such as warmth, discoloration, and burning pain.

Skin Reactions That May Be a Sign of an Emergency

In some cases, a skin reaction may be a sign of a serious skin condition or infection. Contact your doctor or seek emergency care if you have a rash that:

• Breaks out all over your body
• Accompanies a fever
• Happens suddenly and spreads quickly
• Includes blisters
• Occurs along with yellow or green fluid, a sign of infection

Lupus increases your risk of developing vasculitis, a potentially serious condition that causes inflammation in blood vessels and can cause symptoms in skin such as purple and red dots, patches that look like bruises, and other types of rashes.

Managing Burning Skin From a Shower

If you experience burning skin after showering, start by discussing this symptom with your rheumatology or dermatology specialist to determine if medical treatment options are appropriate for you. Your doctor may advise blood tests to find out if another health condition is causing this symptom. Be sure to ask your doctor about appropriate moisturizers, creams, or lotions for your topical skin care.

Dermatologists recommend that people with lupus take extra precautions with skin care, because a lupus rash can increase the risk of lupus disease activity and flare-ups, which may lead to long-term skin problems. Here are some recommendations to protect and care for your skin:

• Avoid direct sun and sunburn, and use a broad-spectrum sunscreen (30 SPF or higher) and protective clothing.
• Avoid tanning beds.
• Quit smoking, which can worsen skin problems and reduce the effectiveness of some medications.
• Avoid touching any rashes.
• Replace fluorescent and halogen light bulbs with incandescent or LED bulbs.

MyLupusTeam members have also shared how they manage this symptom. “Before I am done with my shower, I turn the water to a cooler temperature and rinse my hair and body. Then I pat dry and add lotion with oatmeal,” a member wrote.

“My skin hates the water! Maybe my shower was just too hot. I have to take cool showers,” another member said.

A third member wrote, “If I get my head and neck in cold water when I’m done, it helps me. I’m always hot.”

Find Your Team

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, more than 222,000 members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

Have you experienced a burning sensation in your skin after showering? Share your experience in the comments below, or start a conversation by posting on your Activities page.