Showering should be a relaxing and rejuvenating part of your day, but for some people living with lupus (also called systemic lupus erythematosus or SLE), it can be quite painful. “Does anyone else experience pain while showering?” one MyLupusTeam member asked. “When the water hits my skin, it feels like pins and needles. It’s painful.” Other members have similar experiences, including one who lamented, “Pain during showers leaves me exhausted!”

SLE, the most common type of lupus, is an autoimmune disorder that attacks multiple organs. Symptoms of lupus can make everyday activities painful. It is possible that this pins-and-needles sensation people with the condition experience relates to how it affects their skin or nervous system.

In this article, we will explore six reasons why you may be experiencing tingling and pain while showering — and what you can do about it.

1. Sensitivity to Water Temperature and Pressure

Lupus can increase your sensitivity to various stimuli, including temperature and pressure. Specifically, lupus often causes muscle and joint pain and stiffness in the neck, upper arms, and shoulders. These areas are most likely to be hit directly by shower water, causing heightened sensitivity.

A pins-and-needles sensation while showering may result from the water being too hot or too cold for your sensitive skin. Adjusting the temperature to a more comfortable level could help. Further, reducing the water pressure can ease the impact of droplets hitting your body. “To help this very weird painful feeling, I had to change my shower pressure,” one MyLupusTeam member wrote.

Some MyLupusTeam members opt to avoid showers altogether. “I try to take baths instead,” one member explained.

2. Raynaud’s Phenomenon

Raynaud’s phenomenon is a condition often associated with lupus — up to one-third of people with lupus will experience it during their lifetime. It causes blood vessels in your fingers and toes to constrict (narrow), which can reduce blood flow and make you particularly sensitive to cold. You may notice your fingertips turn white or blue and when you press down on your fingernail, it takes longer than usual for blood to be restored to your fingertips. When exposed to cold water during a shower, individuals with Raynaud’s may experience pins-and-needles sensations in affected body parts.

You can help reduce symptoms related to Raynaud’s by:

• Improving the circulation of blood throughout the body.
• Using warm water instead of cold
• Avoiding contact with cold objects
• Keeping the affected body parts warm, including by using special clothing material, such as wool

3. Sensitivity to Chemicals

Sometimes, people with lupus experience hypersensitivity. Symptoms of this type of hypersensitivity include skin reactions, including vasculitis (inflammation of blood vessels). You may be prone to skin that is overly reactive to certain substances. Certain chemicals found in soaps, shampoos, or shower gels could irritate your skin, leading to a pins-and-needles sensation.

Opting for gentle, fragrance-free products and avoiding known irritants can reduce skin sensitivity in the shower. You can also try applying a gentle, hypoallergenic moisturizer to soothe and hydrate the skin after showering.

4. Peripheral Neuropathy

Lupus can sometimes lead to peripheral neuropathy, a condition that affects the nerves in the extremities. This can result in various sensations, including tingling or numbness. A pins-and-needles sensation during a shower may be a symptom of peripheral neuropathy, especially if you’re experiencing it at other times during the day.

If you believe you are experiencing peripheral neuropathy, consult with a health care professional to get a proper diagnosis. They may have you undergo a physical exam, blood tests, and other tests to figure out whether peripheral neuropathy is causing your symptoms. From there, they can provide guidance on managing the condition and preventing further damage to your nerves.

5. Medication Side Effects

Medications used to treat lupus include nonsteroidal anti-inflammatory drugs (NSAIDs), antimalarial drugs, corticosteroids, immunosuppressants, and biologics. The side effects of these drugs vary widely. Some can cause a pins-and-needles sensation, skin sensitivity, or neuropathic symptoms.

If you recently started a new medication and have noticed an increase in pins-and-needles sensations during showers, it could be a drug side effect. Discuss this with your health care provider so they may help identify alternative treatment options or adjust the dosage to alleviate the symptom. Do not discontinue any medications without medical advice, or you may be at higher risk for a lupus flare.

6. Other Health Conditions

Many people living with lupus are living with a comorbidity — that is, another chronic condition. Comorbidities for lupus can include other autoimmune diseases, such as rheumatoid arthritis or Sjögren’s syndrome. Rheumatoid arthritis is known to cause peripheral neuropathy which — as noted — can cause pins-and-needles sensations.

Further, around 25 percent of people with lupus experience fibromyalgia, a disorder characterized by fatigue, joint and muscle pain, stiffness, numbness, and headaches. These symptoms commonly overlap with those of SLE, so many people go undiagnosed. The commonly experienced tingling sensations associated with fibromyalgia may feel like pins and needles.

If you think you may be experiencing fibromyalgia, rheumatoid arthritis, or any other health problem related to lupus, talk to your doctor about your concerns.

Find Your Team

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, more than 223,000 members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

Have you experienced pain while showering? What tips can you offer to others experiencing this same symptom? Share your experience in the comments below, or start a conversation by posting on your Activities page.