Showering should be a pleasant, restorative ritual. But for people with lupus, the rash that sometimes follows a hot shower can ruin the experience. “I break out in an itchy rash every time I take a shower,” shared a MyLupusTeam member.
Some members have said that showers bring out the malar rash (or butterfly rash), which spans the bridge of the nose and the cheeks. Others find themselves covered in hives after showering.
Lupus-related skin issues also include lesions similar to hives and photosensitivity (sensitivity to ultraviolet radiation), which affects 50 percent of people with this autoimmune disease. Some people with lupus also experience alopecia (hair loss) or Raynaud’s phenomenon, a circulation issue causing sensitivity to cold.
“I don’t get a rash on my face. However, I get a horrible rash all over my abdomen and thighs when I take hot showers. Also, I cannot tolerate the heat at all. I feel horrible and like I’m overheating,” wrote one member.
Whether you’re looking for the right products to use in and out of the shower or ways to turn down the heat when you wash up, here are some tips to keep showers from triggering a rash.
Many members of MyLupusTeam struggle with temperature regulation, reporting hot flashes, excessive sweating, flare-ups in hot weather, and photosensitivity with sun exposure. Too-warm showers can also be a problem. “A hot shower brings on the butterfly rash for me,” said one member.
“Any temperature over 72 degrees Fahrenheit irritates me into a flare, giving me a higher fever and red rash all over my face,” shared another member.
Turning the water temperature to the cooler side can help keep you from feeling overheated and drying out your skin. Washing with hot water damages the skin’s barrier function — the ability to protect the body from environmental threats — for everyone, whether or not you have lupus. Aim for a lukewarm temperature, and avoid lengthy periods under hotter water.
“At different times, I have different skin issues, and over the years, I have learned to just deal with them. I have never had a true butterfly rash. The only time my face turns red is after a shower,” one MyLupusTeam member said.
If showers are a clear trigger for your lupus skin symptoms, you might try showering faster or less often. You can also cut back on time under running water by turning off the tap midshower. Wet your skin and hair, turn off the tap while you lather up, and then turn it back on to quickly rinse off.
Sensitive skin is a common symptom of lupus, so it’s important to avoid harsh ingredients when showering or washing your face. Seek out fragrance-free soaps and shampoos, and look for products labeled “for sensitive skin.” Lotions and creams intended to treat acne or oily skin may be too drying and cause irritation. The following ingredients can be especially drying:
Also limit your use of soap. To avoid stripping away protective natural oils, wash only your underarms and private areas instead of lathering your whole body.
Instead of rubbing your skin dry with a towel, gently pat it. While your skin is still slightly damp, follow up with an ointment or cream (not lotion) to help lock in moisture.
Look for products that contain any of the following ingredients recommended by dermatologists for dry skin:
One member of MyLupusTeam described their skin care regimen during lupus flare-ups. “I wash with a shea butter soap. Pat dry. Then slather on aloe vera gel all over my body (even on areas not affected by a rash), and allow it to soak in,” they explained. “This is followed by a shea butter body cream. After that soaks in, I follow up with 100 percent emu oil (a little goes a long way) — one or two drops cover my entire body.”
This member takes these steps a few times a day, gradually returning to their usual skin care routine when the rash subsides.
Baths can be less drying than showers, especially if you keep the water lukewarm. Time in the tub can also give you a chance to relax and take a much-needed break from a stressful day. If your face is susceptible to malar rashes, a bath lets you keep your face dry while you wash up. You can practice facial care separately to avoid overexposing sensitive skin on your nose and cheeks to hot water or cleansers.
Members of MyLupusTeam shared some of the ingredients they find beneficial when added to bathwater. “I take oatmeal baths,” one member said.
Another responded, “I use some lavender essential oil and Epsom salts in a bath to help the aches as well as skin irritations.”
Some evidence suggests that colloidal oatmeal (a special type to soothe, soften, and hydrate skin) is good for the skin barrier and may reduce the need to use topical corticosteroids for inflammatory skin conditions. It’s a good idea to ask your health care team for medical advice before using essential oils or other bath infusions — you don’t want to use something that could irritate your skin’s condition or cause unwanted side effects.
Controlling lupus symptoms by following your prescribed treatment plan may keep routine activities like showering from ruining your day. Lupus treatments often include the antimalarial medication hydroxychloroquine (Plaquenil), nonsteroidal anti-inflammatory drugs (NSAIDs), and periodic use of steroids like prednisone when managing a flare-up.
You can care for your body by resisting the urge to pick at skin lesions and by reaching out to your doctor when you need help with a new or worsening symptom.
Keep in mind that cutaneous lupus erythematosus (the type that affects the skin) can develop into systemic lupus erythematosus (SLE). About 20 percent of cutaneous lupus cases progress to SLE, so regular doctors’ visits are essential. In addition, some lupus-related rashes can lead to a higher risk of skin cancer. Any lesions that itch or bleed should be evaluated by a medical professional — early detection is the best defense against skin cancer.
MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, over 222,000 people with lupus come together to ask questions, give advice, and share their stories.
Have you noticed worsening skin problems immediately after showering? What parts of your body are most affected by shower-related rashes? Post your thoughts in the comments below, or start a conversation by sharing on MyLupusTeam.