Ever get a flushed face even when you know you’re not running a high fever? You’re not alone. Feeling like your face or other parts of your body are burning up is a common experience among MyLupusTeam members. “My face and body feel like they're on fire, but no temperature. It’s frustrating!” one member wrote.

Flushing and warmth on your face may be related to lupus. Lupus can cause skin issues due to inflammation and an overactive immune response that attacks the skin. For example, a flushed face may be a facial rash, such as a malar rash (butterfly rash), which can come on suddenly or after sun exposure. A flushed face may also be a result of other medical conditions or certain medications.

Find out what a flushed face or facial rash can look like, potential causes, and ways to manage it.

Lupus and Facial Rashes

If your face is flushed and feels warm but your body temperature is normal, it may be that you’ve developed a rash. Most people living with lupus have some sort of skin involvement, which often appears as rashes or sores. For example, 80 percent of MyLupusTeam members report that they’ve had rashes at some point, and 62 percent report that they get a malar rash on their face.

Common Types of Lupus Rashes Can Affect the Face

There are many different ways rashes can show up on the face, but a malar rash is one of the more common types in people with lupus. Specifically, a malar rash is a type of acute cutaneous lupus erythematosus (CLE). Malar rashes have a characteristic butterfly shape as they extend across the bridge of the nose and cover both cheeks. On lighter skin tones, a malar rash is generally red, resembling a bad sunburn or making it look as though you’re blushing. Malar rashes on darker skin tones may look dark purple or dark brown.

A malar rash may also:

• Appear flat or slightly raised
• Develop spontaneously, often after sun exposure
• Sometimes feel scaly and itchy

Discoid lupus is a form of chronic CLE that can cause a rash that usually appears discolored, raised, and scaly. However, these rashes are usually disc-shaped and don’t span the width of the face like a malar rash.

Facial Rashes May Feel Warm or Like They’re on Fire

Many MyLupusTeam members report that their facial rashes feel hot or like their skin is burning even though they don’t have a high temperature. “Feels like I’m running a fever and my skin is hot and burns, but my temperature is normal. Drives me nuts,” one member shared.

Another wrote, “I don’t get the complete butterfly rash, but I do get an inflamed reddish color and my cheeks burn like there’s fire under the skin and the bones underneath are tender when it is active.”

Many members also report pimple- or hive-like rashes on their faces that may itch and burn. “For about six months now, I’ve been getting a pimple-like rash on my face, chin, and neck … . Mine itch and burn. My skin hurts,” one member wrote.

Another shared, “I get an itchy, red, small, pimpled rash on my face that is hot and very itchy and dry.”

Some members report a burning sensation without discoloration or the appearance of a rash. “I've got the burning face but no rash. All so strange,” one member wrote.

“Mine is not a rash, but instead burning cheekbones,” another member shared.

Causes of Flushing and Warmth in the Face

A facial rash is one possible cause of flushing and warmth in the face. Facial rashes from lupus may be a result of:

• Inflammation — Systemic inflammation from lupus can cause lupus rashes, such as a malar rash.
• Sun or UV light exposure — Rashes can develop when immune cells in your skin react to UV light (from the sun or artificial light), leading to inflammation. This type of reaction indicates photosensitivity — sensitivity to UV light.
• Hot showers — Many MyLupusTeam members report rashes, including a malar rash, after taking a hot shower
• Lupus flare — Some people with lupus report that a malar rash is a sign that a flare is starting.

Medications

Certain steroids prescribed to reduce inflammation and immune responses caused by lupus may also cause a flushed face. One study found that 7 percent of people taking a high dose of methylprednisolone over a short amount of time experienced a hot, flushed face. The researchers noted that this side effect commonly occurred in the first week of taking steroids and was reduced by weeks two to four.

In addition, drug-induced lupus (a type of lupus symptom caused by taking certain medications) can lead to rashes on areas of skin exposed to the sun. Medications commonly associated with drug-induced lupus include:

• Hydralazine
• Minocycline
• Quinidine
• Isoniazid
• Procainamide
• Tumor necrosis factor-alpha (TNF-alpha) inhibitors

Talk to your doctor about the medications you’re taking and if any of them might be causing your face to feel flushed.

Lupus Complications

Vasculitis — inflamed blood vessels — is a complication of lupus. Cutaneous vasculitis can affect the skin, causing lumpy, itchy rashes. However, it’s unclear whether these rashes are common on the face or would lead to warmth in the face.

Other Common Causes of a Flushed, Warm Face

A flushed, warm face may be a symptom of other health conditions. For example, menopause (when you no longer have menstrual periods) or perimenopause (the transitional stage before menopause) can cause hot flashes (sudden warm feelings all over the body) which may cause a flushed face.

Rosacea, a chronic skin condition, is also associated with facial flushing. Facial rashes in people with lupus are commonly misclassified as other skin conditions, such as rosacea or psoriasis, so it’s best to find a dermatologist with experience in treating lupus skin issues.

Other common causes of a flushed, warm face include:

• Medications or supplements to treat diabetes or high cholesterol, such as niacin (vitamin B3) supplements, which are known to cause the “niacin flush”
• Physical activity
• Hot or spicy foods
• Quick changes in temperature, such as going from a hot to cold environment or vice versa
• Heat exposure, such as in hot weather
• Alcohol consumption
• Extreme emotions

As the causes of a warm, flushed face are broad, it’s best to speak with your doctor or dermatologist to figure out what may be causing your face to flush. Determining the underlying cause is critical to finding the right treatment options.

Ways To Manage Facial Flushing and Warmth

The best way to manage facial flushing and warmth will depend on the underlying cause. For example, if you get a facial rash after sun exposure, managing photosensitivity is an important step to prevent future rashes. You can create a barrier between yourself and the light by using UV-blocking shades, wearing tightly woven clothes to cover your skin, and choosing lightbulbs that produce the least amount of UV radiation. Additionally, it can help to apply sunscreen before going out into the sun. Look for sunscreen with an SPF of at least 30, though an SPF of at least 70 is even better.

In addition to any lifestyle changes, your doctor may recommend taking medications to help protect your skin against the effects of lupus. These medications can be either specific to your skin, focusing on treating lupus-related skin symptoms like rashes or sores, or they may work throughout your body to manage lupus symptoms affecting various areas.

Some medications that may be used to treat lupus skin problems include:

• Steroids to help with skin inflammation
• Immunosuppressors/immunomodulators to prevent the immune system from attacking the skin
• Antimalarials to protect against skin rashes and the effects of UV light
• Other medications, such as certain antibiotics or retinoid medication

Many MyLupusTeam members have found home remedies that help provide some relief from facial rashes and warmth or burning sensations in the face. One member shared, “I get a wash rag, put ice in it, and put it on my face. It helps. Sometimes, I sleep with it on my face.”

Another member wrote, “I bought this ointment called Proscea. It’s over-the-counter … and let me say it's the best thing I’ve used. I put it on twice a day and I am happy with a clear face.”

Some members have found that natural remedies like witch hazel or products with tea tree oil have helped their facial rashes.

Be sure to seek medical advice from a health care provider or dermatologist before trying any over-the-counter treatments for facial rashes or flushing and warmth in the face.

Talk With Others Who Understand

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

Do you get a flushed, warm face without any signs of fever? What do you do to manage it? Share your experience in the comments below, or start a conversation by posting on your Activities page.