Ever get a flushed face even though you don’t have a high fever? You’re not alone. Feeling like your face or another part of your body feels hot 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.

Lupus can affect the skin by causing inflammation when an overactive immune system mistakenly attacks healthy skin. This inflammation can make parts of your body, like your face, feel warm or look flushed. However, this symptom can also be due to other medical conditions or side effects from certain medications. Keep reading to learn what a flushed face or facial rash might look like, what could be causing it, and how to manage the symptoms.

Types of Lupus Rashes That Can Affect the Face

If your face is flushed and feels warm even though your body temperature is normal, you might have a rash. Most people living with lupus have skin symptoms, often showing up as rashes or sores. For example, 80 percent of MyLupusTeam members report that they’ve had rashes, and 62 percent report that they get a malar rash, also known as a butterfly rash.

Malar Rash

Lupus rashes can appear in different ways, but a malar rash is one of the most common. A malar rash has a butterfly shape that extends across the bridge of the nose and covers both cheeks. On lighter skin, a malar rash often looks red, like you have a bad sunburn or are blushing. On darker skin, a malar rash may look dark purple or dark brown.

A malar rash may:

• Be flat or slightly raised
• Show up suddenly, often after sun exposure
• Feel scaly or itchy

Discoid Lupus Rash

Discoid lupus is a chronic (long-lasting) form of CLE that can cause a discolored, raised, and scaly rash. These rashes typically appear on the face and scalp and are shaped like discs or circles. Unlike a malar rash, discoid rashes don’t span the width of the face.

Sensations of Hot or Burning Skin

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 member 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 describe facial rashes that look like pimples or hives and may itch and burn. “For about six months now, I’ve been getting a pimple-like rash on my face, chin, and neck,” one member said. “Mine itches and burns. My skin hurts.”

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

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

For people with lupus, the combination of a facial rash and inflammation may cause discoloration and warmth. Common reasons for a flushed face include:

• Inflammation — Systemic (whole-body) inflammation from lupus can lead to rashes, such as a malar rash.
• Sun or ultraviolet (UV) light exposure — UV rays from the sun or indoor lights can trigger the immune system in the skin, leading to inflammation. This reaction is called photosensitivity (sensitivity to UV light).
• Hot showers — Some MyLupusTeam members say they get rashes, including malar rashes, after a hot shower.
• Lupus flare — A malar rash may be an early sign of a flare (a period of worsening symptoms).

Medications

Certain steroids used to reduce inflammation and immune responses related to lupus can cause a flushed face. One study found that almost 7 percent of people taking high-dose methylprednisolone for a short time had a hot, flushed face. This side effect usually occurred in the first week of treatment and happened less by weeks two to four.

Some medications can also trigger drug-induced lupus, which may cause rashes — especially on skin exposed to the sun. Medications commonly linked to drug-induced lupus include:

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

Talk with your doctor about the medications you’re taking and whether they might cause facial flushing.

Lupus Complications

Vasculitis (inflamed blood vessels) is a possible complication of lupus. Cutaneous vasculitis affects the skin, causing lumpy, itchy rashes. However, it’s unclear if these rashes often appear on the face or cause facial warmth.

Other Common Causes of a Flushed, Warm Face

A flushed, warm face may be a symptom of other health conditions. For example, menopause (when menstrual periods permanently stop) or perimenopause (the stage leading up to menopause) can cause hot flashes — sudden waves of heat that can cause a flushed face.

Rosacea, a chronic skin condition, is also associated with facial flushing. Because lupus rashes can look like other skin conditions, such as rosacea or psoriasis, it’s important to see a dermatologist (skin doctor) who understands lupus and how it affects the skin.

Other possible causes of a flushed, warm face include:

• Certain medications or supplements, such as niacin (vitamin B3) or treatments for diabetes or high cholesterol
• Physical activity
• Spicy or hot foods
• Sudden changes in temperature, such as moving from a cold room to the hot outdoors
• Heat exposure, such as hot weather
• Alcohol consumption
• Strong emotions

Because there are many reasons your face might feel hot or look flushed, it’s important to talk with your doctor or dermatologist. Pinpointing the underlying cause is the first step to finding the right treatment options.

Ways To Manage Facial Flushing and Warmth

The best way to manage facial flushing and warmth depends on its cause.

Lifestyle Changes

If you get a facial rash after sun exposure, managing photosensitivity can help prevent future flare-ups. You can protect your skin by:

• Hanging UV-blocking window shades
• Wearing tightly woven clothing
• Using lightbulbs that give off little or no UV radiation

It also helps to apply sunscreen before going outdoors. Look for products with an SPF of 30 or higher — SPF 70 offers more protection.

Medications

Your doctor may suggest medication to protect your skin and manage lupus symptoms. Some medications specifically treat lupus-related skin problems like rashes or sores, and others help reduce inflammation throughout the body. Medications that may help include:

• Steroids to help with skin inflammation
• Immunosuppressors or immunomodulators to calm the immune system
• Antimalarials to help prevent rashes and reduce sensitivity to light
• Other treatments, such as certain antibiotics or retinoids (vitamin A-based medications)

Home Remedies

Many MyLupusTeam members describe finding relief from facial rashes or flushing with home remedies. 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 Prosacea. 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 relief using natural remedies like witch hazel or products with tea tree oil.

Always get medical advice from your healthcare provider or dermatologist before trying new over-the-counter treatments or natural remedies. Your doctor can help you avoid reactions and choose options that are safe for your skin.

Talk With Others Who Understand

On MyLupusTeam, the social network for people with lupus and their loved ones, people 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.