What Causes a Lupus Sun Rash?

Elizabeth Narins is a freelance writer and content strategist with more than a decade of experience. She's held staff positions at Women's Health and Cosmopolitan, and was previously the senior director of digital content and social media at WW (formerly Weight Watchers).

Photosensitivity, or light sensitivity, is when you have a strong sensitivity to sunlight and certain indoor lights. This sensitivity is one of the symptoms of lupus, an autoimmune disorder also known as systemic lupus erythematosus (SLE).

Exposure to such light could cause a lupus sun rash, which may show up as a butterfly rash—a rash that spreads across the nose and cheeks—caused by acute cutaneous lupus. Here's what you need to know about sensitivity to the sun or other light sources if you or a loved one is living with lupus.

How Does Sun Exposure Cause a Lupus Rash?

UV exposure can activate lupus flares, leading to rashes, lesions, and other symptoms. Also, skin cell death, or apoptosis, occurs with UV damage. However, this process happens more often than it should in the skin of people with lupus, potentially leading to inflammation and other complications.

Certain drugs that people with lupus sometimes take can further increase photosensitivity. These include:

• Antibiotics (including doxycycline and tetracycline)
• Anti-inflammatories (ibuprofen)
• Blood pressure medications (hydrochlorothiazide and lisinopril)
• Immunosuppressives (methotrexate)

Symptoms

UV exposure can lead to lupus flares that bring symptoms below the surface of the skin, known as systemic symptoms. A person may experience symptoms like fatigue, joint pain, or swelling.

Various skin changes on areas such as the face, neck, hands, and arms can happen due to lupus after you've had sun exposure. They can include:

• Dry, chapped lips
• Hard lumps beneath your skin's surface
• Itchy hives
• Low blood flow within your fingers and toes
• Red palms
• Skin depressions, where the skin is pushed in slightly

What Does Lupus Sun Rash Look Like?

Lupus can affect a person's skin in different ways. However, you may experience the following as part of a sun rash:

• Blistering rash
• Discoid rash, or reddish or purplish rashes with raised patches
• Itching, burning, or painful skin
• Malar rash, or butterfly-shaped cheek rashes
  

A healthcare provider can evaluate your symptoms. They can determine whether you need treatment to reduce inflammation and help your immune system calm down, which can help clear up your skin.

Protection Tips

While it would be virtually impossible to shield yourself from every UV ray, there are a host of protective measures you can take to reduce your UV exposure and, in turn, your risk of a lupus flare. Here are some steps you or a loved one can take to protect against the sun or indoor lighting.

Wear Protective Clothing

Covering your exposed skin can go a long way in shielding you from direct contact with the sun or artificial light. UV-protective or tightly woven clothing to consider using include:

• Wide-brimmed hats
• Long-sleeved tops
• Long pants or skirts

Cover Exposed Skin With Sunscreen

Whether the sun is shining bright or there are clouds overhead, a generous amount of sunscreen will help protect you. Remember, UV rays can peak through cloud cover. Every day you'll be spending more than a few minutes outside, use sunscreen of SPF 70 or higher with protection against UVA and UVB rays.

You'll want to reapply at least every two hours or even more frequently when sweating or swimming. Make sure to get those areas that lupus often affects: the neck, forehead, and ears. Also, consider wearing sunscreen indoors if you are sensitive to indoor lighting.

Minimize Midday Sun Exposure

The sun's rays tend to be strongest between 10 a.m. and 4 p.m., particularly during spring and summer. While you can certainly cover up, going inside during these hours is an even safer bet.

Watch Outdoor Conditions

Whether on the beach, boat, or ski slopes, recreational activities near sand, water, or snow can increase your UV intake. Make sure to use extra caution when in these conditions.

Use Shades, Shields, and Filters

Cover your windows with UV-blocking shades and car windows with tinting. This will help keep sunlight exposure to a minimum while indoors. Also, look for light shields and light bulb filters with readings of 380 to 400 nanometers that filter UV light effectively.

Swap Out Light Bulbs

Change any bulbs for Light Emitting Diode (LED) bulbs. While more research is needed, some people with lupus report that LED light leads to fewer flares.

Avoid Tanning Salons

The UV exposure delivered by tanning beds is a sure risk to those with lupus. UV rays from a tanning bed can cause new or worsening lupus skin lesions.

A Quick Review

People with lupus can have photosensitivity and need protection against the sun and certain artificial lights. UV exposure can lead to new or worsening lupus symptoms, including rashes like a butterfly rash or raised patches of discolored skin. Still, there are ways to avoid a UV-related flare, like wearing sunscreen and protective clothing or using filtered lights and shades.

Health.com uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. American Academy of Dermatology. Lupus and your skin: signs and symptoms.
2. American Academy of Dermatology. Lupus and your skin: overview.
3. American College of Rheumatology. Lupus.
4. Wolf SJ, Estadt SN, Gudjonsson JE, Kahlenberg JM. Human and murine evidence for mechanisms driving autoimmune photosensitivity. Front Immunol. 2018;9:2430. doi:10.3389/fimmu.2018.02430
5. Lupus Foundation of America. UV exposure: What you need to know.
6. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Systemic lupus erythematosus (lupus).
7. American Academy of Dermatology. Lupus and your skin: diagnosis and treatment.
8. Lupus Foundation of America. What is photosensitivity?
9. American Cancer Society. How do I protect myself from ultraviolet (UV) rays?
10. Lupus Foundation of America. Decreasing UV exposure from fluorescent lights.
11. Lupus Foundation of America. Are tanning beds safe for people with lupus?

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