Lupus Rash in Pictures: How to Recognize and Treat It

Lupus is an autoimmune condition that can affect the skin, joints, and internal organs. It can be hard to diagnose because its symptoms are often mistaken for other diseases. Lupus can range from mild to severe. Symptoms can be limited to the skin, or they can affect many different parts of the body and organs. 

Skin rashes are common in all types of lupus. In fact, lupus rash affects about 75% of people with lupus. And in 20% of cases, a rash is the first noticeable sign of lupus. So it helps to know what to look for.

What does a lupus rash look like?

The lupus rash is most common on the face and other sun-exposed skin, like the arms. Depending on where it is on your body, and your underlying skin tone, a lupus rash can look different for different people. Here are some images of the lupus rash on the face and body. 

Acute lupus: Butterfly (malar) rash

A butterfly rash on the cheeks, nose, and chin in darker skin.

A butterfly face rash on the cheeks, nose, and upper lip in lighter skin.

The butterfly malar rash is a telltale sign of lupus. It’s a flat or raised rash that develops in a butterfly shape over the cheeks and the nose. In lighter skin, the rash is red or pink, and it can be mistaken for blushing or a sunburn. In darker skin tones, the rash can look dark red, dark brown, or a darker shade than the surrounding skin. 

A butterfly rash usually doesn’t have any symptoms, but some people describe it as a little painful or itchy. In more severe cases, it can even feel hot. A butterfly rash doesn’t leave scars or discoloration when it goes away. 

Subacute lupus: Sun-sensitive lupus rash on arms, legs, or chest

Close-up of a lupus rash on the arm.

Close-up of a lupus rash on the neck.

People with lupus can get a lupus rash on the body in areas exposed to the sun. In addition to the face, sun-sensitive rashes can affect your:

• Chest

• Upper back

• Arms

• Neck 

This type of lupus rash is usually scaly. In lighter skin, it looks red or pink. In darker skin tones, it looks purple or brown. In some cases, it forms ring shapes on the skin.

The rash doesn’t come on immediately after sun exposure. It can take a few days or longer to appear. For some people, the rash can be quite itchy. This type of rash doesn’t scar the skin when it heals. But it can leave patches of lighter or darker skin, which get better with time. 

Chronic lupus: Discoid lupus rash

Close-up of a person’s scalp with discoid lupus rash.

Close-up of a discoid lupus rash on the arm.

Discoid lupus also usually appears in sun-exposed areas. It’s most common on the face and scalp, but it can affect other parts of the body, too. The rash consists of thick, coin-shaped patches of scarred skin that can be red or dark. Discoid lupus also typically causes hair loss in the affected skin, because skin scarring plugs and destroys the hair follicles. 

Some people feel mild itching or pain with these rashes. Discoid lupus can leave permanent scars, skin discoloration, and lasting hair loss.

What causes lupus rash?

Lupus is a condition that can cause inflammation in any part of the body. It’s an autoimmune condition, meaning your immune system mistakenly reacts against your own body, including your skin. Experts don’t know why this happens, but it’s likely a combination of your genetics and environmental exposures.

Lupus rash symptoms

The symptoms of lupus rashes depend on the individual, the type of rash, and where the rash is on the body. Many people don’t have any symptoms. Some describe a mild itch or soreness. Sometimes, the butterfly rash can feel warm and tender, like a sunburn. If a lupus rash has any symptoms, they usually improve with treatment. 

One common symptom of lupus rashes is hair loss. Some people develop coarse, dry hair around the hairline that breaks easily, leaving short hairs known as “lupus hair.” This usually grows back after lupus treatment. Other people with discoid lupus (see above) can develop hair loss that’s usually permanent. 

Lupus is more than just skin deep. It can affect many other organs, too. In addition to skin rashes and hair loss, some early lupus symptoms include: 

• Fatigue (feeling tired)

• Joint pain

• Skin sensitivity to sunlight

• Muscle soreness

• Fevers

Risk factors for lupus

Lupus can affect anyone, but it’s much more common in women, especially women ages 15 to 44. Lupus also affects people from certain ethnic backgrounds more than others. For example, you have a higher risk of having lupus if you’re:

• Black 

• Hispanic and Latino 

• Asian 

• Indigenous 

How to tell if it’s a lupus rash or something else

People may mistake lupus rashes for a sunburn or other common skin conditions. A dermatologist can usually tell them apart. But sometimes it can be hard. A skin biopsy can help figure it out in these cases. 

Here are some conditions that aren’t skin lupus but may look similar to it: 

• Rosacea: Like a lupus rash, rosacea can also cause red patches across the nose and cheeks. Rosacea is more likely if you have acne-like spots and eye symptoms, like dryness or burning. 

• Sunburn: Like sunburn, skin lupus gets worse in the sun. But sunburns are usually flat and red or darker brown, and they affect all sun-exposed skin. 

• Acne: Both acne and lupus commonly affect the face. But if you see pimples, blackheads, or cysts, then it’s probably acne. 

• Seborrheic dermatitis: This can cause a scaly, red rash around the nose. But, unlike lupus, seborrheic dermatitis often involves the skin crease between the nose and cheek (the nasolabial fold) as well. 

Treatments for lupus rash

The treatment you’ll get for lupus depends on whether your lupus just affects your skin — or if it affects other organs, too. For milder cases in the skin only, the first-choice treatment is a prescription topical cream or ointment. If you have discoid lupus, you might need steroid injections into the spots. Systemic lupus usually requires medications to calm the inflammation or lower the immune system.

Natural remedies to treat a lupus rash

The best thing you can do for a lupus rash is to avoid the sun and other things in your environment that trigger your lupus. 

There’s not enough good evidence to support natural remedies for skin lupus. But here are some supplements that show promise: 

• Vitamin D

• Omega-3 fatty acids, like fish oil

• N-acetylcysteine

• Turmeric

But be careful: Some natural supplements (like alfalfa sprouts, echinacea, and melatonin) may actually worsen lupus symptoms. They can also interact with prescription medications. It’s always best to check with your healthcare team before trying new supplements.

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Written by:

Maryann Mikhail, MD

Maryann Mikhail, MD, is a board-certified dermatologist and medical writer based in South Florida. She is the founder of Waverly DermSpa in Fort Lauderdale and holds a voluntary faculty position at the Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery at the University of Miami MIller School of Medicine.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

Reviewed by:

Maria Robinson, MD, MBA

Maria Robinson, MD, MBA, is a board-certified dermatologist and dermatopathologist who has practiced dermatology and dermatopathology for over 10 years across private practice, academic, and telehealth settings. She is a fellow of the American Academy of Dermatology and the American Society of Dermatopathology.

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Images used with permission from VisualDx (www.visualdx.com).