There are many different skin manifestations in lupus, which vary from person to person. The ‘classical’ skin problem in lupus is the butterfly rash. This is a red rash, sometimes no more than a mild blush that occurs across the bridge of the nose and on the cheeks. This type of rash tends to occur in the systemic form of the disease, where other organs in the body are also involved.
Discoid lupus occurs in patches across the body. These patches tend to be well defined, thickened and scaly; they are slightly red in colour and can itch. (The appearance can vary between individuals and also appear on different areas of the body on the same person). As the patches heal they tend to leave scars and on darker skins the pigment in the skin can be lost, leaving white areas.
Subacute cutaneous lupus is a distinct rash that usually occurs in sun exposed areas of the body. It starts as scaly patches which increase in size to form circular areas, which gradually heal up without leaving scars.
Practically any type of rash can occur in systemic lupus, ranging from widespread mild rashes similar to those seen in viral illnesses such as German measles, to small, distinct patches of rash on the elbows and knees resembling another skin condition, psoriasis. Two particular problems that can occur are panniculitis and urticaria. Panniculitis is inflammation of the fat below the skin resulting in tender red lumps beneath the surface of the skin; these heal slowly over time and can leave dimpling of the skin when fully healed. Urticaria is an itchy, raised red rash similar to nettle rash that can occur with vasculitis or on its own; it heals without leaving scars.
There is no denying that an itchy rash is horrible. However, in a lot of cases there are things that can be done to help provide some relief however. We asked you which products you use for an itchy rash…
It seems that baby lotions are a popular product;
-“I’ve recently had a butterfly rash on my face and I’ve been putting Sudocrem on it. I thought, ‘it works for my baby’s bum, so why not give it a try?’ I’ve had it since the beginning of January and maybe it’s run its course but it seems to have eased off massively during the last couple of weeks, since using the Sudocrem. Just keeping that part of my face very moisturised seems to give me a lot of relief from the itching/burning.”
-“…I put Sudocrem on them and it stops the itching”
-“…try Sudocrem, yes, Sudocrem. It’s not just for baby’s bottoms. Put it on at night and see the difference in the morning”
-“I’m using Johnson’s extra care baby lotion”
We also heard from a lot of people that use Aloe Vera;
-“Aloe Vera cream or lotion is quite soothing.”
-“Aloe Vera, best straight from the plant itself, or if not, then you can buy a 100% organic Aloe Vera gel, which I keep in the fridge.”
-“I’ve had itchy legs for years and I too agree with the Aloe Vera”
-“…Aloe Vera (pure Aloe Vera). Snap a leaf from the plant, maybe half way up the leaf. They are mostly all fat and plump leaves. Tear it open and the cool, slimy (sounds yuck) gel comes out, but it soon dries when applied to the skin. It really does help me….The plants are not really attractive but they grow really quickly and when the leaf is snapped it repairs itself quickly…I think all who suffer itching should have their very own Aloe Vera plants”
Another product that some of you used is Cetraben;
-“Doctor prescribed me Cetraben lotion. It is basically white paraffin oil and really works on itching…”
-“Must admit, since using Cetraben twice a day it is better, although it does flare up out of control sometimes.”
Other suggestions included;
-“Savlon! Or a cold cloth.”
-“Vaseline intensive care moisturiser (white bottle) is the best one I’ve come across.”
-“…best thing is to moisturise at least twice a day. Just something cheap like Nivea or even baby lotion. It is dry skin that meds cause, which causes itching most of the time.”
-“A soak in a warm bath with bicarbonate of soda” – 2 tablespoons should do the trick
-“I bought some E45 cream that helped a bit…”
-“I was recently prescribed ELOCAN cream for sore itchy skin and it worked really well. Also tried Betnovate, but it was too harsh.”
-“…Emolin spray is only available on prescription. It works great for severe blistering/cracking/itchy rashes. Recommended by a top London dermatologist for severe lupus rashes….” “Emolin spray is great. It soaks in and you don’t have to rub or irritate skin in any way. It’s not greasy and also protects your skin from products that you also use.”
-“Doublebase gel. It’s wonderful stuff. Just slather it on all over after a bath or shower, or you can use it before the shower to protect you from shampoo or soap if you have allergies.”
-“There is a product available on prescription called Protopic. It’s an immune suppressant ointment. It’s wonder stuff. £300 per tube, so you may get knocked back for it.”
-“Cetrizine and E45 Itch Relief. Helps a bit.”
Other tips to help cope with itching include:
-Clothing and fabric
oAvoid wearing clothes that irritate your skin, such as wool and some man made fabrics
oWear cotton whenever possible
oAvoid tight fitting clothes
oUse mild laundry detergent
oUse cool, light, loose bedclothes
-When bathing or showering
oUse cool or lukewarm water (not hot)
oAvoid using perfumed soap/shower gel/deodorants. Unperfumed lotions or aqueous cream are available from pharmacists.
oUse unperfumed moisturising lotions and emollients after bathing or showering to help prevent your skin becoming too dry.
oUse an oily moisturiser if your skin is dry or flaky
oUse a mild steroid cream (for no longer than 7 days); for localised itchy areas, hydrocortisone cream is available from pharmacies over the counter or your GP can prescribe steroid cream.
oUse antihistamine tablets to help control allergic reactions and help break the itch-scratch cycle – however, consult your GP before using these because they are not suitable for all cases of itching.
-Try not to scratch the area. Keep your nails short to prevent breaking the skin if you do scratch. At night you may find wearing thin cotton gloves can help.
-Some foods can irritate the skin. It’s best to avoid strong caffeine, alcohol and spicy foods which can cause you to sweat and make the itching worse.
-An ice pack may relieve the itching but it should not be placed directly against the skin. Try wrapping it in a cloth (such as a tea towel). Frozen peas can be used, but if repeatedly re-frozen you must not eat the contents.
We’d like to thank everybody that submitted their tips for this topic. The amount of feedback was great again and we really hope this article will be useful to some people. Apologies to anybody who’s tips weren’t included in this article; unfortunately we didn’t have space for everyone.
Please let us know if you give any of these tips a go. We’d love to know if anybody is more comfortable after trying something suggested.
***Please note that this article is written for informational purposes only and should not be a substitute for professional medical advice or treatment. Do not delay seeking or disregard medical advice based on information here. Always seek the advice of your local family physician or other qualified health professional before starting any new treatment or making any changes to existing treatment. It is also advised that you consult a medical professional before making any changes to diet or starting alternative remedies, which may interact with other medications.***