If you’re living with lupus, there’s a good chance you’re living with a lupus rash, such as the characteristic malar, or “butterfly,” rash. However, lupus can also cause different types of rashes on other parts of the body, changing the affected skin’s color and texture and feeling itchy, painful, or even hot.

“When I flare, my butterfly rash gets very hot to the touch, and I feel achy all over. Yet, I don’t seem to run a fever,” shared a MyLupusTeam member.

“Yes, that happens to me,” another member responded. “Sometimes my eyes burn also.”

If your lupus rash feels hot, you may be experiencing the typical signs of lupus-related inflammation or sun sensitivity — or the heat might stem from an unrelated issue, like menopause. You could also have an infection that requires treatment. Here are some reasons your rash might feel like it’s overheating and tips on when to call your doctor.

Lupus-Related Causes

The skin is one of the major organs affected in lupus. Sometimes this autoimmune disease involves only the skin (cutaneous lupus erythematosus, or CLE), but it most often also affects internal organs (systemic lupus erythematosus, SLE). About 50 percent of people with lupus get the butterfly rash — the nickname is a nod to its pattern across the cheeks and bridge of the nose.

Lupus is a disease of inflammation, and inflammation often involves heat. People with chronic inflammation may get low-grade fevers even when they aren’t sick. Also, parts of the body affected by acute inflammation, like a rash, may be flushed or hot. “This happens to me when I have a flare-up. The inflammation in my body makes the muscles hurt and skin red and warm and sensitive,” shared a MyLupusTeam member.

Others notice that the heat comes first, followed by a rash: “My face rash comes out more when I’m hot and doing housework. I get another rash around my neck, which looks terrible, like a very big heat bump that hurts when touched. They last two or three days,” another member said.

Photosensitivity

About 70 percent of people with lupus experience worsening skin symptoms following sun exposure. Ultraviolet (UV) light can heighten the inflammatory response, making rashes more severe. One MyLupusTeam member described their symptoms: “My skin feels warm to the touch and, like a sunburn, it seems tender.”

“My face gets red and hot every evening with a low-grade fever sometimes. Sun is my enemy. My eyes can’t take the sun even with dark glasses and a big-rimmed hat. If I get even a few minutes of sun, I get chills and aches later and need to go to bed,” another member said.

Vasculitis

Another potential symptom of lupus is vasculitis (inflammation of the blood vessels), which may cause a rise in general body temperature or localized heat in specific areas. Skin affected by vasculitis may have small red or purple dots, which might be hard to see on dark skin, as well as itchy or raised rashes, open sores, or black spots.

Erythromelalgia

A rare condition called erythromelalgia can develop secondary to lupus. Erythromelalgia involves extra blood flow. Symptoms may include a rise in skin temperature, burning pain, and sometimes sweating or swelling. The condition usually affects the feet but can show up elsewhere, like the face, legs, or arms and hands.

Other Reasons Skin Feels Warm

Your skin may feel warm for reasons other than lupus. Some people experience hot flashes, or sudden waves of heat, due to menopause or some unexplained reason. Researchers and doctors believe hot flashes are the body’s exaggerated attempt to get rid of extra heat.

Feeling hot can be a side effect of medication, including lupus meds like corticosteroids (such as prednisone) and nonsteroidal anti-inflammatory drugs (NSAIDs). This side effect can also come with treatments for conditions such as:

• Anxiety
• Attention deficit hyperactivity disorder
• Cancer
• Depression
• Erectile dysfunction
• Thyroid problems

Sometimes a condition itself can lead you to feel overheated. Although lupus may be your main focus, you should consider other potential health conditions, like diabetes, fibromyalgia, and thyroid disease, that can also be an underlying cause of feeling hot.

Managing a Hot Rash

Reducing inflammation is a crucial aspect of treating lupus and helping with symptoms like rashes that feel warm. In addition to taking your lupus medications, try to follow an anti-inflammatory diet that focuses on healthy fats and plenty of vegetables and limits fried or processed foods and added sugar. Also, avoiding alcohol, caffeine, and spicy food can help keep your body temperature from rising.

Some people with lupus report benefits from avoiding gluten. “When I started a gluten-free diet, my butterfly rash disappeared,” a MyLupusTeam member said. You can meet with a registered dietitian nutritionist to determine if a gluten-free diet is worth a try for you.

For photosensitivity, avoiding UV light both outdoors and indoors — including tanning beds — is essential. In addition to applying sunscreen and wearing long-sleeved, protective clothing, try to avoid sitting near bright, sunny windows or using high-wattage overhead lighting.

Your doctor may prescribe steroids to keep certain types of inflammation, such as vasculitis, under control. Medications to treat erythromelalgia include anticonvulsants, antidepressants, and blood pressure drugs. You can cool off by keeping your home’s temperature on the lower side, running fans at night, and placing skin-safe gel packs on your skin. However, avoid ice baths — they can backfire by worsening symptoms and raising the risk of additional skin problems.

When To Call Your Doctor

If your lupus rash doesn’t seem to be getting better after a couple of weeks of treatment, you may need a new regimen. In addition, rashes that spread to the lips or become mouth sores should be evaluated by your rheumatologist or dermatologist.

Sensitive skin that feels hot to the touch could be infected and require antibiotics or other medical care. Two types of skin infections, cellulitis and abscesses, usually cause swelling or pus. Infections are particularly dangerous for people with autoimmune diseases like lupus, because immunosuppressive drugs make it harder for your immune system to fight off the infection. If an infection spreads, it could lead to life-threatening complications.

Anytime you experience a new or unexpected symptom with lupus, including rashes or lesions that feel hot, don’t hesitate to contact your health care provider for medical advice. Getting treatment quickly and watching for changes are key to managing this lifelong condition and feeling your best while living with lupus.

Talk With Others Who Understand

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, over 223,000 people with lupus come together to ask questions, give advice, and share their stories.

Do you experience skin that feels hot as a sign of lupus or lupus flare-ups? What strategies have you used to help keep your body cool? Post your thoughts in the comments below, or start a conversation by sharing on your Activities page.