A malar rash also goes by the name “butterfly rash” because its pattern across the face resembles the insect with outspread wings. But if just one side of your face has a rash, is it still considered a malar rash? Like other MyLupusTeam members, you might be wondering if you have an uncommon form of the common lupus skin symptom.

“The rash I’ve had for several months doesn’t look like a typical butterfly rash because it’s only on my left cheek and left side of my nose,” one member wrote. Another member replied, “My rash is always more prominent on one side than the other.”

Defining just what constitutes a malar rash can be difficult because this symptom doesn’t look the same for everyone. However, some key characteristics can help you tell whether your rash qualifies as a malar rash or a different type of skin symptom.

Read on to learn more about the characteristics of a malar rash, other types of rashes that may affect your face, and possible treatments.

Lupus and Malar Rash

The malar rash, which usually affects the cheeks and bridge of the nose, can show up in many conditions but is mainly linked with lupus. An estimated 50 percent of all people with lupus get a malar rash, and one survey of MyLupusTeam members showed that 62 percent have experienced one.

The malar rash:

• Appears quickly
• Doesn’t last long
• Doesn’t leave scars
• May cause skin discoloration

In people who have systemic erythematous lupus (SLE), malar rash may be the first symptom, sometimes appearing months or even years before other symptoms. In a 2023 study in The Journal of Rheumatology, researchers reported that 30 percent to 50 percent of people with SLE, the most common type of lupus, develop a malar rash.

Some researchers consider the malar rash to be a typical symptom of the localized form of acute cutaneous lupus, one of the three types of cutaneous lupus erythematosus (CLE), which is lupus that affects the skin. “Localized” means the symptom is limited to one area as opposed to all over the body (generalized).

A malar rash may occur spontaneously or after sun exposure. Some people find that a malar rash signals a lupus flare-up.

One Key Characteristic of a Malar Rash: Symmetry

A key feature of a malar rash is that it’s symmetrical: It stretches across the width of the face, covering both cheeks and the bridge of the nose. Thus, a rash on one side of the face, such as just one cheek, would not be considered a malar rash. Other characteristics often (but don’t always) include:

• Discoloration, looking red on light skin and dark purple or brown on darker skin tones
• An elevated or raised appearance
• Scaliness

A malar rash can look like you have a bad sunburn or are flushed or blushing. One MyLupusTeam member wrote, “My malar rash normally is bright red on my cheeks and nose, almost like I used way too much rouge. Sometimes it’s more raised and painful, plus a burning sensation.”

Besides its unique shape, a malar rash has another distinguishing characteristic — it doesn’t affect the underside of your nose, where your nostrils are. Check with your doctor if you have a facial rash and wonder if it’s a malar rash or a different kind of lupus rash.

Other Lupus Rashes or Sores That Affect the Face

A malar rash isn’t the only type of lupus skin condition that can affect your face and other parts of the body. In addition, other inflammatory or autoimmune diseases can cause skin symptoms, which are called nonspecific rashes in lupus.

Discoid Lupus Rashes

Discoid lupus is the most common type of chronic (ongoing) CLE. Rashes caused by discoid lupus are usually disc-shaped (hence the condition’s name) and often appear on the scalp, face, or neck but can also show up elsewhere. In addition to being round, discoid lupus rashes are usually:

• Red, dark purple, or dark brown, depending on skin tone
• Raised
• Scaly

Discoid lupus rashes can also be itchy and may cause scarring, discoloration, and hair loss in the affected area. If you notice a disc-shaped rash on your face, ask your doctor if it might be a sign of discoid lupus. They can help you find ways to manage this chronic condition.

Rashes Around the Eyes

Some people with lupus develop rashes or lesions around their eyes, a symptom that’s also usually related to discoid lupus. These rashes or lesions are tend be:

• Circular or oval
• Slightly raised, making the surrounding area look swollen or puffy
• Scaly

Many MyLupusTeam members have described discoloration and swelling around one or both eyes. One member wrote, “It was hard hiding my swollen eye with makeup. I was only able to cover the redness, but the swelling still showed through my makeup. :(”

The delicate skin can make it difficult to manage a rash around the eyes. Be sure to tell your doctor if you have this symptom, because lupus treatments may help reduce swelling and a rashlike appearance.

Rashes From Light Sensitivity

Lupus can make your skin very sensitive to sunlight and other sources of ultraviolet (UV) light, such as some artificial lighting. This is called photosensitivity, and it affects half of people with lupus, according to Johns Hopkins Lupus Center.

Photosensitivity can lead to a rash on areas exposed to the sun or other sources of UV light. Some people develop a malar, discoid, or other type of lupus rash after being in sunlight or beneath fluorescent lighting. “Sometimes I’ll get a burning rash on one side of my face, especially if it’s a side that is facing the sun or any other source of UV light,” one MyLupusTeam member wrote.

If you develop a rash being in the sun or under artificial lighting, you might have photosensitivity. Discuss this possibility with your doctor, and be sure to take steps to protect your skin: Apply sunscreen with a high SPF, wear sun-protective clothing, and limit exposure to UV light.

Other Rashes on the Face

Sometimes rashes can affect multiple parts of your face or body. “My eyes are swollen, and the rash is around my mouth and goes under my chin,” one MyLupusTeam member shared.

If you experience facial rashes but aren’t sure how to classify them, check with your doctor. They can help you understand the different ways lupus can affect your skin and discuss treatment options for your specific skin symptoms.

It might also be that your rashes aren’t related to lupus. Be sure to tell your doctor about any pattern you notice so that they can help you pinpoint the cause of your rashes and get the right treatment.

How To Treat Rashes

Treating lupus rashes may require seeking medical advice from a dermatologist, ideally one who is familiar with skin involvement from lupus. A dermatologist may do tests, such as a skin biopsy (taking a small sample of tissue for examination under a microscope), to see if your rashes are due to lupus or a different condition.

Treatment for lupus rashes may include:

• Managing photosensitivity, such as using sunscreen and limiting sun exposure to when the UV rays are less strong
• Medication, such as a corticosteroid, an antimalarial drug, a tacrolimus cream, or — in resistant cases — immunosuppressive therapy
• Laser therapy, which may help address scarring or discoloration

You’re far from alone in experiencing rashes on your face and the emotional and physical challenges they can bring. Talk with your doctor about malar rashes and other types of lupus rashes so that you can get started on treatment and move forward on your journey to becoming your best self.

Talk With Others Who Understand

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, more than 223,000 members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

Do you get a malar rash? What does yours typically look like? Share your experience in the comments below, or start a conversation by posting on your Activities page.