“My skin burns to the touch after I take a shower,” said one MyLupusTeam member. “I get redness in my neck and chest and burning skin all over that lasts for hours.” Another member said, “Sometimes, water in the shower stings me. I don’t know why, but it hurts for a while, like an hour, then the sting goes away.”

For many people with lupus, a hot shower may help with relaxation and ease joint pain. But lupus affects everyone a little differently. In some cases, a hot shower can cause a burning or itching sensation on the skin that can be uncomfortable and bewildering.

“Does anyone else experience pain while showering? When the water hits my skin, it feels like pins and needles. It’s painful,” another MyLupusTeam member shared.

Lupus is an autoimmune disorder in which the immune system mistakenly attacks healthy tissue throughout the body. Lupus can cause symptoms on the skin, such as a malar rash (butterfly rash) across the bridge of the nose and cheeks. There are several reasons why you may experience burning skin, itchy skin, or skin sensitivity after a shower. Keep reading to find out possible explanations.

1. Cutaneous Lupus

About 65 percent of people who have systemic lupus have cutaneous lupus erythematosus (CLE) — also known as skin lupus — a type of lupus that affects the skin.

Symptoms of CLE can vary depending on how severe the condition is and may include hair loss, a range of rashes, skin lesions, or scaly patches of skin. Discoid lupus is a type of skin lupus that involves skin lesions that can be painful, itchy, and burning. If you notice round patches on different parts of your body — especially your scalp, face, or ears — that are scaly and discolored, this may be a sign of discoid cutaneous lupus.

Although cutaneous lupus is especially triggered by light exposure, it’s possible that because your skin is already highly sensitive, it may react to other stimuli, such as a hot shower.

2. Indoor Lights

People with lupus are sensitive to the ultraviolet (UV) radiation of sunlight. Some indoor lights, specifically fluorescent and halogen lights, also emit UV radiation and can irritate your skin if you have lupus. This irritation can make your skin feel itchy, especially if you’re very sensitive to light.

Light sensitivity — also known as photosensitivity — may be the reason your skin is feeling itchy or burning after a shower. If you have these types of lights in the bathroom where you take a shower, your skin may be reacting to light rather than the shower itself.

3. Medications

Some lupus medications can have side effects that may affect your skin. For instance, hydroxychloroquine (Plaquenil, Sovuna) may cause a rash as a side effect. A rash can cause a burning sensation in the skin. In rare cases, this medication can cause blistering and peeling, which might explain the burning sensation.

Medications that prevent an immune response, called immunosuppressants, are often used to treat lupus. Pimecrolimus (Elidel) is one such immunosuppressant, and it may cause side effects like burning or stinging on the skin. It’s sometimes used off-label to treat certain skin symptoms of lupus, which means it’s prescribed for something other than what it was originally approved for.

Some medications may increase light sensitivity, which can raise the risk of skin reactions. Talk to your doctor about the potential side effects of any medications you’re taking for lupus or any other condition.

4. A Lupus Flare-Up

When lupus is flaring, your skin may become especially sensitive. You may develop a rash that is accompanied by a burning or itchy sensation. Lupus symptoms can be triggered by stress, illness, exhaustion, exposure to UV light, or injury.

Always let your doctor know if you think you may be having a lupus flare-up to be sure you receive appropriate treatment.

5. Other Diseases

People with autoimmune diseases like lupus are at risk for various health issues that bring on different symptoms. Those with lupus may be more likely to develop skin conditions, thyroid disorders, and, in some cases, allergies. While lupus doesn’t directly increase allergy risk, immune system dysfunction could play a role.

Hyperthyroidism, when your thyroid gland produces too much thyroid hormone, can cause a sensitivity to heat, which may make your skin feel more sensitive to a hot shower and, as a result, feel like it’s burning.

Erythromelalgia, also known as Mitchell’s disease, is a rare condition that can sometimes be linked to lupus, though this connection is uncommon. It involves nerve pain that affects the hands, feet, and skin, causing symptoms like warmth, discoloration, and a burning sensation.

Skin Reactions That May Be a Sign of an Emergency

In some cases, a skin reaction may be a sign of a serious skin condition or infection. Contact your doctor or seek emergency care if you have a rash that:

• Breaks out all over your body
• Comes with a fever
• Happens suddenly and spreads quickly
• Includes blisters

Keep an eye out for signs of infection, such as if the rash is warm to the touch, oozes yellow or green fluid, or is swollen. You may also experience a fever if you have an infection.

How To Treat Burning Skin From a Shower

If you feel burning skin after showering, start by talking with your rheumatologist or dermatologist. They can help you figure out if any treatments might help and may suggest blood tests to check for other possible causes. Also, ask them about the best moisturizers or lotions to keep your skin feeling comfortable.

Dermatologists recommend that people with lupus take extra precautions with skin care because a lupus rash can increase the risk of flare-ups, which may lead to long-term skin problems. Here are some recommendations to protect and care for your skin:

• Use sunscreen — When you’re out in the sun, use a broad-spectrum sunscreen (30 SPF or higher) and wear protective clothing that shields your skin from sunburn.
• Avoid tanning beds — The UV rays from a tanning bed can trigger flare-ups.
• Quit smoking — Smoking can worsen skin problems and reduce the effectiveness of some medications.
• Avoid touching any rashes — This can cause new rashes to develop.
• Use LED bulbs or incandescent bulbs — Fluorescent and halogen light bulbs contain UV light that may cause a flare-up.

MyLupusTeam members have also shared how they manage this symptom. “Before I am done with my shower, I turn the water to a cooler temperature and rinse my hair and body. Then I pat dry and add lotion with oatmeal,” a member wrote.

“My skin hates the water! Maybe my shower was just too hot. I have to take cool showers,” another member said.

A third member wrote, “If I get my head and neck in cold water when I’m done, it helps me. I’m always hot.”

Talk With Your Doctor

If you experience burning or itching skin after a shower, there are ways to find relief. For those with lupus, skin sensitivity can be triggered by a range of factors, from hot water and medications to light exposure and other health conditions. Talk with your doctor to uncover the cause and explore options to protect your skin. Simple changes, like adjusting the water temperature, using gentle skin care products, and taking extra steps to avoid UV exposure, can make a real difference in managing this uncomfortable symptom.

Find Your Team

On MyLupusTeam, the social network for people with lupus and their loved ones, more than 232,000 members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

Have you felt a burning sensation in your skin after showering? Share your experience in the comments below, or start a conversation by posting on your Activities page.