Showering should be a relaxing and rejuvenating part of your day, but for some people living with lupus, it can be quite painful. “Does anyone else experience pain while showering?” one MyLupusTeam member asked. “When the water hits my skin, it feels like pins and needles. It’s painful.”

Other members have similar experiences, including one who lamented, “Pain during showers leaves me exhausted!”

Systemic lupus erythematosus (SLE), the most common type of lupus, is an autoimmune disorder that attacks multiple organs and tissues. Common symptoms of lupus, such as skin and nerve sensitivity, can make everyday activities painful. The pins-and-needles sensation that people with lupus often experience during showers may be related to how lupus affects both the skin and nervous system.

In this article, we will explore six reasons why you may be experiencing tingling and pain while showering — and offer some tips to help relieve the discomfort.

1. Sensitivity to Water Temperature and Pressure

Lupus can increase your sensitivity to various stimuli, including temperature and pressure. For example, lupus often causes muscle and joint pain and stiffness, particularly in areas like the neck, upper arms, and shoulders — regions frequently exposed to shower water. This may lead to heightened sensitivity when water makes contact with these areas. Lowering the water pressure can help reduce the impact of water droplets on your body. “To help this very weird painful feeling, I had to change my shower pressure,” one MyLupusTeam member wrote.

A pins-and-needles sensation while showering may result from the water being too hot or too cold for your sensitive skin. Adjusting the temperature to a more moderate level that suits your skin’s needs can help reduce that discomfort.

Some MyLupusTeam members opt to avoid showers altogether. “I try to take baths instead,” one member explained.

2. Raynaud’s Phenomenon

Raynaud’s phenomenon is a condition often associated with lupus. Studies estimate that up to one-third of people with lupus may experience Raynaud’s during their lifetime. It causes blood vessels in the fingers and toes to constrict (narrow), reducing blood flow and making you especially sensitive to cold. You might notice that your fingertips turn white or blue when exposed to cold, or that it takes longer for blood flow to return after pressing on your nails. When exposed to cold water during a shower, individuals with Raynaud’s may experience pins-and-needles sensations in their hands and feet due to this circulation issue.

You can help reduce symptoms related to Raynaud’s by:

• Wearing compression socks to promote blood circulation
• Using warm water or lukewarm water instead of cold water when showering or bathing
• Avoiding contact with cold objects, such as iced beverages
• Keeping the affected body parts warm after your shower

3. Sensitivity to Chemicals

Sometimes, people with lupus experience increased hypersensitivity. This can make the skin more reactive to certain substances. Chemicals commonly found in soaps, shampoos, or shower gels may irritate the skin, potentially causing a pins-and-needles sensation.

Opting for gentle, fragrance-free products and avoiding known irritants can help reduce skin sensitivity during showers. After showering, applying a hypoallergenic, gentle moisturizer can also soothe and hydrate sensitive skin.

4. Peripheral Neuropathy

Lupus can sometimes lead to a condition known as peripheral neuropathy, which affects the nerves in the extremities (arms and legs). This can result in various sensations, including tingling, numbness, or burning. A pins-and-needles sensation during a shower may be a symptom of peripheral neuropathy, especially if you’re experiencing it at other times during the day.

If you believe you are experiencing peripheral neuropathy, consult with a health care professional to get a proper diagnosis. They may conduct a physical exam, order blood tests, or recommend other diagnostic tests to determine if peripheral neuropathy is the cause of your symptoms. From there, they can offer guidance on managing the condition and preventing further nerve damage.

5. Medication Side Effects

Medications used to treat lupus include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Antimalarial drugs
• Corticosteroids
• Immunosuppressants
• Biologics

Each of these medications can have a range of side effects. Some drugs may cause sensations like burning, crawling, itching, numbness, prickling, or tingling — symptoms collectively known as paresthesias. One such drug is voclosporin (Lupkynis), which is used specifically to treat lupus nephritis, a serious kidney inflammation that occurs in people with lupus.

If you recently started a new medication and have noticed an increase in pins-and-needles sensations, it could be a drug side effect. Discuss this with your health care provider so they may help identify alternative treatment options or adjust the dosage to alleviate the side effect. It is important not to discontinue any medications without medical advice, as doing so could increase your risk of a lupus flare-up.

6. Other Health Conditions

Many people living with lupus are living with a comorbidity — that is, another chronic condition. Comorbidities for lupus can include other autoimmune diseases, such as rheumatoid arthritis or Sjögren’s syndrome. Rheumatoid arthritis, for example, can cause peripheral neuropathy, which — as mentioned earlier — may lead to pins-and-needles sensations.

Further, around 25 percent of people with lupus experience fibromyalgia, a disorder characterized by fatigue, joint and muscle pain, stiffness, numbness, and headaches. These symptoms commonly overlap with those of SLE, so many people go undiagnosed. The pain and sensations associated with fibromyalgia can sometimes feel like pins and needles.

If you think you may be experiencing fibromyalgia, rheumatoid arthritis, or any other health problem related to lupus, talk to your doctor about your concerns.

Find Your Team

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, more than 231,000 members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

Have you experienced pins and needles on any part of your body while showering? What tips can you offer to others experiencing this same symptom? Share your experience in the comments below, or start a conversation by posting on your Activities page.