Many individuals with lupus develop some form of skin condition, particularly on areas of the body, such as the face, neck, arms, and legs, which are exposed to the sun. If you have lupus skin disease, exposure to the sun's ultraviolet rays can make the skin rashes and lesions worse. Therefore, it's important to be under the care of a dermatologist who will treat associated skin conditions and perform regular skin cancer screenings. Even if you see a dermatologist for regular follow-up care, it helps to know more about the effects of lupus on the skin, as well as how to reduce the risk of developing skin cancer.
While lupus skin disease can take one of three forms – chronic cutaneous (discoid) lupus, subacute cutaneous lupus, or acute cutaneous lupus – you are at risk of developing cancer in discoid lesions that you've had for a long time. The lesions are red, scaly, disk-shaped bumps that generally appear on the face and scalp, but some people develop the lesions on other parts of the body, including sores in the mouth and nose. Skin rashes range in severity and may be a constant problem or occur only occasionally.
Problem of Photosensitivity
Photosensitivity – a common symptom of lupus – is a reaction to sunlight or fluorescent light that manifests as a skin rash. More than 60 percent of individuals with lupus report an increased sensitivity to ultraviolet rays following extended exposure to sunlight or fluorescent lighting. But knowing that a rash can be a warning sign of impending flare and seeing your doctor can help minimize the severity.
It also helps to take extra care out in the sun if you have fair skin and light hair and eyes. Individuals who have these features tend to be more sensitive to sunlight and artificial light than people with darker features.
Other Problems Discoid Lesions Can Cause
Aside from the risk of developing skin cancer, even after discoid lesions heal, they can cause permanent scarring and skin discoloration. Lesions you get on your scalp can cause your hair to fall out and lead to permanent hair loss. Consequently, managing the disease and receiving early treatment for discoid lesions is crucial.
Treatment usually includes topical creams and corticosteroids to reduce inflammation. If lesions are severe, your doctor may inject cortisone directly into the lesions. Other treatments may include antimalarial drugs to improve skin rashes and help prevent flares. Antimalarial drugs also offer more protection from UV light.
Stay out of the sunlight and seek shade, particularly between the hours of 10 a.m. and 2 p.m. – the time of day when the sun's rays are strongest. Besides causing lupus flares, sunlight increases the risk of skin cancer. Keep in mind that even on cloudy days, harmful UV rays from the sun can penetrate your skin.
Wear a wide-brimmed hat, protective clothing, and sunglasses when you spend time outdoors. Choose loose-fitting, tightly-woven clothing fabrics for covering the parts of your body that will be exposed to the sun.
Apply sunscreen to all areas of skin exposed to sunlight. Use a broad-spectrum sunscreen with an SPF of 85 or greater that provides skin protection against UVA and UVB rays – both of which increase the risk of skin cancer. Reapply sunscreen frequently throughout the day.
Minimize the number of hours you spend under fluorescent lights or are exposed to halogen lighting, as the ultraviolet rays the light bulbs emit can aggravate your lupus symptoms.
Avoid tobacco smoke, as smoking may increase autoimmune activity and make medications to treat lupus less effective.