Lupus and Dry Skin

posted in Skin Problems in Lupus on December 13, 2023 by

Updated February 15, 2025

Causes of Dry Skin in Lupus

Lupus patients often develop dry skin due to the presence of another autoimmune condition known as Sjögren’s disease. Additionally, medications commonly used by lupus patients may contribute to skin dryness as a side effect.

Symptoms of Dry Skin in Lupus

Dry skin can sometimes be easily identified, as demonstrated in the image provided in this article. Some people describe it as having an “ashy” appearance. Persistent itching, rough or scaly patches, and overall skin tightness may occur. However, dryness is often not readily apparent. The only symptom may be itchiness on areas of the skin where no rashes exist. The dryness may be subtle and only seen through close observation.

Itchy skin due to dry skin can be very distressing, but there are many things patients can do to help dry, itchy skin. In some cases, dry skin can exacerbate existing lupus-related rashes, increasing discomfort. Fortunately, there is a lot patients can do to reduce the dryness and itchiness: https://www.lupusencyclopedia.com/dry-skin-in-lupus/

Below are some of the most important strategies for helping dry, itchy skin.

Strategies for Managing Dry Skin

Hydration

Adequate hydration requires attention both internally and externally. Drinking lots of water to stay hydrated within the body is crucial. Lupus patients should maintain a sufficient water intake to support overall skin health. Many experts recommend drinking nine 8-oz glasses of water daily. Avoiding liquids that cause dehydration, like alcohol and caffeine, is important. Consuming foods rich in water content, such as fruits and vegetables, can also contribute to hydration.

Humidifiers should be placed throughout the home to provide external hydration. A humidifier within the central heating system is ideal but not practical for everyone. At a minimum, there should be a humidifier in the bedroom as we spend more time in the bedroom than anywhere else. If you do not always have it turned on, at least turn it on an hour before going to bed.

Gentle Skincare Routine

Adopting a gentle skincare routine is paramount. For example, avoiding hot water while bathing and showering is critical for preserving the skin’s natural moisturizing oils. Using mild, fragrance-free cleansers and moisturizers, like CeraVe cream, helps avoid potential irritants that can worsen dry skin. Moisturizing regularly, especially after bathing, can lock in essential moisture.

For practical tips for dry, itchy skin, see our blog post entitled “Top Dermatologist Tips in Caring for Itchy, Dry Skin in Lupus and Sjögren’s.”

Ultraviolet Light Protection

Ultraviolet (UV) light exposure (especially to the sun) can worsen lupus symptoms, making UV protection essential for all lupus patients. Applying broad-spectrum sunscreen with a high SPF is crucial when venturing outdoors. Protective clothing, including hats and long sleeves, shields the skin from harmful UV rays.

See the complete list of recommendations on UV light protection at the link at the bottom of our “Lupus Secrets” page. The handout is a valuable resource with a complete list of tips on reducing UV light exposure and subsequently reducing systemic inflammation from lupus.

Consultation with a Dermatologist

Consulting with a dermatologist is advisable for individuals with lupus experiencing persistent or severe dry skin. A dermatologist can assess the specific needs of lupus-affected skin and recommend tailored skincare solutions.

Lifestyle Considerations

Beyond skincare, certain lifestyle adjustments can positively impact skin health for lupus patients. Managing stress, getting sufficient rest, and avoiding excessive alcohol consumption and smoking contribute to overall well-being, potentially benefiting the skin.

Dry skin is a common concern for individuals with lupus, and understanding its causes and effective management strategies is essential. Individuals with lupus can alleviate the discomfort associated with dry skin by adopting a proactive approach to skincare, staying hydrated, and seeking professional guidance when needed. As with many aspects of lupus, a personalized and holistic approach to skincare enhances the quality of life for those navigating the complexities of this autoimmune condition.

Other Causes of Itchy Skin

Not all itchy skin is due to dry skin. Other examples include the following

Aquagenic Pruritis due to Hydroxychloroquine

Hydroxychloroquine (HCQ) can irritate specific nerve fibers known as “itch nerves.” Hot water irritates these nerves further, causing intense itching after bathing or showering in warm water. Since the itch is not due to histamine (as occurs with allergies), typical allergy drugs like anti-histamines do not help.

Aquagenic pruritis occurs in approximately one out of every 20 patients taking HCQ.

Reducing the itching from hydroxychloroquine-induced aquagenic pruritis:

take cooler showers and baths
take HCQ immediately after your shower (therefore, drug levels are at their lowest when you shower or bathe)
sometimes, the HCQ dose may need to be reduced (but we try not to do this if we do not need to)
medications that reduce itch nerve activity (like gabapentin and pregabalin) can be helpful

Drugs

Drugs other than HCQ can cause itch as a side effect.

Leflunomide: Leflunomide is an immunosuppressant occasionally prescribed for lupus management. It can cause itching that is not associated with dryness or rash. The treatment is to reduce or stop the dose.
Opioids: Opioids commonly cause itching as a side effect. Tramadol is a weak opioid widely used for lupus pains, and itching is one of its typical side effects.
Other drugs: Antibiotics, antidepressants, blood thinners, statins (used to reduce cholesterol)

Chronic Idiopathic Itch

Chronic means that something lasts a long time. Iiopathic is the medical term for “we do not know why.” So, chronic idiopathic itch is when itching occurs for more than six weeks (chronic) and there is no identifiable cause (idiopathic) like drugs, dryness, rash, allergies, or neuropathy. As with HCQ aquagenic pruritus, it is due to chronic irritation of itch nerves. Anti-histamines are not helpful. Drugs that reduce nerve activity help reduce itch severity. These include gabapentin, pregabalin, paroxetine, and cannabinoids.

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For more in-depth information on lupus and dry skin:

Read chapters 8 and 14 of The Lupus Encyclopedia, edition 2

Look up your symptoms, conditions, and medications in the Index of The Lupus Encyclopedia

If you enjoy the information from The Lupus Encyclopedia, please click the “SUPPORT” button at the top of the page to learn how you can help.

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If you have dry itchy skin, what has your experience been? What do you recommend for other patients?

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Click on “SUPPORT” at the top of the page to learn how you can support “The Lupus Encyclopedia“

For more in-depth information on Lupus and Dry Skin:

Look up your symptoms, conditions, and medications in the Index of The Lupus Encyclopedia

If you enjoy the information from The Lupus Encyclopedia, please click the “SUPPORT” button at the top of the page to learn how you can help.

What are your comments and opinions?

If you have lupus, what has your experience been? What do you recommend for other patients?

Do you have any questions to ask Dr. Thomas?

Please click on “Leave a Comment” above to comment.

Please support “The Lupus Encyclopedia” blog post page

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Lupus and Dry Skin

Causes of Dry Skin in Lupus

Symptoms of Dry Skin in Lupus