About Lupus

Preventive Strategies: Skin

Preventive Care Strategies: Living with Lupus
Skin Protection

Bella Fradlis, MD
Attending Physician, Division of Rheumatology
Assistant Professor of Medicine, AECOM
Montefiore Medical Center, Jacobi Medical Center

Why does the skin matter?

  • Most people with lupus experience some sort of skin involvement either when first diagnosed or over the course of the disease
  • There are three major types of skin involvement in lupus:
    • Discoid lupus erythematosus (DLE) - Scarring rash, typically over face/ears/scalp
    • Subacute cutaneous lupus erythematosus (SCLE) - Does not leave a scar, +++ photosensitive
    • Acute cutaneous lupus erythematosus (ACLE) - Malar rash = “butterfly rash”
  • Research has shown that exposure of the cells of the skin to UV light leads to DNA damage which can then lead to autoantibody formation and cause local and eventually systemic inflammation

What can you do to prevent heart disease?

  • Avoid sun exposure (beaches, snow, lakes) especially between 10AM and 3PM
  • Use sunscreen DAILY (whether it is cloudy or rainy) -
    • Apply 30-60min before going outside, reapply every 4-6hours
  • Use sunscreen which is at least SPF30; higher SPF such as 70 and Helioplex is available for highly sensitive patients
  • Consider sun protective clothing (SPF30 or greater) but can be expensive. Sunscreen is much cheaper!
  • Avoid medications that may cause photosensitivity – tell your doctor ALL medications you are taking
  • Speak to your doctor about your current medications and whether these can be contributing to sun sensitivity
  • Quit smoking
    • Research has shown that smoking increases the risk of skin involvement in lupus and may contribute to the development of more severe disease of the skin
    • Smoking may also reduce the likelihood of the response of the skin lesions to medications like Plaquenil because smoking is another cause of inflammation

Interested in learning more about other preventive care strategies for living with lupus? Click here to watch a previous presentation Dr. Fradlis gave about how to protect your skin and prevent many other complications of lupus.

This column is not meant to substitute for medical advice from your own healthcare provider – please talk to your doctor about recommendations for preventing lupus complications.  

Dr. Bella Fradlis is an attending rheumatologist who divides her time between Jacobi and Montefiore medical centers, treating a variety of systemic rheumatologic conditions. She received her medical training at Stony Brook University School of Medicine. She then completed an internship year at Long Island Jewish Hospital and internal medicine residency training at Columbia University Medical Center – New York Presbyterian Hospital. Dr. Fradlis completed a clinical rheumatology fellowship at Columbia University Medical Center.