One white and one black woman with differently presenting butterfly rashes across their faces.

Scarring from Lupus Lesions and Rashes

Lupus presents itself in so many different ways. What happens in one lupus warrior’s journey won’t manifest in all lupus warriors. Sometimes there are huge differences from skin tone to skin tone. Where a butterfly rash may not leave scarring on fairer skin on darker skin it can leave huge scars. Let’s talk a little about the differences.

First the facts

According to the Lupus Foundation of America, lupus is three times more common in Black American women. As many as 1 in 250 Black American women will develop lupus. It is unknown why the Black female population is stricken with lupus more. It is only speculated by scientists, according to the Lupus Foundation of America, to be because of genes. Why is this important? Well, Black women are disproportionately hit hard with lupus, but their lupus issues are often overlooked.

Lupus lesions

Lupus lesions are defined medically under discoid lupus. They are often red scaly and thick and can leave some skin discolorations and scarring. In fairer skin, you are able to see the rash clearly. In darker skin, it may look a bit different. As I look at my own lesions. they present dark and scaly with very little red color. Most times when dealing with lupus lesions as it heals on my skin it will leave both hyperpigmentation and hypopigmentation. When I get these lesions. they itch and burn and can be small or large patches.

Flares beyond organs

Just like the organs can be attacked, so can the skin. When lesions appear, it is an autoimmune response where the skin cells are affected. Lesions for me have been caused by some sun exposure and others have been caused just by lupus being out of control in my body. These skin flares are just as difficult to deal with in a different way. Unlike internal flares, lupus lesions can be seen. The malar rash or butterfly rash is one of the looks often seen with lupus. Lupus lesions are another way lupus marks the skin and it can really disfigure darker skin.

Scarring in darker skin

Lesions can sometimes riddle my body. Most prevalently on my lips, ears, legs, and scalp. All have left dark scarring once healed. I have noticed if my lesions are itchy and burning, they leave darker scars or hyperpigmentation. If the lesions are raised patches with no itch or burn, they leave my skin lighter or hypopigmentation. Sometimes the scars fade, other times they leave little craters or dips in my skin.

Dealing with scarring is hard

The hardest part about dealing with lupus lesions, that leave scarring, is the assumptions. Many will assume that your scars are a sign of something that is contagious. They assume the worse and it can make you self-conscious and uncomfortable about going out and interacting when in that type of flare. The pain and scarring can be devastating for anyone dealing with them. It can really drain the lupus warrior physically and emotionally.

There is hope

There is hope in trying to minimize lesions and treating them. For example, injections of corticosteroid as well as oral treatments like hydroxychloroquine and methotrexate. I’ve also used prescribed topical creams and ointments like tacrolimus ointment. One main preventive measure I have taken is minimizing my time in the sun.

I learned how lesions affect me. Scarring was an important part of that education for me because of my darker skin. It was hard not to notice the difference in how the lesions manifested in and on my body. Continuously learning about what lupus can do to my body helps me in fighting lupus wiser.

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