A malar rash, often called a butterfly rash, is a skin irritation extending across your face in the shape of a butterfly. The wings cover your cheeks, and the butterfly's body extends down the bridge of your nose. A butterfly rash is not a condition in itself, but rather a symptom of a larger disease. Malar rashes are most often associated with the autoimmune disease lupus.
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Lupus is a chronic disease in which your immune system becomes overactive and attacks your body. It causes inflammation of the skin and joints, headaches, fever, chest pain and fatigue. Not all forms of lupus cause skin irritations, but approximately half of all lupus sufferers develop butterfly rashes. Although lupus is chronic, the rashes it causes come and go. Sun exposure, insufficient sleep and poor diet can contribute to lupus flare-ups and trigger the appearance of a malar rash.
Doctors may treat butterfly rashes with corticosteroid creams or lotions, which are applied topically to the rashes. Corticosteroids mimic the natural hormone cortisol, which acts to regulate the immune system and reduce inflammation in the body. Side effects of corticosteroids include acne, new hair growth, bruising and weight gain. More serious side effects can occur with high doses of steroids. Because of this, doctors usually give the lowest effective dose of corticosteroids to patients with lupus. Only use corticosteroids under the supervision of a doctor. Contact him immediately if your lupus symptoms include shortness of breath or chest pains or if you develop an infection.
When corticosteroids cause too many side effects or are not enough to control the symptoms of lupus, doctors may prescribe antimalarials as well. These drugs were originally developed to treat malaria but now are used to manage lupus. If you take both steroids and antimalarials, you may be able to reduce your steroid dosage. Antimalarials help heal your skin and protect it from sun exposure, which is a frequent trigger of lupus flare-ups. Most people do not experience side effects from antimalarial drugs, but the treatments can take several months before showing results.
Sun exposure can trigger or worsen malar rashes, so you should always wear a hat with a wide brim and sunscreen with at least SPF 55 when in the sun. Fatigue is another common symptom of lupus and can contribute to other symptoms. If you get enough rest, you are likely to have fewer flare-ups and recover from them faster than lupus patients who need more sleep. Regular exercise and a healthful diet of whole grains, fruits, vegetables and lean protein can also help you manage your symptoms.