Lupus and black skin
Given the prevalence of Lupus in the Black community, we’ve taken a deep dive into how it affects Black Skin – its causes, symptoms and treatments
LUPUS – WHAT IS IT?
Lupus is a long-term condition that causes joint pain, tiredness, and skin rashes, it occurs as the body’s immune system becomes active and essentially alters the healthy tissues in the body. Commonly striking women of a childbearing age, Lupus can also develop amongst men, children, and teenagers too (often between the ages of 15-44) and according to statistics, Lupus has affected 5 million people worldwide.
According to a recent study provided by the Lupus Organisation, the autoimmune disease is 3x more likely to be prevalent in black women with as many as 1 in 500 black women in UK alone (compared to 1 in 1000 caucasian women), developing the disease. Whilst the cause of Lupus is still not verified, research into the genetic makeup of the black community has arisen.
As a chronic condition, Lupus symptoms can last from anywhere between six weeks to years. Harming the body’s immune system, it forces the body’s system (which fights off bacteria, viruses, flu and disease) into “autoimmunity”. This process of autoimmunity means the immune system can’t distinguish between foreign invaders such as bacteria and viruses and the body’s healthy tissue – as a result the body starts to attack the healthy tissue.
DIFFERENT TYPES OF LUPUS
There are different types of lupus that individuals can be diagnosed with;
SLE (Systemic Lupus Erythematosus)
The most common type of Lupus that can impact the whole body and can range in severity. Causing inflammation in the skin, joints, lungs, kidneys, blood, and heart, SLE can affect any of the body’s organs or organ systems.
DLE (Discoid lupus Erythematosus)
This type of lupus only affects the skin, and it appears as rashes on the face, neck and even scalp. The rash areas may become thick, scaly and scar the skin.
Drug-Induced Lupus
This occurs because of individuals having a reaction from certain prescription drugs – Hydralazine (hypertension medication), Procainamide (heart arrhythmia medication) and Isoniazid (antibiotic used to treat tuberculosis). Typically, this lupus disappears when the medication is no longer being taken.
CLE (Subacute Cutaneous lupus Erythematosus)
A form of lupus that develops when the body is exposed to the sun and skin lesions appear on parts of the body as a result.
Neonatal Lupus
It can occur with women who are pregnant and already have lupus. At birth this can mean that the baby can have symptoms such as skin rashes, liver problems or low blood counts. Often the lesions can disappear after a few weeks but in more severe cases, babies may suffer with longer life-threatening conditions such as heart blockages.
LUPUS SYMPTOMS
Whilst the actual cause of Lupus is still unclear, there are symptoms to look out for:
*It is important to note that because Lupus can affect any part of the body and the condition is different for everyone, no two people may feel the same and so we always recommend consulting a trusted medical practitioner.
Common symptoms include:
· Fatigue
· A loss of appetite and weight loss
· Pain or swelling in joints and muscles
· Swelling in the legs or around the eyes
· Swollen glands, or lymph nodes
· Skin rashes, due to bleeding under the skin
· Mouth ulcers
· Sensitivity to the sun
· Fever
· Headaches
· Chest pain when breathing
· Unusual hair loss
· Arthritis
LUPUS SYMPTOMS ON BLACK SKIN
There are some acute differences when noticing lupus on black skin as opposed to white skin according to Dr Mary Sommerlad, Black Skin Directory Practitioner and Consulting Dermatologist. She highlights, “A rash, also known as a “butterfly rash” appears across the nose and upper cheeks. In brown and black skin this rash can appear either as red, brown or darker than the original skin colour whilst in white skin tones the rash appears as red or pink and can last hours to days”.
Dr Mary goes on to share, “A widespread rash throughout the torso or limbs that looks like a viral rash. In skin of colour, this will appear as flat dots and raised spots which can appear as brown, purple, or black colour. A widespread blistering eruption that makes skin peel away can also look like a severe drug reaction”.
HOW TO TREAT LUPUS ON THE SKIN?
“Lupus is best managed by seeing a Consultant Rheumatologist who can properly assess you for lupus and manage your symptoms appropriately. If you purely have a skin disease, you can be managed by a Dermatologist, but it is important to be aware that several people with skin lupus only will progress to SLE over time. Treatments do include topical steroids and non-steroid SLS, antimalarials and disease modifying medications” Dr Mary advises.
SKINCARE TIPS & ROUTINE RECOMMENDATIONS
Consistently apply an SPF30 or above - It is estimated that at least 60% of Lupus patients are affected by exposure to UV rays which can trigger a flare up in symptoms - frequently applying an SPF30-50 is strongly advised and if in the sun for long periods of time wearing a hat, sunglasses or sun protective clothing such as a mask, longer sleeved items of clothing or head wrap.
Avoid Potentially Irritating Ingredients such as alpha hydroxy acids and retinoids. Opt for more gentle skincare ingredients such as Aloe Vera, Niacinamide, Hyaluronic Acid, they work to hydrate, soothe and strengthen the skin’s barrier without causing irritation. We also recommend introducing ingredients with antioxidant properties such as Vitamin C, to help fight against environmental and lifestyle damage to the skin, brighten the complexion & even out the skin’s tone.
If introducing any new skincare products and ingredients, please do seek the advice of your Dermatologist.
LUPUS, HAIR & SCALP
When it comes to Lupus on the scalp it can present itself as irregularly shaped patches of hair loss (ranging in size) with hyperpigmentation and a variation of colour is noticed on the scalp’s surface as well as an increased amount of shedding and thinning. Regarding treating Lupus on the scalp, Black Skin Directory Practitioner and Trichologist at Fulham Hair & Scalp Clinic, Eleanore Richardson highlights, “Treating Lupus symptoms on the scalp can be difficult as the condition can progress unpredictably”.
“The use of cortico-steroids injections to control the inflammation under the scalp surface – this immediately helps to control the condition. A dermatologist or trichologist will be able to identify whether any areas of hair loss noticed are scarring or if there is opportunity for re-growth” she adds.
HELPFUL LINKS & FURTHER RESOURCES