Have you ever noticed that some people have red, brown or purple spots on their faces, like a butterfly spreading its wings across their nose and cheeks? Maybe you have experienced something like this too. This is what we call 'Butterfly Rash' or medically known as 'Malar Rash'. This can sometimes be accompanied by a little itching and burning. It is normal to feel a little scared when you see this. So, let's talk about it all clearly today.
What exactly is this Malar Rash?
Simply put, it's a skin spot or rash that starts on one cheek, crosses over your nose, and spreads to the other cheek. It gets its name because it resembles the shape of a butterfly.
The appearance of this may vary depending on skin tone.
- This may appear red or pink to someone with light skin .
- This may appear brown, black, or purple to someone with dark skin .
Sometimes this rash can be flat, sometimes it can be slightly raised, and sometimes it can be scaly. What is special is that this rash usually does not spread to the laugh lines that run from the nose to the corners of the mouth when you laugh. Very rarely, it can spread to the forehead and chin.
Why does a rash like this occur?
The main reason for this is a change in our body's own immune system. Imagine that we have a defense army in our body. That is our immune system. Their job is to fight germs and viruses that enter the body and protect us from diseases.
But sometimes our own defenses make a little mistake. They see our own healthy cells and think, 'Here's an enemy,' and start attacking them. We call this an autoimmune response. That's when inflammation like this appears on our skin in the form of a rash.
The connection between butterfly rash and lupus
You've probably heard of a disease called lupus. The butterfly rash is one of the most common and well-known symptoms of lupus. In fact, doctors consider this rash to be a key piece of evidence when diagnosing lupus.
This rash can be seen with several different types of lupus.
- Systemic Lupus Erythematosus (SLE)
- Cutaneous Lupus Erythematosus (especially Acute Cutaneous Lupus Erythematosus)
- Discoid Lupus
- Subacute Cutaneous Lupus
The important thing is that not everyone who gets a butterfly rash on their face has lupus. However, it is very important to seek medical advice as this is a strong indication of lupus.
Is lupus the only cause? Are there other causes?
Yes, lupus is just one cause. There can be many other causes of butterfly rash. Let's see what they are.
| Medical condition | A simple explanation |
|---|---|
| Rosacea ( Rosacea ) ( Rosacea ) | A common skin condition that causes the face to become red and inflamed, with small pimples. |
| Cellulitis | A bacterial infection that affects the deeper layers of the skin. The skin becomes red, swollen, and feels hot. |
| Erysipelas | A bacterial infection of the superficial layers of the skin. Similar to cellulitis, the rash has clearly defined borders. |
| Pellagra | A condition caused by a deficiency of vitamin B3 (Niacin). A rash appears on areas exposed to the sun. |
| Dermatomyositis | A rare condition that causes muscle weakness and skin rash. |
How do I find out what exactly this is?
If you get a rash like this on your face, the best thing to do is see your doctor.He will ask you about your medical history and whether you have any other symptoms. Then he will examine you.
To find the exact cause, you may be asked to do tests like these:
- Blood tests: Check immune system function and other markers.
- Urine tests: Check to see if organs like the kidneys have been affected.
- Skin biopsy: A very small piece of skin is taken from the area of the rash and examined under a microscope.
Sometimes your doctor may refer you to a dermatologist .
How do you treat this rash?
Treatment depends on the cause of the rash, which means that the treatment will vary depending on the cause.
- For bacterial infections like rosacea , cellulitis, and erysipelas: Antibiotics are given.
- For conditions like lupus and dermatomyositis: Topical corticosteroid creams, antimalarial medications, and immunosuppressants may be given.
- For Pellagra (vitamin B3 deficiency): Niacin tablets are given.
After the rash heals, skin discoloration may sometimes remain. This can sometimes be permanent. You can also talk to your doctor about this and get the necessary advice.
This rash has come and gone, can it come back?
Yes, it can happen. Certain things can cause this rash to flare up or get worse. We call these 'triggers'.
A major trigger is sunlight. Exposure to ultraviolet (UV) light from the sun can increase the rash in someone with lupus or rosacea . This is called photosensitivity .
These triggers vary from person to person. You can talk to your doctor to identify your triggers and get advice on how to avoid them. For example, you can use a good sunscreen , wear a hat, and wear clothing that covers your body when you go out in the sun.
Can this be covered with makeup?
Yes, there's nothing wrong with using makeup to temporarily hide the rash. But talk to your doctor about choosing products that are hypoallergenic and suitable for your skin type. Also, make sure to thoroughly cleanse and remove all makeup from your face before going to bed at night.
Take-Home Message
- A butterfly-shaped rash on the face (malar rash) can occur for a variety of reasons. It can be a simple skin problem or a symptom of a serious illness.
- This can be a major symptom of lupus, but it can also be caused by other skin conditions, such as rosacea .
- Certain triggers, such as sunlight, can worsen or cause new rashes.
- If you have a rash on your face that you don't know the exact cause of, don't ignore it and definitely see your doctor.
- With proper diagnosis, treatment, and lifestyle changes, this condition can be well controlled. So don't panic.
👩🏽⚕️ Additional questions (FAQs)
💬 What is Butterfly Rash / Malar Rash?
This is not a common skin condition! 'Butterfly Rash' is a pathognomonic, fatal rash that appears as a dark red/purple rash that spreads across a person's nose and down both cheeks (like the wings of a butterfly), but does not extend from the nose to the nasolabial folds! This is often the main outward symptom of a serious internal disorder!
💬 What is the main cause of this butterfly-shaped red rash (Malar Rash) on the face?
The main and most dangerous cause of this is the development of a deadly autoimmune disease called 'Lupus (Systemic Lupus Erythematosus / SLE)'! In this, our own immune system goes crazy and attacks our own skin, liver, kidneys, and heart 100% of the time. In addition, this can also be caused by 'Rosacea' (redness of the skin) and severe bacterial infections of the face (Cellulitis/Erysipelas).
💬 When a butterfly rash appears, how do you know if it's 'Lupus'? Why do you need to be hospitalized?
If this butterfly rash burns like fire/increases when you go out in the sun (Photosensitivity), along with 'all the joints in the hands/fingers are swollen and painful (Arthritis),' if there are continuous sores in the mouth/nose (Oral ulcers) and if you feel extremely tired, it is definitely Lupus! This can lead to kidney/heart failure and death within months, so you should see a Rheumatologist immediately!
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