Essential Guide: Recognizing Lupus in Your Esthetic Practice

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Continuing Education

Esthi’s, you may remember lupus as one of last month’s trending topics across the internet. Perhaps you even recall a few clients presenting with subcutaneous symptoms of lupus. If you’re unfamiliar with this condition and its characteristics, let’s start here. Lupus is classified as an autoimmune disorder, and while estheticians are not licensed to diagnose or treat it, recognizing when to refer clients to the appropriate healthcare channels is crucial. Lupus has several classifications and many systemic symptoms that may not be visible on the hair, skin, or nails. However, there are external characteristics to watch for. Let’s talk about those:

Butterfly Rash

Known as a classic lupus rash, it typically appears as a deep red or purple color on the skin, depending on the skin’s natural pigmentation. This rash may be raised and often resembles rosacea during the beginning or end stages of a flare. A butterfly rash can result from the body having an abundance of inflammation, triggered by stress and photosensitivity.

Sudden Hair Fall and Scalp Irritation

The scalp is an extension of the face and where there is skin, estheticians have a role. Hair loss can also be a symptom of hypothyroidism, stress, medication side effects, and other forms of alopecia. In lupus, inflammation restricts the hair follicle’s ability to grow hair.

Sudden Loss of Pigmentation

Cutaneous lupus, discoid lupus, and other variants can trigger inflammation that can lead to loss of pigment and make the skin appear similar to vitiligo More often, the tissue mass underneath these specific areas of pigmentation loss appears sunken or less dense.

Photosensitivity

Regardless of Fitzpatrick skin type, pronouns, or ethnic background, individuals with lupus are extremely photosensitive. They may burn almost immediately and simultaneously lose energy, often becoming lethargic.

Cardiovascular Symptoms

Vasculitis is often associated with lupus patients, making them more prone to bruising, pain, thinning of the skin, and discoloration.

Undiagnosed Lupus

Active symptoms can come and go, making it difficult to get an immediate diagnosis. Typically, this diagnosis comes from a rheumatologist, as lupus is considered a rheumatological disease often co-treated with dermatology.

Diagnosed Lupus

Clients aware of their lupus diagnosis will know their medications, which is important as these can pose contraindications. Common medications include:

Corticosteroids
Hydroxychloroquine
Mycophenolate
Belimumab

These drugs alter and weaken the immune system to redirect the overactive immune response. They often cause increased photosensitivity, thinner skin, slower healing, and easy bruising, especially on the face. (Plaquenil/hydroxychloroquine is usually safe.)

Service Contraindications

When you recognize that a guest is on any of these medications or has been within the last six months, refrain from performing services like chemical peels, dermaplaning, microdermabrasion, sculpting facial massage, vacuum sculpting/hydra facial, extractions, waxing, tweezing, cupping, nano channeling, light therapy, excessive thermotherapy, and aftercare that is not conducive to protecting, calming, and soothing the skin.

Top 6 Tips for Keeping Your Butterfly Guest Comfortable

Conduct a Written and Signed Consultation:
- Always start with thorough documentation.
Investigate Consultation Answers:
- Ask about diagnosis timing, medications, flare history, triggers, and relief measures.
Encourage SPF Use:
- Always offer and encourage the use of sunscreen.
Gentle Touch is the Best Touch:
- Opt for gentle techniques to avoid aggravating the skin.
Request Written Consent from Clients’ Providers:
- Ensure treatments are safe with written consent from their healthcare providers.
Use Gentle Enzyme Exfoliation:
- Avoid mechanical exfoliation to prevent skin damage.

By understanding lupus and its effects on the skin, estheticians can provide appropriate care, ensuring that clients with lupus feel safe, comfortable, and well-cared for.

To learn more about LearnSkin’s annual event and certificate program, investigate the links below!

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* This blog is for general skin, beauty, wellness, and health information only. This post is not to be used as a substitute for medical advice, diagnosis, or treatment of any health condition or problem. The information provided on this Website should never be used to disregard, delay, or refuse treatment or advice from a physician or a qualified health provider.