Discoid lupus erythematosus (DLE) is a form of cutaneous lupus that mainly affects the skin. You’ll usually see round, scaly patches that can be red or skin-colored. Over time these lesions may scar, thin the skin, or cause permanent hair loss if they appear on the scalp. DLE often shows up on sun-exposed areas: face, ears, scalp, and neck.
If you notice disc-shaped, scaly patches that don’t go away, see a dermatologist. They’ll examine the lesions and often do a skin biopsy to confirm DLE. Blood tests like ANA (antinuclear antibody) may be done, but many people with DLE have normal bloodwork.
Treatment focuses on stopping inflammation fast to prevent scarring. First-line options include high-potency topical corticosteroids or topical calcineurin inhibitors (like tacrolimus). For thicker or stubborn lesions, doctors inject steroids into the lesion (intralesional steroid).
If topical options aren’t enough, oral antimalarial drugs such as hydroxychloroquine are commonly used and work well for many people. For severe or resistant cases, other immunosuppressants (methotrexate, azathioprine) may be considered by a specialist. Always discuss benefits and risks with your clinician.
Sun protection makes a big difference. Use a broad-spectrum SPF 30+ sunscreen daily, wear wide-brimmed hats, and choose UPF clothing when you can. Avoid tanning beds and strong UV sources, since sun exposure often triggers flares.
Quit smoking if you can—smoking reduces the effectiveness of treatments like hydroxychloroquine and increases flare risk. Treat the skin gently: mild cleansers, fragrance-free moisturizers, and avoiding harsh scrubs help. If you have lesions on the scalp, avoid tight hairstyles and rough brushing to limit further damage.
Scarring and hair loss from DLE can be tough. Early treatment gives the best chance to prevent permanent damage. For existing scars, options include silicone sheets, cosmetic camouflage, and referral to a dermatologist or hair specialist for hair-restoration advice.
Watch for signs that suggest systemic lupus (worse fatigue, joint pain, fevers, mouth ulcers or blood test changes). While most people with localized DLE don’t develop systemic disease, report new symptoms to your doctor promptly.
Living with DLE means regular follow-ups, sun-smart habits, and quick treatment of new lesions. With early care you can reduce flares, limit scarring, and keep your skin healthier. If you’re unsure about a spot on your skin, ask a dermatologist—early action matters.
In exploring the connection between genetics and Lupus, studies suggest a strong hereditary link in both Discoid and Systemic Lupus Erythematosus. Certain gene variations have been identified that could increase an individual's risk of developing these conditions. These genetic factors, in combination with environmental triggers, can lead to the onset of Lupus. However, it's important to remember that having these gene variations doesn't necessarily guarantee you'll develop Lupus, it merely increases the risk. In summary, while genetics play a significant role in Lupus, they aren't the sole determinant.