What causes a butterfly rash?

A butterfly rash is most often associated with systemic lupus erythematosus, or lupus. Lupus is a chronic autoimmune disease that can have a serious and widespread effect on the body, including the skin, joints, muscles, and other organs.

In some cases, a red facial rash with a butterfly-like shape can appear on the face, but it is related to other causes besides lupus. The rash seen in these other diseases, disorders or conditions does not always involve the nose. They include:

  • Dermatomyositis (chronic disease characterized by muscle inflammation and weakness)
  • Drug photosensitivity (rash worsens with UV exposure)
  • Erysipelas (bacterial skin infection)
  • Pellagra (niacin, or vitamin B3 deficiency)
  • Rosacea (chronic, inflammatory skin condition)
  • Scarlet fever
  • Sunburn or windburn

What are the potential complications of a butterfly rash?

You can best minimize the serious and potentially life-threatening complications of lupus, which is the most common cause of a butterfly rash, by following your treatment plan and seeing your healthcare provider as recommended. Complications of lupus can affect almost any organ in the body and include:

  • Arthritis

  • Bleeding

  • Blood clots

  • Central nervous system damage and stroke

  • Frequent infections

  • Kidney damage and kidney failure

  • Liver damage

  • Myocarditis (inflammation of heart tissue)
  • Pleurisy

  • Seizures

  • Vasculitis

  • Worsening of the butterfly rash and other rashes on the body, especially with sun exposure


  1. NINDS Dermatomyositis Information Page. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/dermatomyositis/dermatomyositis.htm.
  2. Lupus. National Institute of Arthritis and Musculoskeletal Diseases. http://www.niams.nih.gov/Health_Info/Lupus/default.asp.
  3. What are the Common Symptoms of Lupus? Lupus Foundation of America. http://www.lupus.org/webmodules/webarticlesnet/templates/new_learnunderstanding.aspx?articleid=2235&....
  4. Costner MI, Grau RH. Update on connective tissue diseases in dermatology. Semin Cutan Med Surg 2006; 25:207.
  5. Bope ET, Kellerman RD (Eds.) Conn’s Current Therapy. Philadelphia: Saunders, 2013.

What is a butterfly rash?

A butterfly rash is a reddish rash on the face that spreads over the bridge of the nose and across the cheeks, making the shape of a butterfly. A butterfly rash, also called a malar rash or flush, is most commonly associated with systemic lupus erythematosus, or lupus, a chronic autoimmune disease. About 50% of people with lupus have a butterfly rash (Source: Read more about butterfly rashintroduction


What other symptoms might occur with a butterfly rash?

A butterfly rash and other symptoms of lupus are the result of tissue inflammation throughout various parts of the body. The type and severity of symptoms vary between individuals and with the type of lupus. Lupus symptoms generally occur as periodic attacks, or flare-ups, followed by periods of time in which symptoms improve.

At the onset of the disease, the butterfly rash and ot... Read more about butterfly rashsymptoms

Medical Reviewer: William C. Lloyd III, MD, FACS Last Annual Review Date: Aug 23, 2013 Copyright: © Copyright 2014 Health Grades, Inc. All rights reserved. May not be reproduced or reprinted without permission from Health Grades, Inc. Use of this information is governed by the HealthGrades User Agreement.

This Article is Filed Under: Allergies and the Immune System