People call lupus erythematosus the “wolf” that loves to “bite” young women because the majority of lupus erythematosus attacks young women, with nine out of ten patients being female and one male. In modern society, beauty, skin care and youthfulness are among the most important elements of women’s lives. Many lupus patients tell me that they are not afraid of dying, but of changing their body shape after taking hormones, and of going through menopause in their twenties and thirties. From time to time, there are cases of lupus patients committing suicide, and one of the reasons leading to the mental breakdown of these girls is the fear of losing their youth and beauty. With the obvious improvement in the efficacy of the treatment of lupus erythematosus, we proposed a few years ago, “To let lupus erythematosus patients live as long as healthy people, live as healthy people, have children as healthy people, and enjoy life as healthy people.” Retaining youth and beauty is one of the important elements for lupus patients to enjoy life. How can lupus erythematosus patients preserve their youthful beauty? You can start from three aspects. The ovarian function is the basic source of female youthful charm, and the failure of ovarian function means early menopause. However, one of the main side effects of cyclophosphamide, the main drug used to treat lupus erythematosus, is damage to ovarian function; the Chinese herbal medicine Leigongteng, which is effective for lupus erythematosus, also has strong ovarian toxicity. If cyclophosphamide is used to treat lupus erythematosus and ovarian function is not monitored, nearly half of patients will already have ovarian failure before reaching disease remission. The ovarian toxicity of the regimen is even greater, with about half of the patients experiencing ovarian failure after six months of use. Since lupus erythematosus is associated with female hormones, ovarian failure can lead to remission of lupus erythematosus afterwards. In the days when lupus erythematosus was very ineffective, there was a therapeutic viewpoint to induce ovarian failure to help control the disease. The ovarian function was traded for the prolongation of life. However, today, when the prognosis of lupus erythematosus is very good, the price of ovaries for life expectancy seems too heavy. Although tretinoin preparations have better efficacy in lupus erythematosus, on balance, we oppose the use of tretinoin for the treatment of lupus erythematosus in the reproductive age. If Leigongteng is used together with cyclophosphamide, although the efficacy will be improved, the ovarian toxicity will be greater; we often see some lupus erythematosus treated with Leigongteng due to the pursuit of “Chinese medicine without side effects”, which partially impairs the ovarian function. Once the disease worsens, it will be difficult to make decisions on medication: if you don’t use cyclophosphamide, your life will not be saved; if you use cyclophosphamide, your ovaries will not be saved. I really regret that I shouldn’t have used leucovorin in the first place. However, for the elderly with lupus erythematosus after menopause, leucovorin is a very good choice. Patients treated with cyclophosphamide need to pay attention to their menstrual condition. If menstruation decreases, or is late, you need to tell your doctor to check the sex hormone levels in your blood to determine if ovarian function is impaired. If abnormalities in sex hormone levels occur, timely adjustment of treatment can prevent ovarian failure. Continuing with cyclophosphamide more than a few times, the patient will rapidly enter menopause. Therefore, if this phenomenon is ignored, it will cause lifelong regret. 2, hormones affect the body shape is only a temporary phenomenon Hormones can cause the body to become fat, and it is unevenly obese. The parts where hormones cause fat deposits are precisely the most taboo parts of a fit body. Abdominal fat deposition leads to the increase of waist circumference; facial obesity is called full-moon face; the increase of fat on the back of shoulder is called buffalo back. However, hormone is the basic drug for the treatment of lupus erythematosus, and almost all medium to heavy lupus erythematosus need to be treated with hormone. Therefore, the most helpless medication for women with lupus is hormones. Although most cases of lupus require hormones, often starting with as many as 10 prednisone pills per day. However, if well managed, most patients only experience mild obesity in the first 3 to 6 months of medication, and patients can mostly reduce hormones to less than 2 tablets per day within 6 to 9 months, and most can regain their original body shape within a year as the hormone dosage is reduced. In the past decade, due to the application of hormone co-reducers and the gradual recognition of the medical profession, prolonging the course of hormone therapy and over-reliance on hormone therapy for lupus erythematosus have done more harm than good. The course of hormone treatment for lupus erythematosus has now been significantly shortened. In the past, lupus erythematosus required lifelong hormone use, but today 80% of patients can stop hormone use within 1 to 2 years. Therefore, the effect of hormones on body shape is only a temporary phenomenon. As long as the lupus erythematosus patients can find a good rheumatologist, they need not worry too much about the side effects of hormones and the change of body shape. 3. Sunlight is the main culprit of skin erythema Most of the rashes of lupus erythematosus grow on sun-exposed parts. Among them, erythema on the face is the most common, called butterfly-shaped erythema. For the first time, a large thick red rash suddenly grows on the face, which makes people feel the tendency to be disfigured, which is a very sad thing for young girls. In fact, most of the rashes of lupus erythematosus can disappear completely without leaving scars after proper treatment. Do not apply topical creams indiscriminately to the rash of lupus erythematosus. Hormone is not an effective medicine for lupus rash, hydroxychloroquine sulfate and methotrexate are often more effective. But more importantly, it is important to avoid sun exposure in lupus with a rash. If one can avoid sunlight and ultraviolet rays, after proper treatment, the rash begins to diminish in most patients within one month, and in three to six months, the rash can disappear completely. Sunlight and ultraviolet rays aggravate the rash of lupus erythematosus, which is medically known as “photosensitivity”. Photosensitivity is usually caused by the ultraviolet component of sunlight (UVA, UVB, UVC). Ozone in the atmosphere absorbs UVC and glass absorbs UVB, thus reducing the damage they cause. But patients can still get sunburned through glass windows, which do not filter out long-wave UVB. Grounds with reflective properties, such as sand, snow and concrete floors can increase UV radiation. In snow and beach, it can increase about 50-75% of UV radiation, and even under the umbrella of the beach, it is difficult to avoid being exposed to a large amount of UV radiation. Therefore, patients with lupus erythematosus should avoid going to snowy mountains or beaches during daytime. Lupus patients also need to use sunscreen when they go out at noon on cloudy days because UVA, the ultraviolet radiation that affects lupus, can pass through clouds, which can only partially reduce the intensity of the ultraviolet radiation. Snowy mountains or beaches on cloudy days are equally harmful to lupus. The easiest protection reduces being outside from 10AM-4PM. If you need to be outside during this time, it is best to wear long clothing and pants to reduce exposure and use sunscreen on exposed skin. Wearing a hat, long-sleeved tops, long pants and an umbrella with UV protection can provide some protection. In addition to sunlight, electric welding, photocopiers, projection lamps, and television photography lamps can produce ultraviolet light, and prolonged exposure may also lead to aggravation of lupus. In contrast, it is generally believed that electric lamps and white fluorescent lamps for daily life lighting have no effect on lupus. To sum up, as long as more attention is paid to treatment and life, lupus patients can completely preserve their youthful beauty.