Key takeaways:
Lupus flare-ups are periods of worsening lupus symptoms. They can last for days, weeks, or sometimes months.
Common triggers for lupus flares include stress, infection, UV light exposure, and missed doses of medication.
To prevent a lupus flare, focus on your medication schedule, self-care, and sun protection. Hydroxychloroquine is the best medication to help prevent lupus flares.
Lupus is a life-long autoimmune condition. Symptoms from autoimmune conditions can come and go. If you have lupus, you might call this a lupus flare-up. Learning what your flare triggers are and avoiding them are great ways to take control of your lupus.
Here, we’ll review the signs and symptoms of lupus flare-ups, why they happen, and how to treat and prevent them.
What is a lupus flare?
If you’re living with lupus, you may notice that some days feel good, and some days feel not so good. This is normal. But, sometimes, you may feel a lot worse for stretches of time. According to lupus experts, flares are when symptoms get worse for a short period of time in a way your healthcare team can measure (by examining you or with a lab test). Sometimes, new symptoms can also occur.
A lupus flare-up may come on suddenly or over a period of a few days. Unfortunately, there’s no way to predict how bad a flare will be or how long it might last.
What are the signs and symptoms of a lupus flare?
Lupus flares are different for each person, since everyone has their own version of lupus. For example, let’s say you typically get rashes and joint pain when your lupus isn’t well controlled. During a lupus flare, you could expect to have rashes, joint pain, and possibly a new symptom, too.
Some common signs and symptoms of a lupus flare include:
Painful and swollen joints
Rashes
Sores in the mouth or nose
Fatigue
Fevers (not caused by infection)
Abnormal blood or urine test results
How quickly can lupus flare up?
It depends. Some flare-ups can occur suddenly, over the course of just 1 or 2 days. Some flares take a longer time to build up — over several days to weeks.
What can trigger a lupus flare?
Many different things can trigger a lupus flare. Some triggers are within your control, but some aren’t. And, sometimes, it’s not possible to identify any trigger at all.
Here are some common lupus flare triggers.
Missed medication
It’s crucial to take your lupus medications as directed, in order to prevent flares. But, if you’re having trouble getting or taking your medications for any reason, talk to your rheumatology team or pharmacist. They can often help find a way to get you the medication you need. They can also help find an alternative if you’re having difficulty with side effects.
If it’s hard for you to remember to take your medications, you could try using an app for medication reminders, setting an alarm on your phone, or placing the pill bottle by your toothbrush.
Stress
Stress is a common trigger for lupus flares. This could include emotional stress, like grief from a loss or a life change, like divorce. It also could include physical stress. For example, traumatic injuries and major surgeries increase the risk of a lupus flare.
Some research finds that people who’ve experienced trauma — physical or emotional — are twice as likely to experience lupus flares.
Not enough sleep
Sleep is important for managing inflammation. Studies have found a link between sleep deprivation and an increase in inflammatory chemicals. Lack of sleep can also worsen stress, which is another trigger for lupus flares.
Infection
Even a mild illness, like a cold or other viral infection, can trigger a lupus flare. In most people, the immune system can fight an infection, then return to normal. But, in lupus, it may kick into overdrive and cause worsening of lupus symptoms.
Hormone changes
It’s common for people to experience a lupus flare when hormone levels fluctuate, such as during menstrual cycles or pregnancy. A flare during pregnancy is more likely if lupus isn’t well-controlled prior to conception.
Medications
Certain medications can trigger a lupus flare. For example, sulfa antibiotics, like Bactrim, might cause lupus flares in some people (but not in everyone). And some people might be sensitive to hormonal forms of contraception. It’s a good idea to speak with your rheumatologist before starting a new medication.
Ultraviolet (UV) rays
UVA and UVB rays from the sun and certain kinds of indoor lights can trigger lupus flares. UV light damages skin cells, which triggers the immune system to try to clean them up. People with lupus may be more sensitive to this cell damage than others.
It can take several days or weeks for this type of flare to develop. So, sometimes, people don’t notice the connection right away.
Smoking
It’s not exactly clear if smoking can trigger a lupus flare. But research suggests that smoking makes it more difficult to treat a flare.
Foods
Some foods — like alfalfa sprouts and garlic — may trigger lupus flares. That’s because they increase immune system activity, and the immune system is already too active in lupus. The studies to support this aren’t very strong, but many lupus experts agree that it’s reasonable to consider avoiding these foods, if possible. Accidentally eating one of these foods is OK and won’t result in immediate harm.
The same is true for echinacea, a dietary supplement that some people take while sick to get better faster. Try to avoid echinacea.
When should I see a healthcare professional for a lupus flare?
Lupus flares can make it hard to work, take care of your family, and do the things you enjoy. If you feel like you’re having a lupus flare, discuss your symptoms with your rheumatologist. You might need to go in for an appointment or get blood and urine tests.
Your rheumatologist might need to adjust your medication(s) if your symptoms are very severe or certain new symptoms are present. You might only need a new medication (such as a corticosteroid) for a short amount of time. But you may need to take other medications for longer. There’s no one-size-fits-all approach. You and your prescriber will work together to find the treatment that works for you.
You can take action to treat your lupus flare, too. Doing the following can help you feel better sooner:
Rest and sleep. This might mean taking some time off of work or asking for help around the house. You know yourself best. Take it easy.
Focus on your mental health and stress levels. There are stress management resources out there to help.
Lean on your support system. Friends, family, or local lupus support groups can help you get through a flare.
Take medications as directed. Missed doses of medications are a common cause of lupus flares. So, be sure to stay organized and take your medications as directed.
Tips for preventing a lupus flare
There’s no doubt about it: Lupus flares are no fun. But there’s a lot you can do to decrease your risk of having a flare in the future.
Consider taking the following steps to help prevent lupus flares:
Get enough sleep.
Maintain a balanced diet.
Exercise regularly.
Prioritize mental wellness.
Stop smoking.
Take your medications as directed.
Use sun protection.
Avoid direct sunlight when possible.
What medication can help prevent lupus flares?
Hydroxychloroquine is the best medication to help prevent lupus flares. Many studies have shown that hydroxychloroquine decreases your risk of lupus flares. It also protects you from many other complications of lupus.
If you can’t take hydroxychloroquine due to its side effects or if you have an allergy, chloroquine or quinacrine might be options.
Is there a lupus diet I should follow?
Despite what you may have read online, there’s no specific lupus diet. But eating a balanced diet will help your body stay as healthy as possible — and decrease the chances of a lupus flare.
Some people with lupus report that eating fewer processed foods and more vegetables can help improve symptoms. A healthy diet will also decrease your risk of other health problems (like heart disease) that are more common in people with lupus.
Frequently asked questions
A lupus flare can last for days, weeks, or, in some cases, months. It’s a good idea to contact your rheumatologist when you have a flare, so they can suggest medication changes, if needed. They can also help you rule out any other causes for your symptoms.
Get medical attention immediately if you have:
Chest pain
Trouble breathing
Fever over 101°F
Decrease in urine output
Confusion
Sudden weakness
Difficult-to-control bleeding
Of course, this isn’t an all-inclusive list, so use your best judgment or call your primary care physician. If you can’t get yourself to the ER safely, call 911.
Disability is usually defined by the impairments due to a condition, rather than the condition itself. So, some people with lupus may qualify for disability benefits due to the effects of it. If you have lupus and it limits your ability to move, function, or work, speak with your healthcare team. They can help you get the services and documentation you need.
A lupus flare can last for days, weeks, or, in some cases, months. It’s a good idea to contact your rheumatologist when you have a flare, so they can suggest medication changes, if needed. They can also help you rule out any other causes for your symptoms.
Get medical attention immediately if you have:
Chest pain
Trouble breathing
Fever over 101°F
Decrease in urine output
Confusion
Sudden weakness
Difficult-to-control bleeding
Of course, this isn’t an all-inclusive list, so use your best judgment or call your primary care physician. If you can’t get yourself to the ER safely, call 911.
Disability is usually defined by the impairments due to a condition, rather than the condition itself. So, some people with lupus may qualify for disability benefits due to the effects of it. If you have lupus and it limits your ability to move, function, or work, speak with your healthcare team. They can help you get the services and documentation you need.
The bottom line
Lupus flare-ups can take a toll on your quality of life. If you’re suffering from a flare, discuss your symptoms with your rheumatologist to see if your medications need to be adjusted. Focus on self-care, and lean on your support system to get you through it. To prevent lupus flares, take your medications as directed. Diet, exercise, rest, and mental wellness are also important.
Why trust our experts?
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