A “flare” refers to a temporary period when the symptoms of a chronic disease suddenly become noticeably worse or more intense. This exacerbation, sometimes called a flare-up or relapse, is a hallmark of many long-term illnesses. During a flare, disease activity increases, causing worsened signs that interfere with daily life. The episode is distinct from day-to-day management because it represents a transient spike in severity that will eventually subside or lessen.
The Underlying Mechanism of a Flare
The physiological basis for most flares is a sudden increase in the underlying pathological process of the disease, which is often inflammation. In autoimmune conditions, this involves the immune system mistakenly attacking the body’s own healthy tissues. This heightened immune response is characterized by the increased activity of specialized cells and the release of signaling molecules called cytokines. Cytokines are small proteins that act as messengers to promote inflammation, recruiting other immune cells to the affected site. This surge of pro-inflammatory factors leads to the tissue damage and localized symptoms associated with the flare. For example, in joint diseases, this surge causes the increased swelling, pain, and stiffness felt in the joints.
Chronic Conditions Where Flares Occur
Flares are most commonly associated with autoimmune and immune-mediated inflammatory diseases, where the immune system is dysregulated. These include systemic conditions such as Systemic Lupus Erythematosus (SLE), which can affect multiple organ systems, and Rheumatoid Arthritis, which primarily targets the joints. Multiple Sclerosis (MS) is another neurological autoimmune condition characterized by flares that involve the central nervous system. Inflammatory Bowel Disease (IBD), encompassing Crohn’s disease and Ulcerative Colitis, is a prominent example of a condition with flares that affect the digestive tract. Additionally, skin conditions like Psoriasis feature flares that manifest as painful, inflamed patches on the skin. Even chronic pain syndromes like Fibromyalgia can feature periods of intense, heightened pain that are often described as flares.
Recognizing Triggers and Warning Signs
Identifying triggers and recognizing the onset of a flare is a crucial part of managing a chronic illness. Common triggers include physical or emotional stress, acute infections like the flu, and changes in diet, particularly the consumption of pro-inflammatory foods. Other factors, such as poor sleep, hormonal shifts, or extreme weather and temperature changes, can also contribute to an impending flare. Many individuals experience subtle pre-flare symptoms, known as a prodrome, that signal the disease is becoming more active before full symptoms manifest.
Warning Signs (Prodrome)
These warning signs can include:
- Increased, overwhelming fatigue that rest does not resolve.
- A low-grade fever without an apparent cause.
- General malaise.
- Mood changes, such as increased anxiety or depression, and localized aches.
Tracking these subtle changes in a symptom journal can help a person identify their triggers and warning signs, allowing for earlier intervention.
Immediate Management of an Active Flare
When a flare is actively underway, the focus shifts to reducing heightened disease activity and managing symptoms. The first step involves consulting a healthcare provider, as severe or non-resolving flares often require an adjustment to the established treatment plan. This may include a temporary increase in the dosage of existing anti-inflammatory medications or the short-term use of corticosteroids to quickly dampen the immune system’s overreaction. Self-care measures support recovery by reducing physical and mental strain. Rest is essential for both physical and mental decompression, alongside applying temperature therapy for symptom relief. Maintaining proper hydration and focusing on nutrient-rich foods supports the body during the acute phase.