Lupus is a chronic autoimmune disease with periods of illness, known as flares, and periods of remission. A flare is a temporary phase when the disease becomes active, causing symptoms to worsen or new ones to appear. During a flare, the immune system mistakenly attacks healthy tissues, leading to inflammation and potential damage. The course of the disease is often unpredictable, with flares interrupting times of minimal symptoms.
Signs and Symptoms of a Lupus Flare
The signs of a lupus flare are highly individual and can change from one flare to another. The appearance of new symptoms or the worsening of existing ones is a primary indicator of a flare.
Constitutional symptoms are generalized feelings of illness that affect the whole body. One of the most common is an increase in fatigue that goes beyond normal tiredness. This can be accompanied by a persistent, low-grade fever not caused by an infection. Some individuals may also experience unexplained changes in their weight.
Musculoskeletal issues frequently signal a lupus flare. This can manifest as increased pain, stiffness, and swelling in the joints, which can make movement difficult. The discomfort may be more pronounced in the mornings or after periods of rest.
The skin is often affected during a lupus flare. A well-known sign is the development or worsening of a butterfly-shaped rash, called a malar rash, across the nose and cheeks. Other skin problems include lesions or sores in the mouth or nose. Hair loss can also occur or become more significant.
Flares can also impact internal organs, leading to more serious symptoms. Inflammation in the lungs or heart can cause shortness of breath or chest pain. If the kidneys are affected, a person might notice changes in urination, like frothy urine, or swelling in the legs. These symptoms require prompt medical evaluation.
Common Triggers of Lupus Flares
While the cause of a flare is not always clear, specific factors can provoke disease activity. Exposure to ultraviolet (UV) light, from the sun or artificial sources, is a well-established trigger for many people with lupus. This photosensitivity can cause a flare, leading to rashes and worsening symptoms.
Infections can place stress on the immune system and instigate a flare. Illnesses such as a cold or the flu can activate the body’s defense mechanisms. In lupus, this response can become misdirected against the body’s own tissues, increasing disease activity.
Emotional and physical stress are also recognized as potential triggers. Significant life stressors, a lack of adequate sleep, or physical overexertion can contribute to a flare. The body’s response to stress can influence immune function, leading to an uptick in disease symptoms.
Medication adjustments can play a role in flare development. Abruptly stopping lupus medications without a doctor’s guidance can lead to a rebound in disease activity. Certain other drugs, such as some types of antibiotics or blood pressure medications, have also been known to trigger a flare.
Managing a Lupus Flare
When a lupus flare occurs, communicating with a healthcare provider is the first step. It is helpful to track new or worsening symptoms to provide the doctor with information to adjust treatment. At home, prioritizing rest and avoiding known triggers, like sun exposure, can help manage the flare.
A doctor will respond to a flare by adjusting the patient’s medication regimen. For mild to moderate symptoms like joint pain and inflammation, nonsteroidal anti-inflammatory drugs (NSAIDs) may be recommended. To quickly suppress the immune response, corticosteroids such as prednisone are often prescribed, with the dosage tailored to the flare’s severity.
For more severe flares, particularly those affecting internal organs, other immunosuppressive medications may be considered. These treatments work to calm the overactive immune system and prevent long-term damage.
Strategies for Flare Prevention
Long-term strategies are centered on maintaining remission and reducing the frequency of flares. Consistent adherence to prescribed medications is necessary to keep lupus activity low.
Regular follow-up appointments with a rheumatologist are also necessary. These visits allow the doctor to monitor disease activity through physical exams and lab tests, even when a person is feeling well. This proactive monitoring can help catch early signs of a potential flare and allow for timely treatment adjustments.
Lifestyle modifications contribute to long-term health. Consistent sun protection, including the use of sunscreen and protective clothing, is important for those with photosensitivity. Adopting stress management techniques, eating a balanced diet, and engaging in moderate exercise as approved by a doctor can also help reduce the risk of flares.