“I go from freezing to burning and dripping sweat,” said a member of MyLupusTeam about their experiences with lupus. Another member shared, “One moment, I am so hot it feels like there is fire surging through my veins, and my mouth feels like it’s melting lava. Then the next moment, I am shivering cold.”

Excessive sweating, overheating, hot flashes, and changes in body temperature are often seen in people with lupus. These sudden shifts — from sweating episodes to chills — are especially common in people with systemic lupus erythematosus (SLE), the main type of lupus. SLE is an autoimmune disease, which means the immune system mistakenly attacks healthy cells instead of only fighting infections. About 70 percent of the 1.5 million people in the United States with lupus have SLE.

Because lupus involves the immune system, symptoms can vary widely. Along with temperature changes, some people also report joint pain or skin problems. To better understand what’s happening in the body, doctors may order blood tests such as antinuclear antibody (ANA) tests. An ANA test checks for antibodies that show the immune system may be attacking the body by mistake. Your healthcare provider can help track these results and watch for an increased risk of related complications.

This article will share why people with SLE experience sweating episodes and what you can do about these symptoms.

What Is Excessive Sweating?

Sweating is the body’s way of cooling itself. We usually sweat while exercising or in warm weather. Sweating can also be a response to stress or nervousness. Excessive sweating — called hyperhidrosis — is abnormal, profuse sweating that’s generally unrelated to heat or physical exertion. Excessive sweating can affect just some parts of the body, such as the palms of your hands. It can also make you sweat profusely all over. If you have hyperhidrosis, you may sweat so much that it soaks through your clothes or drips off your hands.

The Impact of Excessive Sweating

Excessive sweating can be uncomfortable and inconvenient. Additionally, sweating and swings in body temperature can worsen the sleep problems that often come with having lupus. Night sweats in particular can make getting a good night’s sleep next to impossible.

A MyLupusTeam member wrote, “I am waking up because I am freezing due to being soaked from head to toe with night sweats.”

“I am waking up because I am freezing due to being soaked from head to toe with night sweats.”
— A MyLupusTeam member

Hyperhidrosis can also be embarrassing, affecting emotional health and social life. Having perpetually clammy hands or regularly sweating through clothing can make going about day-to-day activities (work, play, errands) especially challenging. Excessive sweating can also raise the risk of skin infections, making daily life with lupus even harder.

What Causes Excessive Sweating in People With SLE?

Excessive sweating can be a direct result of (or a primary symptom of) lupus. Lupus, however, is a complex and unpredictable condition. Excessive sweating may also occur as:

• A side effect of medications
• A symptom of menopause
• An indication of a hormone imbalance
• A symptom of another condition

“Does anyone get hot flashes? I have been experiencing them frequently lately, and I’m not sure if it’s my new medicine or menopause,” a MyLupusTeam member wrote.

Primary Lupus Symptom

Lupus can affect different organs and systems of the body. It often comes and goes in a cycle of remission and flare-ups, and it can range in severity. Possible symptoms of lupus — including anemia, joint pain, rashes, and hair loss — vary greatly from person to person. Excessive sweating can be:

• One of the first indications of lupus
• A sign that a flare is coming
• The result of lupus’s impact on the central nervous system (CNS)

Immune Response

Excessive sweating, especially night sweats, often happens with autoimmune diseases, not just lupus. Autoimmune conditions can cause an excess of nitric oxide in your body. Evidence shows that nitric oxide levels are especially high during increased disease activity, such as lupus flares. High nitric oxide levels can cause blood vessels in the skin to dilate (widen), which brings more body heat to the surface. This can cause higher body temperature, flushed skin, and excessive sweating.

Central Nervous System

The autonomic nervous system is a part of the CNS. It regulates body functions that we don’t have to think about doing, like controlling breathing, heart rate, blood pressure, and body temperature. When lupus affects the autonomic nervous system, it can cause a wide range of symptoms, including excessive sweating.

Hormonal Changes and Menopause

Ninety percent of people living with lupus are women, according to the Lupus Foundation of America. Researchers believe hormones (especially estrogen) may play a role in the onset and severity of lupus. Fluctuations in estrogen levels linked to puberty, menstruation, perimenopause, and menopause frequently cause hot flashes and excessive sweating.

“My whole body gets so hot that I feel like I want to jump out of my skin,” one MyLupusTeam member said about their hot flashes.

“My whole body gets so hot that I feel like I want to jump out of my skin.”
— A MyLupusTeam member

Early menopause happens more often among people with lupus than those who don’t have the condition. Because hot flashes and sweating are signs of menopause, it can be hard to tell whether excessive sweating is caused by menopause, lupus, or something else.

Hormone-related hot flashes and heavy perspiration can affect anyone, regardless of their sex. Hot flashes and sweating can be a sign of low testosterone levels in men, according to the nonprofit Kaleidoscope Fighting Lupus, which provides education and support for people living with lupus.

Treatment Side Effect

Depending on the type of lupus you have, as well as your symptoms and their severity, your treatment plan may include a combination of several medicines. Medications commonly used to treat SLE include:

• Antimalarial drugs, such as chloroquine
• Corticosteroids, like prednisone
• Immunosuppressants, including methotrexate
• Nonsteroidal anti-inflammatory drugs (NSAIDs)

All medications bring a risk of side effects, so the more medications you take, the more likely you are to have side effects. Some people find themselves using several drugs to manage their lupus symptoms, other conditions they may have, and the side effects of their medications. For example, drugs prescribed for depression, high blood pressure, heart disease, kidney disease, and even seasonal allergies can cause hot flashes and overheating.

Complications, Conditions, or Other Diseases

Some people refer to lupus as “the great imitator” because its symptoms can mirror those of many other diseases or health conditions. Excessive sweating could be a symptom of a co-occurring condition, a disease that a person has in addition to or as a result of lupus. Lupus nephritis, for example, causes kidney problems.

Fever and sweating, especially night sweats, may also mean that your body is trying to fight off an infection. People with lupus may be more prone to secondary infections, due not only to the disease, but also due to treatment. This is especially true if your rheumatologist or other healthcare provider has you on disease-modifying antirheumatic drugs (DMARDs).

Autoimmune Diseases

Excessive sweating is a common symptom of autoimmune disorders such as rheumatoid arthritis, vasculitis, and lupus. Those with lupus are at higher risk of additional autoimmune diseases. In fact, 1 in 3 people with lupus also have at least one other autoimmune disorder, according to the Lupus Foundation of America.

Metabolic Disorders

Metabolic diseases, such as thyroid disorders and diabetes, are known causes of problems with temperature regulation or perspiration. Diabetes can damage blood vessels and nerves, which may harm the sweat glands and limit the body’s ability to cool down. Thyroid disorders generally result from high levels of the hormone thyroxine in the body. Too much thyroxine (hyperthyroidism) can make people sensitive to heat and affect how the body controls temperature.

Ways To Manage Excessive Sweating

Fortunately, there are several ways to help manage excessive sweating in lupus. First and foremost, focus on keeping your lupus well controlled. This includes taking your medication as prescribed and sticking to your treatment plan.

You can also follow these tips to stay on top of your lupus and sweating:

• Avoid triggers that worsen your symptoms or cause flare-ups.
• Dress comfortably in loose-fitting, breathable fabrics.
• Limit sun exposure by staying indoors during peak sun hours and using a good sunblock with a high SPF.
• Manage stress levels by seeing a therapist, practicing mindful meditation, and engaging in other proven stress-reduction techniques.
• Stay away from alcohol and caffeine, as they can make sweating and hot flashes worse.
• Keep hydrated by drinking cool water throughout the day.

Members’ Tips for Staying Cool and Dry

Members of MyLupusTeam have shared these additional suggestions for managing sweating and hot flashes:

• Apply cold compresses or ice packs.
• Consume cold treats like popsicles and smoothies.
• Use a cooling mattress, mattress covers, or sheets.
• Place a fan by your bed.
• Lower the air-conditioner temperature at bedtime.

Find Your Team

On MyLupusTeam, the social network for people with lupus and their loved ones, members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

Do you experience hot flashes or excessive sweating? How do you handle your hot flashes, heat sensitivity, and excessive sweating? Share your experiences in the comments below, or join the conversation on your Activities page.