Lupus is an autoimmune disease that causes inflammation across the body and may seem frustratingly unpredictable. The symptoms of lupus can come and go during periods of flares, or flare-ups, and remission (reduced or no symptoms).

The risk of a flare increases when a person tapers or stops their lupus treatments. However, flare-ups are a normal part of living with lupus, even when your condition is well controlled.

Over time, many people living with lupus learn what may trigger their symptoms or worsen them. Knowing your triggers can help you prevent flares or identify them in their early stages. Different ways of treating lupus flares can also help you improve your symptoms. By working with your rheumatologist, you can find the best ways to manage your symptoms and reduce the impact of lupus flare-ups on your quality of life.

What Do Lupus Flares Feel Like?

Lupus flares can have many symptoms. Most people experience a combination of:

• Increased pain (both in the joints and muscles)
• Rashes (including the lupus rash, a butterfly-shaped mark on the face)
• Headaches
• Stomachaches
• Fever
• Fatigue
• Dizziness

Some people may also have swollen legs or sores (ulcers) in their nose and mouth. There’s no clear agreement on what a disease flare is, but most doctors agree that it means a noticeable rise in disease activity that may even lead to a change in therapy.

MyLupusTeam members have described lupus flares in a number of ways. “Flares for me begin with fever, body aches, and severe fatigue,” one member described. Another added, “Ugh, lupus flares stink! I have joint pain, burning mouth, and nose sores.”

What Triggers Lupus Flares?

Emotional, physical, or environmental factors may cause or signal lupus flare-ups. These factors are often referred to as triggers.

Each person’s triggers are unique. It can take time for people with lupus to fully understand what triggers their flare-ups. “At first, identifying my flare triggers was difficult. I still have some difficulty,” one member shared.

Another member wrote, “I believe my pain is the most severe when I have physical stress like surgery or injury. It took me a number of years to make that connection.”

Noticing patterns over time is important for identifying triggers. “You will see what doesn’t work for you,” a member advised someone who was new to MyLupusTeam. “Lupus can be so different for each person. Take it slow and get to know the new you.”

For those who are still trying to recognize their triggers, it can be helpful to understand common triggers for others with lupus. Stress, food, hormonal changes, weather, and sun exposure top the list of disease flare triggers on MyLupusTeam.

Stress

Stress, whether physical or mental, is one of the most common and challenging flare triggers for members of MyLupusTeam.

Sometimes, this stress comes from heightened emotions. “I’ve spent the afternoon sobbing, and I can feel a flare coming on from the stress,” one member shared.

Other times, it’s caused by external factors like work or everyday life, as another member wrote: “I started a new job this week, and stress from the learning curve has triggered a flare.”

Anxiety about stress itself can be a problem for some members, leading to a negative-feedback loop. “I know stress causes flare-ups, but then I stress about not stressing,” one member commented.

No matter the cause, it’s important to identify ways to relieve stress. Your health care provider may be able to help you find strategies that work best for you.

Hormonal Changes

About 90 percent of people living with lupus are women, according to the Arthritis Foundation, and most develop the condition during their reproductive years. Hormonal changes related to menstruation, pregnancy, or menopause can be major flare triggers. Some members have trouble making a definitive connection between hormonal changes and lupus flares. Members have asked, “Can my period cause a flare-up?” and “Does anyone get flares around their period?”

The answer for some is a resounding yes. One member commented, “I flare every month with my cycle!” Another added, “I experience it most months, though in varying degrees. It’s most intense for me the week before.”

Flares can become more severe during menopause. “Hormone shifts seem to trigger flares,” one member explained. “It got really crazy when I started going through menopause.”

Weather and Sunlight

Weather and sun exposure can trigger flares for some members. “The weather is changing. I find this has a major impact on me,” one member wrote.

Exposure to light — both the sun and artificial light — can trigger lupus symptoms because lupus can cause photosensitivity (sensitivity to ultraviolet rays). “I’ve had the absolute worst flare of my life this week. This whole flare was triggered by sun exposure. That is so depressing to me,” one member shared.

Flares triggered by weather or sun exposure can be especially frustrating if the best solution is to avoid these triggers entirely. “To me, our hot Texas summers are the worst,” a member wrote. “I had to stop showing real estate properties because of the heat and extremely painful flares.”

Some members have been able to manage weather-induced flares with medication. “I had a slight flare a few weeks ago when the weather first changed,” one member said. “I am learning some of my flare triggers, which allows me to take medicine to try to head off the flares.”

However, some medications may cause photosensitivity as a side effect. Whenever you’re prescribed a new medicine, be sure to ask if it can affect sun sensitivity. Talk to your doctor or pharmacist to make sure the medication is right for you, especially if your lupus is triggered by the sun.

Other Lupus Triggers

Many factors can cause lupus symptoms to flare. MyLupusTeam members have also identified the following triggers:

• Having surgery
• Getting and fighting off infections, including the common cold
• Receiving flu shots or other vaccines
• Eating certain foods
• Feeling exhausted
• Breathing secondhand cigarette smoke

How Can You Prevent Lupus Flares?

The best way to prevent lupus flares is to avoid known triggers. However, this is much easier said than done with some triggers. You might be diligent about staying out of the sun and wearing high-SPF sunscreen, for example, but it can be hard to avoid hormonal changes or emotional stress brought on by situations outside of your control.

Finding an effective treatment for lupus is another way to prevent at least some flare-ups. When your immune system is better controlled, flares are less likely. To help keep your lupus under control, your rheumatology team may prescribe:

• Antimalarial drugs like hydroxychloroquine (Plaquenil)
• Corticosteroids like prednisone
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Immunosuppressants
• Biologics

Some people find that supplements help, but research doesn’t yet support the benefit of supplements for lupus.

Most of the time, controlling lupus and preventing flares comes down to having the right plan. Work with your rheumatologist to create a treatment plan that works best for you. Often, that involves taking medication, getting plenty of physical and emotional rest, eating a balanced and healthy diet, engaging in moderate exercise, avoiding known triggers, treating any infections, and managing stress.

How Can You Manage Lupus Flares?

No matter how well you know your triggers, you’ll likely find that your lupus symptoms come and go. Sometimes, you may not even know what triggered a flare.

Most people manage their lupus flares at home. Resting, avoiding current stressors, and finding ways to deal with stress all may be helpful.

If you have repeated flares or a flare that’s not getting better, talk with your health care team. These flare symptoms may indicate that your lupus isn’t under control and it’s time to change your lupus treatment plan.

Your doctor might adjust your medication, work with you to help secure medical leave from your job, or help you make beneficial lifestyle changes. There are many treatments and therapies for lupus. It may take some time, but you and your doctor will figure out what works for you.

Find Your Lupus Team

On MyLupusTeam, the social network for people living with lupus and their loved ones, more than 231,000 members come together to ask questions, give advice, and share their stories with others who understand lupus.

Are you trying to figure out what triggers your lupus flare-ups? Have you found ways to prevent or manage flares? Share your questions, thoughts, or tips in the comments below or by posting on your Activities page.