Lupus Triggers & Flares
Reviewed by: HU Medical Review Board | Last reviewed: January 2020 | Last updated: August 2023
Since lupus is a chronic autoimmune disorder, it can be unpredictable. Some people experience mild symptoms while others face severe complications. Most people with lupus have times when their disease flares and their symptoms get worse. This is followed by remission or times when symptoms improve or go away entirely.
How mild, moderate or severe these flares are can be very different from person to person. Some people may find that a mild or moderate flare causes a rash or more joint pain. In others, severe flares require medical attention because organ damage can occur. Remission times can be unpredictable too, lasting for days or years, depending on the individual.1-3
What causes lupus flares?
Figure 1. An infographic showing different types of lupus triggers.
Triggers in a person’s environment can cause a lupus flare, those periods when symptoms get worse. There is no way to tell if a flare will be mild, moderate, or severe. Some common flare triggers include:2-3
- Ultraviolet rays from the sun or fluorescent light bulbs
- Infections, colds, or other viruses
- Certain medicines, including sulfa drugs, tetracycline, and penicillin
- Emotional stress, such as a death in the family, divorce, or illness
- Physical stress, such as surgery or traumatic injury
- Pregnancy or giving birth
- Physical exhaustion or overwork
Each person’s triggers are different, so learning your body and what seems to cause your flares can help you manage your disease. Some people have flares fairly often while others experience a flare once every few years or every 10 years.4
Signs that a flare is coming
Figure 2. An infographic showing common lupus flares.
Most people experience warning signs that a lupus flare is coming. It can take some time to recognize your own warning signs and learn what steps you can take to avoid or reduce the severity of a flare. In some cases, getting extra rest may help while in others getting medical treatment quickly works best.
Signs that a flare is coming include:
- Feeling more tired
- Stomach ache
- Severe headache
You should call your doctor or nurse if you notice warning signs of a flare. The doctor may change your drugs or want to take some other action.3
Your doctor will generally want to see you in the office every 3 to 4 months so that he or she can help predict and manage flares as well. The results from regularly scheduled lab tests can also help your doctor follow your disease activity levels of inflammatory markers, complement levels, urine protein, and antibodies.
It’s important to monitor flares and understand your unique triggers so that you can control symptoms as much as possible. Lifestyle changes, such as eating a balanced diet and getting enough rest and exercise, can help. Rapid response to flares helps reduces the long-term damage lupus can cause to major organs and improve your quality of life. With aggressive treatment, some people with lupus are even able to gain long-term remission of the disease.5
Lupus does not have a formal definition for remission the way cancers do. However, some people are diagnosed with lupus only to find that their symptoms and blood abnormalities go back to normal, sometimes staying that way even after they stop taking their lupus medications. Other people find that their lupus stays quiet only if they continue taking their drugs.6