Lupus Triggers and Flares

Reviewed by: HU Medical Review Board | Last reviewed: February 2024

Lupus is a chronic autoimmune disorder with unpredictable flares and remissions. Flares are when symptoms worsen and you feel ill. Remission is the time between flares when symptoms improve and you feel better. There are several common triggers and symptoms linked to lupus flares.1

What is a lupus flare?

In people with lupus, the immune system creates substances called autoantibodies. These autoantibodies attack healthy tissues in the body. The resulting damage causes inflammation. During a lupus flare, this process is more pronounced, and you may feel worse.1

Most people with lupus experience alternating periods of flares and remission. Some flares are mild, and others are more serious.2,3

Mild flares may cause a rash or joint pain. Severe flares can lead to organ damage. Flares often require a change in your treatment, so it is important to contact your doctor if you suspect a flare.2,3

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What causes lupus flares?

Flares can happen even when you take medicine for lupus. Flares are often triggered by illness, stress, or some other factor. Common lupus triggers include:1,2,4

  • Emotional stress
  • Lack of rest or sleep
  • Physical stress from surgery, injury, or infection
  • Pregnancy
  • Stopping lupus medicine
  • Certain prescription drugs, like sulfa antibiotics, tetracyclines, and penicillins
  • Foods and herbs that boost the immune system, like echinacea, alfalfa sprouts, and bean sprouts
  • Cigarette smoke
  • Low vitamin D levels
  • Ultraviolet (UV) light exposure

Ultraviolet light exposure and lupus flares

It is critical to protect yourself from UV exposure to prevent lupus flares. Direct sunlight is a common source of UV exposure. However, there are other sources of UV light that can trigger a lupus flare, including:1,4

  • Sunlight reflected off snow or water
  • Phototherapy lamps
  • Stage lights
  • Halogen or fluorescent lights
  • Black lights
  • Tanning beds
  • Nail polish curing lamps
  • Sanitizing lights
  • Light from welding equipment
  • Counterfeit currency detectors
  • Dental and printing polymerizing equipment
  • High-intensity light bulbs, including mercury vapor, arc, or metal halide

What are the symptoms of a lupus flare?

The symptoms you have during a flare are often similar to the ones you had when you were first diagnosed. It is also possible to have new symptoms. Treating symptoms right away may help prevent or reduce the severity of the flare.1,2

Symptoms vary between people, but common symptoms of a lupus flare include:1,2

  • Fever
  • Joint pain, swelling, and stiffness
  • Feeling more tired
  • Skin rash or sores
  • Sores in the mouth or nose
  • Hair loss
  • Chest pain with breathing
  • Numbness, burning pain, or tingling
  • Leg swelling
  • Stomach pain
  • Headache
  • Dizziness

Managing lupus flares

Lupus flares are unpredictable. They can occur even if you follow your treatment plan, manage stress, and get plenty of rest. Contact your doctor right away if you feel like your symptoms are getting worse. Early treatment can help reduce the effects of a flare.1,2

If your symptoms have worsened, your doctor may want to do lab work. There is no single lab test to diagnose a lupus flare. Doctors diagnose flares based on your symptoms and a combination of lab tests.3

Steps you can take on your own to reduce your risk of a flare include:2

  • Take your medicine as directed
  • See your doctor regularly
  • Watch for warning signs of a flare
  • Minimize triggers like stress, UV light, and lack of sleep
  • Maintain a healthy diet
  • Get regular exercise

Lupus remission

Remission and lupus low disease activity state (LLDAS) are terms used for the time between flares when your lupus is not active. Experts disagree about the best definition of remission. But they agree that long-term remission is the goal of lupus treatment. The more time you are in remission, the less organ damage you will have.5

Finding the best treatment to help you have fewer flares can take time. Work with your doctor to find a treatment plan that works for you. Always talk to your doctor before stopping your medicine, even if you feel better.6

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