Preventing a Lupus Flare

Your doctor has put together a treatment plan that is designed specifically for you and your lupus. This probably includes physical and emotional rest, aggressive treatment of infections, good nutrition, and avoidance of direct sunlight and other sources of ultraviolet light. Your doctor may have also prescribed medications to control disease symptoms and other health problems that you might have. One of the most important ways you can help yourself is to understand your treatment plan and the things you need to do to keep your disease under control.

Sometimes, despite the treatment plan and your efforts, you may experience a lupus flare. A flare is a worsening of symptoms that signals increased disease activity. A variety of factors can cause a flare, and you should contact your doctor immediately if you suspect a flare is developing. The doctor will evaluate your condition and take steps to control the seriousness of the flare. He or she will also reevaluate your overall treatment plan and make any needed changes.

Warning Signs of a Flare

• Increased fatigue
• A new or higher fever
• Increased pain
• Development or worsening of a rash
• Upset stomach
• Headache or dizziness
• Development of symptoms you haven’t had before

What Triggers a Flare?

A flare can be triggered by one factor or a combination of factors. The most common are:

• overwork or not enough rest;
• stress or an emotional crisis;
• exposure to sunlight or other sources of ultraviolet light;
• infection;
• injuries or surgery;
• pregnancy or the time right after the baby’s birth (the postpartum period);
• sudden stopping of medications for lupus;
• sensitivities or allergies to items that you put on your skin, such as hair dye, hair permanent solution, makeup, and skin creams;
• certain prescription drugs;
• over-the-counter medications, such as cough syrup or laxatives; and
• immunization

Caring For Yourself

• Learn to recognize the warning signals of a flare and tell your doctor about them.
• Maintain your physical health. Be sure to visit your doctor regularly, even if you are feeling well. Schedule regular dental, eye, and gynecological exams.
• Get enough sleep and rest. Be flexible with your schedule of daily activities.
• Try to limit your stress. Because this may be hard to do at times, consider developing a plan for dealing with potentially stressful situations. Develop a support system that includes family, friends, medical or nursing professionals, community organizations, and support groups. Remember, it helps to talk to someone when you’re feeling stressed.
• Participate in a well-planned exercise program to help you maintain physical fitness and reduce stress.
• Eat a healthy diet.
• Limit your exposure to the sun and other sources of ultraviolet light, such as fluorescent or halogen lights.
• Tell your doctor right away about any injury, illness, or infection or if you do not feel well in any way.
• Delay elective surgery (including dental surgery and teeth pulling) until your lupus is under control or in remission.
• Lupus may cause problems for a pregnant woman and her baby. As a result, women with lupus should carefully plan any pregnancy. Do not stop using your method of birth control until you have discussed the possibility of pregnancy with your doctor and he or she has determined that you are healthy enough to become pregnant.
• Talk with your doctor before you stop taking any prescribed medications.
• Check with your doctor or nurse before taking any over-the-counter medications.
• Be careful when trying any over-the-counter preparations used on your skin or scalp. First, determine whether you have a sensitivity or an allergy to it. Put a small amount of the preparation on the inside of your forearm or on the back of your ear. If any redness, rash, raised areas, itching, or pain develops, do not use the preparation.
• Be aware that certain prescription drugs may trigger a flare. Tell any doctor, nurse, or health care professional you visit that you have lupus. Also tell your lupus doctor or nurse if any new medications have been prescribed for you.
• Be sure to check with your lupus doctor before receiving any immunization. Routine immunizations, including those for the flu and pneumonia, are an important part of maintaining your health, and you should get them if your doctor approves.

Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, January 1999