Understanding Lupus Flares

Lupus can change over time. There may be periods when symptoms are relatively settled and others when the disease becomes more active.

A period of increased lupus activity is often described as a flare.

Flares can vary considerably. Some mainly affect symptoms such as joints or skin, while others can involve internal organs and need more urgent medical assessment.

One of the difficulties is that a change in symptoms does not automatically mean lupus is flaring. Infection, another health condition, side effects of treatment and other problems can sometimes cause similar symptoms.

Knowing your usual pattern, attending regular monitoring and telling your healthcare team when something changes can help them work out what is happening.

What is a lupus flare?

A lupus flare is a period when systemic lupus erythematosus (SLE) becomes more active.

For some people this may mean familiar symptoms become noticeably worse. For others, new symptoms may appear.

A flare may be mild, moderate or severe depending on what parts of the body are affected and the degree of disease activity.

Lupus can affect many different organs and tissues, so there is no single flare pattern that applies to everyone.

Your healthcare team considers your symptoms alongside examination findings, blood tests, urine tests and other investigations when needed.

This means a flare cannot always be confirmed from symptoms alone.

What can a flare feel like?

The symptoms of active lupus depend on how lupus affects you.

Changes could include symptoms such as:

• worsening joint pain, stiffness or swelling
• an increase in fatigue
• new or worsening skin rashes
• mouth or nose ulcers
• unexplained fever
• increased hair loss
• chest symptoms
• new swelling
• changes involving other parts of the body affected by your lupus

However, this is not a checklist for diagnosing a flare.

Many of these symptoms can have other causes.

Fatigue, for example, can become worse because of poor sleep, infection, anaemia, stress, another health condition or persistent pain as well as lupus activity.

Similarly, a temperature could be caused by infection rather than lupus inflammation.

Tell your healthcare team what has changed rather than trying to decide for yourself whether a flare is responsible.

Not every symptom change is a flare

This is one of the most important things to understand about living with lupus.

A bad day is not necessarily a flare.

More pain does not automatically mean lupus has become more active.

Feeling exhausted does not automatically mean your treatment has stopped working.

Healthcare professionals may need to consider whether symptoms are caused by:

• active lupus
• infection
• another health condition
• treatment side effects
• existing organ damage
• persistent pain or fatigue
• a combination of different factors

This distinction matters because the right response will depend on what is actually causing the symptoms.

For example, increasing medicines that suppress the immune system would not necessarily be appropriate if an infection were responsible.

What causes lupus flares?

It is not always possible to identify why lupus becomes more active.

The NHS notes that the reason symptoms flare up or settle down is not fully understood.

You may notice patterns in your own health, but it is worth being cautious about assuming that one particular food, activity, stressful day or other event directly caused a flare.

There are, however, some things that are important in managing lupus and reducing avoidable risks.

These include:

• taking prescribed lupus medicines as agreed with your healthcare team
• attending regular monitoring
• protecting yourself appropriately from ultraviolet (UV) exposure
• avoiding smoking
• keeping eligible vaccinations up to date
• looking after general health
• discussing significant changes in symptoms promptly

Your individual care plan should always take priority.

What should I do if I think lupus is flaring?

If your symptoms become noticeably different or worse, consider the plan you have agreed with your lupus team.

If you have been given specific instructions about what to do during a suspected flare, follow those instructions.

Otherwise, contact your GP, rheumatology team or specialist nurse when appropriate and explain what has changed.

Useful information might include:

• which symptoms have changed
• when the change started
• whether symptoms are getting worse
• whether you have a temperature
• whether there is new swelling
• whether you have symptoms of infection
• whether you have started any new medicines
• whether you have missed or changed any lupus medicines
• how the symptoms are affecting daily life

Your healthcare team can decide whether you need an appointment, blood tests, urine tests or another type of assessment.

Medicines and your flare plan

Medicines used to treat lupus aim to control disease activity and protect the body from inflammation and organ damage.

Do not increase, reduce or stop prescribed lupus medicines because you think you are having a flare unless your healthcare team has specifically instructed you to do so.

Feeling better does not necessarily mean a medicine is no longer needed.

Likewise, feeling worse does not automatically mean you need a higher dose or additional treatment.

Some people may have an agreed plan explaining what to do if particular symptoms return. If you have one, keep it somewhere accessible and make sure you understand when you should contact your team.

If you are unsure about your medicines, speak to your rheumatology team, GP or pharmacist.

You can also read our Lupus treatment guide for more information about how lupus is treated and monitored.

Sun and UV protection

Ultraviolet light can be important for people with lupus, particularly those who are photosensitive.

Current UK specialist guidance recommends high-SPF, broad-spectrum protection against UVA and UVB along with sensible measures to reduce UV exposure.

This may include:

• using a high-SPF broad-spectrum sunscreen
• choosing products with good UVA protection
• reapplying sunscreen as directed
• seeking shade where practical
• wearing protective clothing
• using hats and sunglasses when appropriate

UV sensitivity varies between people.

Some people notice obvious skin symptoms after exposure, while others may not.

Your healthcare team or dermatologist can give more specific advice if photosensitivity is an important part of your lupus.

Rest, movement and pacing

When symptoms worsen, you may need to reduce what you are doing.

Rest can be important when you are unwell, but this does not necessarily mean complete inactivity for prolonged periods.

Where appropriate to your health and disease activity, maintaining some movement can support mobility, strength and general wellbeing.

The right balance will vary from person to person and from one period of illness to another.

Pacing can help when fatigue or pain makes normal activities difficult.

This might mean:

• breaking activities into smaller stages
• prioritising essential tasks
• alternating activity with rest
• accepting help when you need it
• avoiding the pressure to catch up with everything on a better day

Our Lupus fatigue guide includes more practical information about pacing and managing limited energy.

Food and general health

There is no special diet that can reliably prevent lupus flares.

A healthy, balanced diet is recommended for general health, just as it is for people without lupus.

Some people may need more individual dietary advice because of kidney involvement, cardiovascular risk, osteoporosis, medicines or another health condition.

If you are considering major dietary changes or supplements because of lupus, discuss them with an appropriate healthcare professional.

Do not replace prescribed lupus treatment with supplements, restrictive diets or alternative therapies.

Infection and vaccinations

Infections are particularly important for people living with lupus.

Some lupus treatments reduce immune-system activity and can increase susceptibility to certain infections.

Infection can also produce symptoms that may resemble a lupus flare, such as fatigue, fever or feeling generally unwell.

Contact your healthcare team if you have symptoms of infection or are unsure whether a change in symptoms could be lupus or something else.

Current UK specialist guidance recommends that eligible vaccinations are reviewed regularly in people with SLE.

The vaccines that are appropriate for you may depend on your age, health and the medicines you take.

Ask your healthcare team, GP or pharmacist if you are unsure which vaccinations you should receive or whether the timing of a vaccine needs to be considered around treatment.

Monitoring matters even when you feel well

Some changes in lupus activity can be difficult to detect from symptoms alone.

This is particularly important because organ involvement, including kidney involvement, may sometimes be identified through monitoring before obvious symptoms develop.

That is why regular appointments, blood-pressure checks, blood tests and urine tests can remain important even when you feel relatively well.

Do not skip monitoring simply because your symptoms have improved.

Regular monitoring allows your team to look for changes in disease activity, treatment side effects and other health risks.

Keeping track of changes

You do not need to record every symptom every day.

But if your health is changing, a short record may help.

You could note:

• the date symptoms changed
• what feels different
• new rashes or swelling
• pain or stiffness
• fatigue
• temperature if relevant
• new medicines
• infection symptoms
• how your sleep is affected
• how symptoms are affecting normal activities

Photographs can sometimes be useful for symptoms such as rashes that may have changed before your appointment.

Bring anything useful to your appointment rather than trying to interpret it yourself.

Our Preparing for your rheumatology appointment checklist can help you organise your symptoms, medicines and questions.

Emotional wellbeing during a flare

A return or worsening of symptoms can be difficult emotionally as well as physically.

You may feel frustrated, anxious, disappointed or worried about what the change means.

This can be particularly difficult after a period when lupus has been relatively settled.

You do not have to pretend that this is easy.

Try to give yourself permission to adjust plans, accept practical help and talk about how you are feeling.

If lupus is affecting your mental health or emotional wellbeing, our Mental wellbeing with lupus guide explains practical ways to look after yourself and where to find additional support.

When should I contact my healthcare team?

Contact your GP, rheumatology team or another appropriate healthcare professional if:

• your usual lupus symptoms become significantly worse
• you develop a new symptom that concerns you
• symptoms persist rather than settling
• you develop unexplained swelling
• you have a temperature or signs of infection
• you notice a significant change in your urine
• you develop new weakness, numbness or neurological symptoms
• pain or fatigue suddenly becomes much more difficult to manage
• symptoms are significantly affecting normal activities
• you are unsure whether you may be experiencing a flare

Your own lupus team may have given you more specific instructions. Follow those where applicable.

When to get urgent help

Some symptoms need urgent medical assessment and should not simply be assumed to be part of a lupus flare.

Call 999 if you develop symptoms such as:

• severe difficulty breathing
• sudden chest pain that does not go away
• chest pain accompanied by sweating, sickness, light-headedness or breathlessness
• sudden weakness or numbness affecting one side of your body
• sudden facial weakness
• new difficulty speaking
• sudden severe confusion
• loss of consciousness

If you need urgent medical advice but you are unsure whether it is a 999 emergency, use NHS 111.

Do not delay seeking help because you think a serious new symptom may simply be lupus.

Questions to ask your healthcare team

It can help to understand what your own healthcare team considers a flare and what they want you to do when symptoms change.

Questions you might ask include:

• How will I know if my lupus may be becoming more active?
• Which symptoms should I contact you about?
• Do I have an individual flare plan?
• What should I do if several symptoms worsen together?
• How can you tell the difference between a flare and an infection?
• Which blood or urine tests are used to monitor my lupus?
• What should I do if I develop a fever?
• Should I ever adjust my medicines during a flare?
• What symptoms require urgent assessment?
• Who should I contact between appointments?

Write down the answers if that would make them easier to remember.

Can lupus flares be prevented?

It is not possible to guarantee that you will never experience another flare.

Lupus is unpredictable, and some increases in disease activity happen without an obvious cause.

Modern lupus treatment aims to achieve remission or, where that is not possible, low disease activity while reducing the risk of flares and long-term organ damage.

Things that can support this include:

• taking prescribed treatment as agreed
• attending regular monitoring
• discussing side effects rather than stopping medicines yourself
• using appropriate UV protection
• not smoking
• keeping eligible vaccinations up to date
• maintaining suitable physical activity where possible
• eating a balanced diet
• contacting your healthcare team when something important changes

These measures can support your overall lupus care, but experiencing a flare does not mean you have done something wrong.

Living with uncertainty

One of the hardest parts of lupus can be not always knowing how you will feel tomorrow.

Learning about your condition can help, but you should not feel responsible for constantly monitoring every sensation or trying to prevent every possible change.

Your healthcare team is there to assess disease activity and help you make decisions about treatment.

Your role is not to diagnose your own flare.

It is to notice important changes, follow your agreed care plan and ask for help when you need it.

About this information

This information is for general guidance and does not replace advice from your GP, rheumatology team or another healthcare professional.

Symptoms that resemble a lupus flare can sometimes have another cause, including infection. Do not use this information to diagnose a flare or to start, stop or alter prescribed medicines without professional advice.

Information updated: September 2026

Sources used for this page

NHS — Lupus
General NHS information about lupus symptoms, flare-ups and treatment.

British Society for Rheumatology — 2026 guideline for the management of children, young people and adults with systemic lupus erythematosus
Current UK specialist guidance covering assessment of disease activity and flares, monitoring, treatment adherence, UV protection, physical activity, diet, vaccination and long-term management.

EULAR — Recommendations for the management of systemic lupus erythematosus: 2023 update
Evidence-based recommendations covering individualised management, monitoring, treatment targets and prevention of flares and organ damage.