Whether you have an autoimmune condition, or another long-term condition prone to flare ups, it’s important to know how to handle a flare up
We talk you through some common autoimmune conditions and some other conditions that are not related to the immune system, and what flare ups might feel like if you have those conditions. Plus, we explore potential triggers of flare ups, how to manage a flare up and general lifestyle tips to help, whatever condition you have.
What is a flare up?
A flare up is a temporary worsening of the symptoms of an existing disease or condition. There are lots of different conditions where people may experience flare ups.
Some of those conditions are known as autoimmune conditions, where the immune system begins to react abnormally and starts attacking healthy cells and tissues. These can cause different symptoms depending on the condition.
There are also other conditions, that are not autoimmune ones, where people may also experience flare ups.
A note on helping to prevent flare ups
If you have an existing, diagnosed condition, whether that’s an autoimmune condition or otherwise, that you’re being treated for, the best way to help prevent flare ups is to ensure that you always follow the treatment plans recommended for you by your doctor or specialist.
This can include ensuring that you always take your prescribed medication, and making sure you manage the supply of your medication so that you don’t run out. This doesn’t mean you won’t experience flare ups, but it’s the best way to help prevent them as far as possible.
If you think you’re experiencing a flare up of your condition, talk to your GP or specialist.
Autoimmune condition flare ups
Lupus flare ups
Lupus is a condition where the immune system mistakenly attacks healthy tissue, including in the skin, joints and internal organs. You can find out more about lupus in our What is lupus? article.
Lupus can be unpredictable and people living with it often experience times when they have few or no symptoms (remission) and times when their lupus is very active (flares).
Flares can range in severity and frequency, and often occur suddenly and unexpectedly. Signs of a lupus flare up can include:
• Increased exhaustion
• Increased pain
• Fever
• Rashes
• Generally feeling unwell
• Mouth ulcers
• Persistent headaches
What causes a lupus flare up?
It’s not yet fully clear what causes a lupus flare up, but potential triggers can include:
• Stress
• Ultraviolet rays from the sun or certain light bulbs
• Illnesses or viruses
• Surgery or accidents
• Pregnancy
• Certain prescription drugs
• Sensitivity to items like skin creams or hair dye
How to manage a lupus flare up
There are some things you can do during a lupus flare up, that may help you to manage your symptoms, including:
• Learn to prioritise activities, say no to things and pace yourself
• Reduce your risk of catching infections by practicing good hygiene, like washing your hands often, washing fruit and veg and avoiding places where risk of infection is high, like public transport
• Avoid potential triggers like ultraviolet rays from the sun or certain light bulbs
• Stop smoking if you do smoke. People with lupus can be prone to respiratory infections, and studies have shown that smoking can interfere with the benefits of lupus medications
• Make a flare day comfort kit to keep to hand. This can include things like lip balm, hand cream, soft socks and blankets. The Lupus Trust has more information on flare day comfort kits.
If you’re experiencing severe or new symptoms, it’s important to seek medical advice.
Psoriasis flare ups
Psoriasis is an autoimmune skin condition, where the skin produces too many new skin cells, too quickly, meaning patches of skin can become itchy and inflamed. You can find out more about psoriasis is in our What is psoriasis? article.
Most cases of psoriasis go through cycles, with flare ups occurring for a few weeks or months before easing or stopping.
During a psoriasis flare up, psoriasis symptoms get worse and may include:
• Red, flaky, crusty patches of skin covered with silvery scales
• In some people, itching and soreness
What causes a psoriasis flare up?
Common psoriasis triggers can include:
• An injury to the skin, like a cut or an insect bite
• Drinking too much alcohol
• Smoking
• Stress
• Hormonal changes, for instance around puberty or the menopause
• Some medications including lithium, some antimalarial medicines and anti-inflammatory medicines like ibuprofen
How to manage a psoriasis flare up
If you’re experiencing a psoriasis flare up, and have an existing treatment plan, ensure that you stick to your treatment plan. If you feel your treatment isn’t working, speak to your GP. If you have particularly severe symptoms during a flare up, or you’re not responding well to treatment, your GP may refer you to a dermatologist (skin specialist).
Treatment for psoriasis flare ups generally falls into three categories:
• Topical treatments, like emollients, or steroid creams/ointments
• Phototherapy
• Medication in the form of tablets, capsules and injections
Rheumatoid arthritis flare ups
There are several different types of arthritis (to learn more, visit our Arthritis Health Hub page), but here we talk you through what a rheumatoid arthritis flare up can be like.
Rheumatoid arthritis is an autoimmune condition that causes pain, stiffness and swelling in the joints. Rheumatoid arthritis flare ups can be unpredictable and start suddenly, and can last for hours, days or weeks.
Symptoms of a flare up can include:
• Increasing of swelling/stiffness in the joints
• Worsening pain in the joints
• Generally feeling unwell
• Night sweats, fever and/or weight loss
• Increased tiredness
What causes a rheumatoid arthritis flare up?
Potential triggers for rheumatoid arthritis can include:
• Infections, such as chest or urinary tract infections
• Stress
• Overexertion
• Poor sleep
• Tapering or stopping of rheumatoid arthritis treatment(s). Remember, medication should be taken as prescribed unless advised otherwise by your doctor
How to manage a rheumatoid arthritis flare up
There are some general strategies for coping with a rheumatoid arthritis flare, which include:
• Ensuring you rest and try to relax as soon as you realise you’re experiencing a flare up
• Use cool packs on affected joints
• Use aids where helpful, for instance if your knee is affected, a stick might be helpful
• Do gentle exercises, to help relieve stiffness
• Use hot baths or showers (as hot as is comfortable for you) to relieve early morning stiffness and pain
• Let friends and family know that you’re experiencing a flare up, and accept any help they offer
Multiple sclerosis (MS) flare ups
Multiple sclerosis (MS) is an autoimmune condition where the immune system mistakenly attacks the layer that surrounds and protects the nerves, called the myelin sheath. This leads to messages travelling along the nerves becoming slowed or interrupted. It can cause a wide range of symptoms including problems with vision, arm or leg movement, sensation or balance.
In MS, flare ups are often referred to as relapses, and are particularly common in people who have relapsing remitting MS, a form of the condition where people have periods of more severe symptoms (relapses) and periods of remission.
An MS flare up can last anywhere from a few days to a few weeks or months. The most common symptoms associated with a flare up or relapse include:
• Fatigue
• Dizziness
• Balance and coordination issues
• Eyesight problems
• Bladder problems
• Weakness in an arm or leg
• Areas of numbness or pins and needles
• Pain
• Issues with memory and concentration
• Issues with mobility
What causes an MS flare up?
Often people find that flare ups occur with little or no warning, however there are some potential triggers that increase the risk of a flare up, including:
• Infections, such as a cold, flu or a bladder infection
• Prolonged periods of stress
• Smoking
How to manage an MS flare up?
If you think you’re having a flare up, speak to your GP or MS nurse straight away. You may be offered steroids if it’s a serious flare up, or rehabilitation which combines many different approaches to help manage the condition, including physiotherapy, occupational therapy and dietary advice.
Some other things you might want to consider when managing a flare up include:
• Asking for support from friends and family to help you with things that you may not be able to do or may be more challenging whilst you’re experiencing a flare up, for instance cooking, cleaning or collecting children from school
• If you need additional support, it might be possible to arrange some social services support in the short term – speak to your MS nurse to understand what’s available
• Seeking support from your employer or education provider if you need to consider taking time off during a flare up, or make other adaptions, like temporarily reducing or adjusting your hours
• You might find that you experience problems thinking through complex tasks, which is called a cognitive relapse. If you find this interferes with your ability to complete important tasks, an occupational therapist or neuropsychologist can help you find strategies to manage this
Flare ups of other conditions
Gout flare ups
Gout is a form of arthritis that causes sudden attacks of severe pain, which can be reoccurring, and is usually felt in one or more joints at the same time. Find out more about gout in our What is gout? article.
Gout flare ups develop rapidly over a few hours, and often last between three and 10 days. Symptoms of a gout flare up include:
• Severe joint pain
• The joint feeling very hot and tender
• Swelling in and around the affected joint
• Red, shiny skin over the affected joint
What causes a gout flare up?
Potential causes for a gout flare up include:
• Drinking too much alcohol or eating a very large, fatty meal
• Becoming dehydrated
• Having an illness that causes a high temperature
• Injuring a joint
• Taking certain medicines
How to manage a gout flare up?
Things you can do to help to manage a flare up of gout include:
• Resting and raising the affected joint
• Keeping the joint cool, for instance by applying an ice pack for up to 20 minutes at a time
• Drinking lots of water (unless your GP tells you not to)
• Keeping bedclothes off the affected joint at night
• Taking any medicine you’ve been prescribed for gout as directed and as soon as possible
Eczema flare ups
Eczema is the name for a group of conditions which make your skin dry, irritated, red, itchy and cracked. The most common form is atopic eczema, which you can find out more about in our Health Hub Eczema Condition Page.
A flare up of atopic eczema is where symptoms get worse for a period of time, and they may occur as often as two or three times per month.
During a flare up you might find that your skin becomes increasingly red or darker than your usual skin tone (depending on the colour of your skin), itchy and sore due to inflammation.
What causes an eczema flare up?
Various things can trigger an atopic eczema flare up, and these vary from person to person. Common triggers can include:
• Irritants – like soaps or detergents
• Environmental factors or allergens – like cold or dry weather, house mites or moulds
• Food allergies – like cows’ milk or wheat
• Certain materials worn next to the skin
• Hormonal changes – like during menstruation or pregnancy
• Skin infections
How to manage an eczema flare up?
There are some things to consider when managing an atopic eczema flare up, including:
• Ensure you’ve got enough of your emollients and any other daily medicines available
• It can also help to keep a photo diary of your symptoms to share with your healthcare provider so they can understand what’s been happening
• For many people, topical steroids may be prescribed to help bring a flare up under control. If you’re prescribed steroids, make sure you follow the guidelines carefully and use the recommended amount
• If you work, consider discussing your condition with your employer to ensure you can make any necessary changes during a flare up
• Ask for support from friends and family if you need it
Fibromyalgia flare ups
Fibromyalgia is a long-term condition that causes pain all over the body, despite there not being any damage to muscles or other tissues. You can find out more about fibromyalgia in our What is fibromyalgia? article.
During a fibromyalgia flare up, you may experience a worsening of fibromyalgia symptoms which can include:
• Widespread pain
• Extreme sensitivity
• Stiffness
• Poor sleep quality
• Cognitive problems, like trouble remembering or learning new things
• Headaches
What causes a fibromyalgia flare up?
Potential triggers for a fibromyalgia flare up can include:
• Stress
• Changes to your daily routine
• Poor nutrition
• Hormonal changes
• Poor quality sleep or changes to sleep patterns
• Weather or temperature changes
• Becoming unwell, for instance infections like flu
• Starting new medication or treatments, or changing something in your normal fibromyalgia treatment routine
How to manage a fibromyalgia flare up?
If you’re experiencing a fibromyalgia flare up, the lifestyle tips in the final section of this article, particularly around sleep and relaxation, might help you to manage your symptoms.
You might also find support groups and organisations that offer advice to people with fibromyalgia helpful.
Diverticulitis flare ups
Diverticulitis is a condition where diverticular (small bulges or pockets in the large intestine) become inflamed or infected due to bacteria being trapped inside them. You can find out more about diverticular disease (in which these pockets form) and diverticulitis in our What is diverticular disease and diverticulitis? article.
A flare up of diverticulitis can cause symptoms such as:
• Constant, severe tummy pain
• A high temperature
• Diarrhoea or constipation
• Having mucus or blood in your poo, or bleeding from your bottom
If you’re experiencing any bleeding or severe pain, seek immediate medical advice, by contacting your GP, or if that’s not possible, calling NHS 111 or your local out-of-hours service.
What causes a diverticulitis flare up?
A diverticulitis flare up is caused by an infection in one or more of the diverticula. This can be triggered when hard stool or undigested food becomes trapped in one of the pouches, which gives bacteria the chance to spread.
How to manage a diverticulitis flare up?
If you’re experiencing a diverticulitis flare up, it can usually be treated at home with a course of antibiotics prescribed by your doctor. They might also recommend sticking to a fluid only diet until your symptoms improve.
It may also help to follow a low-fibre diet whilst you’re recovering to enable your digestive system to rest, then returning to a high-fibre diet (aim for 30g of fibre per day) once your symptoms have gone. Pain relief, such as paracetamol may help if this is suitable for you. You should avoid taking aspirin or ibuprofen as they can cause stomach upset. If paracetamol isn’t suitable for you, or it’s not providing sufficient pain relief, speak to your doctor.
Lifestyle tips to help with flare ups
Whichever condition you’re experiencing, there are some general healthy lifestyle tips which are recommended for everyone and may help you to manage your condition.
Speak to your GP or healthcare provider if you’re unsure how to make these tips work with your condition.
Diet & maintaining a healthy weight
Eating a healthy, balanced diet and maintaining a healthy weight can be very important in managing your health and feeling the best that you can.
It can help to:
• Eat at least five portions of a variety of fruit and veg every day
• Include high fibre starchy foods like potatoes with their skins or wholemeal bread
• Include dairy or dairy alternatives
• Eat protein like beans, pulses, eggs or lean meat, chicken and fish
• Choose unsaturated oils and spreads and eat them in small amounts
• Foods like biscuits, cakes, crisps, chocolate and ice cream are high in fat, salt or sugar and should be eaten less often and in small amounts
• Drink plenty of fluids (at least six to eight glasses or cups per day)
This can help you to maintain a healthy weight, particularly when coupled with exercise that’s appropriate for you – read on to find out more.
For more information on how to get the best nutrition, visit our Nutrition hub.
Exercise
Exercise has huge benefits for your health, in the moment and in the long term, for instance, people who exercise regularly have a lower risk of developing many long-term conditions such as diabetes or heart disease.
The NHS outlines physical activity guidelines, but if you’re experiencing a flare up of a health condition or have a health condition and haven’t exercised for some time, the best thing to do is to speak to your GP or healthcare specialist, to find out what type of exercise is most suitable for you, both during and after a flare up. This will help you to keep active in the best way possible to enable your recovery.
Sleep hygiene
Good quality sleep can help you to manage your symptoms during a flare up but can also aid with recovery. That can be easier said than done, and if sleep is an issue for you, speak to your GP or specialist for advice specific to your condition.
However, the are some general tips for good sleep hygiene that may help:
• Stick to a regular routine, aiming to go to bed and get up at the same time every day
• Expose yourself to bright sunlight as soon as you get up
• Make your bedroom sleep friendly, keeping it cool and dark
• Don’t eat or drink an hour before going to sleep
• Create a wind down routine – this could include things like having a warm bath or doing some journaling
You can also visit our Sleep hub for more advice on how to get a good night’s sleep.
Manage everyday stress
With many conditions, stress can make you feel worse, so finding ways that help you manage everyday stress can be helpful.
If your stress is related to your condition, speak to your GP or specialist, or it may help to find a support group for people who have the same condition as you, that will enable you to talk to people going through similar experiences.
Other things you can try that can help to manage everyday stress include:
• Self-help techniques, such as meditation or mindfulness
• Talking to trusted friends, family or colleagues
• Being physically active
• Planning ahead for potentially stressful days or events
• Gratitude – try listing three things each day that you’re grateful for
You can also visit our Life balance hub for more information about managing everyday stress.
Avoid smoking
With many health conditions, smoking can make symptoms worse, and it also increases your risk of other health conditions including heart disease and certain cancers. So, if you do smoke, one of the best lifestyle changes you can make is to quit smoking.
Our Ways to help quit smoking contains helpful tips on how to give up smoking, and you’ll find lots more information in our Smoking & cutting down hub.
Cut down on alcohol
As with smoking, consuming too much alcohol can make symptoms of existing conditions worse, and put you at greater risk of other health conditions like high blood pressure or liver disease. So, if you do drink alcohol, reducing the amount you consume is a positive change to make. The NHS recommends that people consume no more than 14 units of alcohol per week, spread across three or more days.
Visit our guide on how to do an alcohol detox safely at home for more advice on how to reduce your alcohol consumption.
Whatever your condition, flare ups can be challenging, so make sure you seek support when you need it and follow the advice of your health care professional.
