Lupus (Systemic Lupus Erythematosus)

Home Treatment

Good self-care is essential to managing lupus (systemic lupus erythematosus, or SLE). Learn to recognize your body's warning signs of a flare. Warning signs may include increased fatigue, joint pain, rash, or fever. When you notice any of these signs, take steps to control your symptoms.

Stress may trigger lupus symptoms. Keep your stress level as low as you can.

• Keep your daily schedule as simple as possible.
• Keep your list of obligations to others to a bare minimum.
• Delegate to others.
• Exercise regularly. A daily walk, for example, can reduce stress, clear your head, improve your mood, and help fight fatigue.
• Use relaxation techniques such as meditation, yoga, and guided imagery to calm your body and mind.

Fatigue is common in people with lupus. To fight fatigue:

• Get plenty of rest. Some people with lupus need up to 12 hours of sleep every night.
• Pace yourself. Limit tiring activities.
• Ask others for help. Don't try to do everything yourself.
• Take short breaks from your usual daily activities. Consider cutting down on work hours or getting help with parenting responsibilities, at least during periods when lupus symptoms are severe.
• Exercise regularly. Physical activity boosts energy and helps you stay in good condition. Walking and swimming are good forms of exercise for people with lupus.
• If you suspect that depression is contributing to your fatigue, get prompt treatment from your doctor, a mental health professional, or both.

Take care of your skin. Ask your doctor about the use of corticosteroid creams to relieve skin symptoms that are particularly troublesome. If you are bothered by the way a lupus rash looks on your face or if you have scars from lupus, you can try makeup, such as Covermark, to cover the rash or scars.

Ultraviolet (UVA and UVB) light triggers disease flares in up to 70% of people with lupus.⁸ Exposure to ultraviolet light, as from sunlight, can trigger or start skin rash, joint pain, or fatigue, or it can make these symptoms worse. To minimize your exposure to ultraviolet light:

• Avoid the sun. If you must be in the sun, cover your arms and legs, wear a hat, and apply broad-spectrum sunscreen (covering both UVA and UVB rays) with a high sun protection factor (50 SPF or higher) to protect your skin. Reapply sunscreen after swimming, sweating, or toweling off. Experiment with sunscreens. Some may irritate your skin or wash off too easily.
• Avoid going out when the sun's rays are the strongest. In most areas, this is between the hours of 10 a.m. and 4 p.m., especially during the summer.

Good general care is essential. A healthy lifestyle not only improves your quality of life but may also reduce your chances of having more frequent and severe flares. Good care includes:⁹

• Getting vaccinations to help protect you from illnesses such as pneumonia and the flu.
• Treating high blood pressure.
• Taking medicine to help prevent osteoporosis caused by corticosteroids.
• Preventing plaque in the arteries (atherosclerosis) that can be made worse by corticosteroids.
• Protecting yourself against infections you can get more easily due to decreased immune system function.

Other good health habits that will help protect you include:

• Regular exercise.
• Education about lupus and self-care.
• Not smoking. Studies show that smoking makes symptoms worse in people with lupus and may decrease the effectiveness of some medicines. Experts suggest that people with lupus avoid all tobacco products.¹⁰
• Eating a healthful, balanced diet.
• Regular dental care.
• Regular eye examinations by an ophthalmologist.
• Developing a support system of family, friends, and health professionals.

Some people with lupus are sensitive to antibiotic drugs called sulfonamides (sulfa drugs). These include Bactrim, Septra, and many others. Your doctor can prescribe drugs that do not contain sulfa, if needed.

If you have lupus and are a woman in your childbearing years, pay special attention to pregnancy-related concerns, both before conceiving and while pregnant. Most women with well-controlled lupus can take birth control pills if they choose that method of birth control, and for most women lupus will not interfere with becoming pregnant or with pregnancy. But some women with lupus, especially those with active disease, are at higher risk of complications with pregnancy. All women of childbearing age should check with their rheumatologist when they are planning to become pregnant.

Home treatment and regular checkups are sometimes sufficient for managing mild lupus or for periods of remission. Be sure to have your doctor monitor your condition on a regular basis. These regular checks are important to detecting and treating progressive organ damage.

It is important that the people in your life understand what lupus is, how it affects your life, and how you can best cope with it. Help them understand your limitations and needs when your symptoms flare. Support groups are great places to learn coping strategies from others. For information about support groups, see the Other Places to Get Help section of this topic.

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Author:	Shannon Erstad, MBA/MPH	Last Updated: May 13, 2008
Medical Review:	Adam Husney, MD - Family Medicine Anne C. Poinier, MD - Internal Medicine Stanford M. Shoor, MD - Rheumatology
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