Lupus (Systemic Lupus Erythematosus) Health (cont.)

Medical Author:
Medical Editor:
Medical Editor:

Self-Care at Home

Home care for lupus generally involves taking the prescribed medications and adhering to good practices such as using sunscreen because there is often a history of skin sensitivity to sunlight.

  • People with sun-induced rashes should always wear a high SPF lotion that blocks both UVA and UVB types of ultraviolet light.
  • Those taking oral steroid therapy or immune-suppressing agents should be vigilant if a fever develops, since fever can occur with lupus flares or with a superimposed problem, especially infection.
  • A combination of rest, especially during flares, and exercise for joints and muscles is important and should be supervised by the treating physician and physical therapists.

Medical Treatment

  • Ibuprofen (Motrin, Advil) and other nonsteroidal anti-inflammatory drugs are used to reduce inflammation. Ibuprofen and similar drugs can harm kidney function, especially in people who already have kidney problems.
  • Many people with lupus can experience significant relief of their symptoms without the use of steroids or other immune-suppressing agents (such as azathioprine [Azasan, Imuran] or cyclophosphamide [Cytoxan, Cytoxan Lyophilized, Neosar]). However, certain acute complications (such as acute kidney failure) caused by lupus may require high doses of oral or intravenous steroids along with other immune-suppressive drugs. Some people will require long-term treatment with steroids and immune-suppressing agents.
  • Antimalarial drugs such as hydroxychloroquine and chloroquine are excellent alternatives for people with lupus who do not respond well to ibuprofen or aspirin (Bayer Aspirin, Bufferin, Ecotrin). Many people on antimalarial drugs experience significant relief of their symptoms, especially rashes, fatigue, and joint and muscle pains. Hydroxychloroquine has been shown to decrease the frequency of flares in patients with systemic lupus erythematosus. Based on these data, it is widely believed that all patients should be treated with hydroxychloroquine indefinitely, unless they develop adverse effects. However, with antimalarial drug use, careful periodic evaluation of the eyes is required to prevent serious complications.
  • A new B-cell-suppressing treatment is belimumab (Benlysta). Belimumab blocks the stimulation of the B cells (a B-lymphocyte stimulator [BLyS]) and is indicated for the treatment of adult patients with active autoantibody-positive systemic lupus erythematosus who are receiving standard therapy. It is important to note that the efficacy of belimumab has not been evaluated in patients with severe active central nervous system lupus or severe active lupus nephritis. Belimumab has not been studied in combination with intravenous cyclophosphamide or other biologic therapies.
  • Some patients can benefit from dietary treatment with food supplementation with dehydroepiandrosterone (DHEA) over the counter. On the contrary, patients with autoimmune diseases, including lupus, should not take "immune booster" supplements such as echinacea.
  • For people with sun-sensitive lupus rashes, appropriate use of ultraviolet-blocking sunscreens and protective clothing is critical. Heat, infrared light, and, rarely, fluorescent light can also bring on flares. Topical steroid creams are also helpful for lupus-associated rashes, once they develop. A doctor should closely monitor extended use of steroid creams, especially on the face and covered areas.
  • Treatment of seizures or psychiatric disturbances usually involves therapy directed at the type of disturbance itself (the use of anticonvulsants for seizures, for example, and the use of antidepressants for severe depression).
  • Steroids are used to rapidly reduce inflammation when necessary.
    • An important side effect of steroids and other immune-suppressing agents is an increase in the susceptibility to dangerous infections.
    • In pregnancy, the preferred steroid for the treatment of lupus is prednisone (Meticorten, Sterapred, Sterapred DS) because it crosses into the fetus much less than other steroid agents.
    • Steroids should not be stopped abruptly if you have been taking them for more than several weeks. Your health care professional will direct you how to taper the medicine.
  • If blood clots form spontaneously in the body, treatment with an agent that prevents clot formation is critical. For this reason, use of heparin or warfarin (Coumadin) is advised. In pregnancy, heparin is the agent of choice because of the adverse fetal effects of warfarin.
Medically Reviewed by a Doctor on 5/8/2014

Patient Comments

Viewers share their comments

Lupus - Symptoms Question: The symptoms of lupus can vary greatly from patient to patient. What were your symptoms at the onset of your disease?
Lupus - Treatments Question: What treatments have been effective for your lupus?
Lupus - Experience Question: Please describe your experience with lupus.
Lupus (Systemic Lupus) - Prevention Question: What prevention measures do you use to avoid getting lupus flares?