What do flares look like?: Understanding Exacerbations in Chronic Illness

October 1, 2025 •

4 min read

Chronic illnesses like rheumatoid arthritis and lupus are often characterized by periods of wellness and sudden exacerbations known as flares. Knowing what do flares look like is a crucial first step for anyone managing a long-term health condition, as symptoms can range from increased pain and fatigue to specific organ-related issues.

Quick Summary

Flares are periods of worsened symptoms in chronic conditions like autoimmune diseases. Their presentation varies depending on the illness and can include increased pain, severe fatigue, rashes, or digestive issues.

Key Points

Intense Fatigue: Unlike normal tiredness, flare-related fatigue is often debilitating and is not relieved by rest.
Variable Symptoms: While some systemic signs are common, the physical manifestation of a flare is unique to each illness, such as the skin plaques in psoriasis or the joint swelling in RA.
Inflammatory Markers: Systemic inflammation during a flare can cause non-specific symptoms like low-grade fever and a general feeling of being unwell (malaise).
Distinctive Rashes: Conditions like lupus and psoriasis have characteristic rashes that can indicate a flare is active, such as the butterfly rash or silvery-scaled plaques.
Effective Management: Management strategies include recognizing early warning signs, avoiding triggers, and working with a healthcare provider to adjust medication and other therapies.
Importance of Tracking: Keeping a symptom diary is crucial for understanding your body's specific flare patterns and communicating them effectively to your doctor.

A medical flare, or flare-up, is an episode of increased disease activity where symptoms of a chronic illness worsen after a period of relative stability. These episodes can be unpredictable and debilitating, making it difficult for individuals to perform daily tasks. While flares can feel similar across different conditions—often involving systemic symptoms like fatigue and malaise—the specific, disease-defining manifestations differ significantly.

Common Systemic Symptoms of a Flare

Many flares, regardless of the underlying condition, share a set of common, non-specific symptoms that signal increased inflammation in the body. Recognizing these can provide an early warning.

Intense Fatigue: This is often more severe than a person's baseline tiredness and is not relieved by rest. It can feel physically and mentally debilitating, making simple activities exhausting.
Malaise: A general feeling of being unwell, similar to having a mild flu. It indicates that the immune system is in a heightened state of attack.
Low-Grade Fever: A persistent, low-grade fever that isn't due to an infection is a common sign of a flare, especially in autoimmune conditions.
Changes in Mood: Increased irritability, anxiety, or depression can accompany a flare, driven by both the physical discomfort and the systemic inflammation.

Specific Flare Symptoms by Condition

Beyond the general systemic symptoms, flares present with unique characteristics depending on the specific chronic illness. Here is a breakdown of what a flare can look like for different conditions.

Rheumatoid Arthritis (RA)

An RA flare is characterized by an increase in inflammation affecting the joints.

Joint Pain, Swelling, and Tenderness: Typically affects the same joints on both sides of the body, such as fingers, wrists, and knees. Swelling is often visibly apparent.
Increased Joint Stiffness: Especially noticeable in the morning or after periods of rest, and may last for longer than usual.
Rheumatoid Nodules: In some cases, small, firm lumps can appear under the skin, most often near affected joints.

Systemic Lupus Erythematosus (SLE)

Lupus flares are known for their wide-ranging effects on the body, affecting many different systems.

Facial 'Butterfly' Rash: A distinctive, red, butterfly-shaped rash that covers the cheeks and bridge of the nose is a classic sign of a lupus flare.
Other Skin Lesions: Rashes and lesions may appear elsewhere on the body, often worsening with sun exposure.
Joint Pain and Swelling: Similar to RA, but can be asymmetrical and typically non-deforming.
Hair Loss (Alopecia): Flares can lead to patchy or generalized hair loss.

Psoriasis

Psoriasis flares are marked by changes to the skin and can also affect the joints.

Red, Scaly Plaques: The most common sign is the development of thick, red patches of skin, known as plaques, covered with silvery-white scales. On darker skin tones, these can appear purple or brown.
Itching and Burning: The affected skin can become intensely itchy or have a burning sensation.
Nail Changes: Pitting, discoloration, or separation of the nails from the nail bed (nail psoriasis) can occur.
Joint Pain (Psoriatic Arthritis): Some individuals experience inflammation and pain in the joints alongside their skin symptoms.

Inflammatory Bowel Disease (IBD)

IBD flares (Crohn's disease and ulcerative colitis) primarily affect the gastrointestinal tract but can also cause extraintestinal manifestations.

Gastrointestinal Distress: Includes increased abdominal pain, cramping, urgency of bowel movements, and diarrhea.
Ocular Inflammation: Conditions like episcleritis (red, sore eye) or the more severe uveitis (eye pain, light sensitivity, blurry vision) can signal an internal flare.
Skin Problems: Rashes and skin lesions can appear in conjunction with intestinal inflammation.

Comparison of Flare-Up Symptoms


Characteristic	Rheumatoid Arthritis (RA)	Systemic Lupus Erythematosus (SLE)	Psoriasis	Inflammatory Bowel Disease (IBD)
Primary System Affected	Joints	Multiple systems (skin, joints, organs)	Skin, joints	Gastrointestinal tract
Prominent Skin Signs	Rheumatoid nodules near joints	Facial 'butterfly' rash, other lesions with sun sensitivity	Red/purple plaques with silvery-white scales	Various rashes, can be less specific
Primary Pain Location	Joints, often symmetrically	Joints, often asymmetrically, and other areas	Itchy skin, painful joints (PsA)	Abdominal cramping and pain
Other Unique Signs	Prolonged morning stiffness	Oral ulcers, hair loss	Nail pitting, specific rash types	Eye inflammation (uveitis, episcleritis)

How to Manage a Flare-Up

Identifying a flare is the first step toward effective management. Treatment often involves a multi-pronged approach tailored to the specific condition.

Rest and Gentle Activity: Rest is crucial to conserve energy, especially with intense fatigue. Gentle exercise can help with stiffness but should not exacerbate symptoms.
Medication Management: This is often the most important step. For some flares, a short course of corticosteroids may be needed to reduce severe inflammation. For persistent or severe flares, a healthcare provider may need to adjust long-term medication (e.g., DMARDs or biologics).
Trigger Avoidance: Identifying and avoiding personal triggers—which can include stress, poor sleep, certain foods, or overexertion—is key to prevention.
Heat and Cold Therapy: For conditions like RA, ice can help reduce acute swelling, while heat can ease stiffness.
Monitor and Communicate: Keep a symptom diary to track changes in severity, duration, and frequency. This information is invaluable for your healthcare provider in adjusting your treatment plan.

Conclusion

Learning what do flares look like is a vital part of managing a chronic illness and improving one's quality of life. The specific signs and symptoms of a flare vary widely depending on the underlying condition, from the characteristic butterfly rash of lupus to the joint swelling of rheumatoid arthritis and the plaques of psoriasis. Recognizing the general systemic signs like extreme fatigue, fever, and malaise is also critical for early intervention. By understanding the unique manifestations of their disease, individuals can better anticipate, manage, and communicate their needs with their healthcare team. Early and proactive management of flares can help mitigate their severity and duration, preventing further complications.

Note: This article is for informational purposes only and does not constitute medical advice. Consult a healthcare professional for diagnosis and treatment. For more information on autoimmune disorders, consider resources from the Cleveland Clinic, a recognized leader in healthcare.

Frequently Asked Questions

A medical flare-up is a period when the symptoms of a chronic disease suddenly get worse after a time of relative stability. It represents an increase in disease activity and inflammation in the body.

While a flare can feel like a flu-like illness (malaise, fever), it is caused by the underlying chronic condition, not an infection. Specific disease symptoms, such as joint swelling or a distinctive rash, will typically worsen during a flare.

No, the severity, duration, and specific symptoms of a flare can vary greatly from person to person, even with the same disease. Genetics, triggers, and the affected body systems play a role.

Common triggers for flares include emotional and physical stress, infections, overexertion, weather changes, and poor sleep. Avoiding known triggers can help reduce the frequency of flares.

The duration of a flare varies widely, from a few days to several weeks or even months. Consistent management and working with a healthcare provider are important for shortening their duration.

While mild flares can often be managed at home, it is important to contact a healthcare provider for severe flares, new symptoms, or if a flare is not responding to typical self-management strategies. A doctor can help determine if a medication adjustment is needed.

A flare is an active period of increased disease symptoms, while remission is a period when symptoms lessen or disappear completely. The goal of most treatments is to achieve and maintain remission.