It might seem counterintuitive to flare while on steroids, since steroids are often used to *treat* flares. But there are a few reasons this can happen.
Over time, the body can develop tolerance or resistance to steroids, meaning they become less effective. This can be related to changes in DNA that make some people less Show Full Answer
It might seem counterintuitive to flare while on steroids, since steroids are often used to *treat* flares. But there are a few reasons this can happen.
Over time, the body can develop tolerance or resistance to steroids, meaning they become less effective. This can be related to changes in DNA that make some people less sensitive to the medication from the start. Long-term steroid use can also lead to dependence, where the adrenal glands slow down or stop producing cortisol naturally. If the dose is reduced too quickly, the body may struggle to compensate, which can trigger a flare.
This is why doctors use a gradual tapering process rather than stopping steroids suddenly. It's also worth noting that steroids don't address the root cause of lupus — they mainly manage inflammation. So other triggers like stress, sun exposure, hormonal changes, or infections can still cause a flare even while on steroids.
If flares are happening despite steroid treatment, a doctor may consider adding or adjusting other medications such as:
- Hydroxychloroquine (Plaquenil) — an antimalarial that helps control lupus activity
- Immunosuppressants like azathioprine or mycophenolate mofetil
- Biologic drugs that target specific parts of the immune system
It's always worth having an open conversation with a rheumatologist if flares are continuing despite treatment.
July 18
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