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Excessive Sweating and Lupus

Updated on January 24, 2022
Medically reviewed by
Ariel D. Teitel, M.D., M.B.A.
Article written by
Nyaka Mwanza


Excessive sweating, overheating, hot flashes, and extreme changes in body temperature are common symptoms of lupus — and especially so in systemic lupus erythematosus (SLE). SLE is the most common type of lupus, affecting around 70 percent of the estimated 1.5 million people with lupus in the United States.

“I go from freezing to burning and dripping sweat,” said a member of MyLupusTeam about their experiences with lupus.

Another member shared, “One moment I am so hot it feels like there is fire surging through my veins and my mouth feels like it’s melting lava. Then the next moment I am shivering cold.”

What Is Excessive Sweating?

Sweating is the body’s way of cooling itself. We usually sweat when we exert ourselves or when our environment is hot. Sweating can also be a response to stress or nervousness. Excessive sweating — called hyperhidrosis — is abnormal, profuse sweating that’s generally unrelated to heat or physical exertion. Excessive sweating can affect just some parts of the body, such as the palms of the hands. It also can make you sweat profusely all over. With hyperhidrosis, a person may sweat so much that it soaks through clothes or drips off the hands.

The Impact of Excessive Sweating

Excessive sweating can be uncomfortable and inconvenient. Additionally, sweating and swings in body temperature can add to the sleep problems that people with lupus often struggle with. Night sweats in particular can make getting a good night’s sleep next to impossible.

A MyLupusTeam member wrote, “I am waking up because I am freezing due to being soaked from head to toe with night sweats.”

Hyperhidrosis can also be embarrassing, affecting a person’s emotional health and social life. Having perpetually clammy hands or regularly sweating through one’s clothes can make going about your day-to-day activities (work, play, errands) especially challenging.

People who sweat excessively are also more prone to skin infections, further increasing the risk of infection that people with lupus face, due to the condition’s effects on the immune system.

What Causes Excessive Sweating in People With Lupus?

Excessive sweating can be a direct result of (or a primary symptom of) lupus. Lupus, however, is a complex and unpredictable condition. Excessive sweating may also be:

  • A side effect of medications
  • A symptom of menopause
  • An indication of a hormone imbalance
  • A symptom of another condition

"Does anyone get hot flashes? I have been experiencing them frequently lately and I’m not sure if it’s my new medicine or menopause," a MyLupusTeam member wrote.

Primary Lupus Symptom

Lupus can affect different organs and systems of the body. It often waxes and wanes in a cycle of remission and flare-ups, and it can range in severity. Possible symptoms of lupus — including anemia, joint pain, skin rashes, hair loss, and more — are numerous and vary greatly from person to person. Excessive sweating can be:

  • One of the first indications that a person has lupus
  • A sign that a lupus flare is coming
  • A result of lupus’ impact on the central nervous system (CNS)

Immune Response

Excessive sweating, especially night sweats, is a common symptom of a lot of autoimmune diseases, not just lupus. One effect of autoimmune conditions is an excess of nitric oxide in one’s body. Evidence shows that nitric oxide levels in the body are especially high during increased disease activity, such as lupus flares. Elevated nitric oxide levels can cause blood vessels in the skin to dilate (or widen), which brings more body heat to the surface. Temperature increases, flushed skin, and excessive sweating are often the result.

Central Nervous System

The autonomic nervous system is a part of the CNS. It controls processes and functions that we don’t have to think about doing, like breathing, heartbeat, regulating blood pressure, and controlling body temperature. When lupus affects the autonomic nervous system, it can cause a wide range of symptoms, including excessive sweating.

Hormonal Changes and Menopause

Ninety percent of people living with lupus are women, according to the Lupus Foundation of America. Therefore, researchers suspect hormones (especially estrogen) play a role in the onset and severity of lupus. Fluctuations in estrogen levels linked to puberty, menstruation, perimenopause, and menopause frequently cause hot flashes and excessive sweating.

“My whole body gets so hot that I feel like I want to jump out of my skin,” said one MyLupusTeam member about their hot flashes.

Early menopause happens more frequently among people with lupus than among those who don’t have the condition. Since hot flashes and sweating are signs of menopause, it can be hard to tell whether one’s excessive sweating is due to menopause, lupus, or something else entirely.

Hormone-related hot flashes and heavy perspiration can affect anyone, regardless of their sex. Hot flashes and sweating can be a sign of low testosterone levels in males.

Treatment Side Effect

Depending on the type of lupus you have, the symptoms, and their severity, your treatment plan may include a combination of several different medicines. Some medications commonly used to treat lupus include:

  • Antimalarial drugs, such as Aralen (chloroquine)
  • Corticosteroids, like prednisone
  • Immunosuppressants, including methotrexate
  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as naproxen

All medications come with the risk of side effects, so the more medications you take, the more likely you are to experience side effects. Some people find themselves using several different drugs to manage their lupus symptoms, other conditions they may have in addition to lupus, and the side effects of their medications. For example, drugs prescribed for depression, high blood pressure, hypertension, heart disease, kidney disease, and even seasonal allergies can cause hot flashes and overheating.

Complications, Conditions, or Other Diseases

Some people refer to lupus as “the great imitator.” That’s because its symptoms can mirror so many other diseases or health conditions. Excessive sweating could be a symptom of a co-occurring condition, a disease that a person has in addition to or as a result of lupus. Lupus nephritis, for example, causes kidney problems.

Fever and sweating, especially night sweats, may also be an indication of your body trying to fight off an infection. People with lupus may be more prone to secondary infections. This is especially true if your rheumatologist or other health care provider has you on disease-modifying antirheumatic drugs (DMARDs).

Autoimmune Diseases

Excessive sweating is a common symptom of autoimmune disorders such as rheumatoid arthritis, vasculitis, and, of course, lupus. Those with lupus are at higher risk of additional autoimmune diseases. In fact, 1 in 3 people with lupus also has at least one other autoimmune disorder.

Metabolic Disorders

Metabolic diseases, such as thyroid disorders and diabetes, are known culprits of causing temperature regulation or perspiration problems. Diabetes can damage blood vessels, nerves, and through that, sweat glands. This can limit the body’s ability to keep cool through sweating. Thyroid disorders are generally caused by having too much of the hormone thyroxine in the body. Hyperthyroidism can cause heat sensitivity and temperature dysregulation.

Ways To Manage Excessive Sweating

Fortunately, there are several ways to help manage excessive sweating in lupus. First and foremost, keeping your lupus well-controlled is the best way to manage your excessive sweating. This includes taking your medication as prescribed and adhering to your treatment plan.

Here are some other ways to stay on top of your lupus and sweating:

  • Avoid triggers that exacerbate your symptoms or cause flare-ups.
  • Dress comfortably in loose-fitting, breathable fabrics.
  • Limit sun exposure by staying indoors during peak sun hours and using a good sunblock with a high SPF.
  • Manage stress levels by seeing a therapist, practicing mindful meditation, and engaging in other proven stress-reduction techniques.
  • Stay away from alcohol and caffeine, both of which can cause sweating and hot flashes and worsen these symptoms.
  • Stay hydrated by drinking cool water throughout the day.

Tips for Staying Cool and Dry With from MyLupusMembers

Members of MyLupusTeam have shared the following suggestions for managing their sweating and hot flashes:

  • Take black cohosh supplements.
  • Use a cooling mattress, mattress covers, or sheets.
  • Drink cold water.
  • Use cold compresses or ice packs.
  • Consume cold treats like popsicles and smoothies.
  • Place a fan by the bed.
  • Turn down the air conditioner temperature before bed.

Talk with People Who Care

On MyLupusTeam, the social network and online support group for people living with lupus, members talk about a range of experiences — both medical and personal. Sweating is one of the most discussed topics.

Do you experience hot flashes or excessive sweating? How do you handle your hot flashes, heat sensitivity, and excessive sweating? Share your experiences in the comments below or join the conversation on MyLupusTeam.

All updates must be accompanied by text or a picture.
Ariel D. Teitel, M.D., M.B.A. is the clinical associate professor of medicine at the NYU Langone Medical Center in New York. Review provided by VeriMed Healthcare Network. Learn more about him here.
Nyaka Mwanza has worked with large global health nonprofits focused on improving health outcomes for women and children. Learn more about her here.

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