--- title: "Lupus: Symptoms, Causes & NHS Treatment | HealthAnswers" description: "Lupus (SLE) — butterfly rash, joint pain, fatigue, diagnosis with blood tests, and NHS treatment with hydroxychloroquine and specialist care." url: https://healthanswers.co.uk/conditions/lupus/ robots: noindex --- # Lupus: Symptoms, Causes & NHS Treatment | HealthAnswers Health A–Z Lupus (SLE) — butterfly rash, joint pain, fatigue, diagnosis with blood tests, and NHS treatment with hydroxychloroquine and specialist care. Written by HealthAnswers editorial team Medically reviewed by [HealthAnswers UK doctor review panel](https://healthanswers.co.uk/our-doctors/) Reviewed 3 July 2026 ## Quick answer What is lupus? Systemic lupus erythematosus (SLE) is an autoimmune disease where the immune system attacks healthy tissues — causing joint pain, skin rashes (often butterfly-shaped across cheeks), fatigue, and flares triggered by sun exposure. Diagnosis combines symptoms with blood tests including ANA antibodies. Hydroxychloroquine is cornerstone treatment; flares need specialist management. See a GP if you have persistent joint pain with rash or sun sensitivity. ## Who is this page for? This page is for people in the UK who want a plain-English overview of Lupus, including when to seek help and what NHS care usually involves. It explains general information, not what is wrong with you personally. ## Who should skip this page? Skip this page if you need a diagnosis, a prescription, or emergency care. It cannot replace a GP, pharmacist, NHS 111 or 999. If you are in immediate danger, call 999; for urgent advice that is not life-threatening, call 111 in England, Scotland or Wales, or use your GP out-of-hours service in Northern Ireland. On this page 9 sections ## Key facts about lupus - Lupus affects roughly 1 in 1,000 people in the UK — women far more than men, often diagnosed aged 15 to 45. - Classic malar (butterfly) rash across cheeks and nose worsens with UV light — sun protection is essential. - ANA test is sensitive but not specific — diagnosis requires clinical pattern plus other antibodies. - Hydroxychloroquine reduces flares and long-term damage — requires eye screening. - Lupus can affect kidneys, brain, and blood — severe organ involvement needs urgent rheumatology. ## Lupus — systemic lupus erythematosus (SLE) **Systemic lupus erythematosus (SLE)** — commonly **lupus** — is a **chronic autoimmune disease** where the immune system produces **antibodies that attack the body’s own tissues**. It can affect **skin, joints, kidneys, brain, heart, lungs, and blood** — in **unpredictable flares and remissions**. Affects roughly **50,000 people** in the UK — **women 9 times more** than men — often starting **15 to 45 years**. ## Symptoms — highly variable **Common:** - joint pain and swelling — hands, wrists, knees - extreme fatigue - photosensitivity — rash after sun - butterfly (malar) rash — cheeks and nose - oral ulcers - hair loss — non-scarring - Raynaud’s — fingers white/blue in cold - fever during flares - chest pain — pleurisy or pericarditis **Organ involvement (serious):** - lupus nephritis — protein/blood in urine, swollen ankles - neuropsychiatric lupus — seizures, psychosis, severe headache - anaemia , low platelets , low white cells - deep vein thrombosis — antiphospholipid syndrome overlap **No two patients identical** — mild skin/joint disease to life-threatening renal crisis. ## Diagnosis **No single test.** Rheumatology uses **2019 EULAR/ACR criteria** combining: **Blood tests:** - ANA — positive in ~98% of SLE but also in other conditions - anti-dsDNA — more specific; tracks disease activity - anti-Smith — highly specific but not sensitive - low complement (C3, C4) during active disease - FBC , ESR/CRP , urinalysis , creatinine **Biopsy:** - skin — discoid lupus - kidney — lupus nephritis classification guides treatment **Average time to diagnosis** — years historically — improved with awareness. ## Triggers and flares - UV light — primary avoidable trigger - infections - stress - pregnancy and postpartum - smoking — worsens disease - medicines — procainamide, hydralazine, isoniazid — drug-induced lupus (usually resolves on stopping) ## Treatment ### Everyone with SLE (unless contraindicated) **Hydroxychloroquine:** - reduces flares, protects organs, improves survival - annual eye screening — rare retinopathy ### Flares - NSAIDs — joint pain - steroids — prednisolone — bridge or severe flare - immunosuppressants — azathioprine, mycophenolate, methotrexate - biologics — belimumab, rituximab — specialist ### Lupus nephritis **Aggressive immunosuppression** — mycophenolate or cyclophosphamide — nephrology-rheumatology joint care. ### Antiphospholipid syndrome **Anticoagulation** — aspirin or warfarin — prevents clots. ## Sun protection — non-negotiable - SPF 50 , reapply - hat, long sleeves - avoid midday sun - UV is a flare trigger even through clouds ## Pregnancy and lupus **High-risk pregnancy** — specialist care: - disease must be quiescent before conception - some medicines teratogenic — plan with rheumatology - flares can occur postpartum Many women with mild-moderate SLE have **healthy pregnancies**. ## Lupus vs rheumatoid arthritis | | Lupus | RA | | --- | --- | --- | | Rash, sun, kidneys | Common | Unusual | | Joint erosions | Less typical early | Classic | | ANA | Usually positive | Usually negative | Both need rheumatology — can overlap. ## Living with lupus - Lupus UK — support, benefits advice - vaccinations — flu, pneumococcal; avoid live vaccines if immunosuppressed - cardiovascular risk — manage BP, cholesterol, stop smoking - fatigue management — pacing Lupus is **serious but manageable** — modern treatment means most people live full lives; **sun protection and hydroxychloroquine** are foundations, not afterthoughts. ## ! When to see a GP about lupus See a GP for persistent joint pain with rash, mouth ulcers, sun-sensitive skin, or unexplained fatigue and fever. Urgent assessment for blood in urine, severe headache with vision changes, chest pain, or breathlessness — possible lupus affecting kidneys, brain, or lungs. Rheumatology referral for suspected SLE — do not rely on internet symptom checkers alone. ## Common questions about lupus What are the first signs of lupus? Joint pain and swelling, extreme fatigue, butterfly rash on face, photosensitivity (rash after sun), mouth ulcers, hair loss, and fever. Symptoms flare and remit — can mimic other conditions. Diagnosis often takes time — track symptoms for GP. Is lupus fatal? Most people with lupus live normal or near-normal lifespans with modern treatment. Severe organ involvement (lupus nephritis, brain, severe blood disorders) increases risk — early specialist care improves outcomes. Leading causes of death are infection and cardiovascular disease — manage risk factors. What is the butterfly rash in lupus? Red or purple rash across cheeks and bridge of nose sparing nasolabial folds — classic but not everyone gets it. UV light triggers or worsens — high SPF, hats, shade essential. Discoid lupus causes scarring skin patches without full systemic disease in some people. How is lupus diagnosed? Clinical history, examination, blood tests — ANA (often positive), anti-dsDNA, anti-Smith, complement levels, FBC (low WCC/platelets), urinalysis for protein/blood. Skin or kidney biopsy in selected cases. Rheumatology confirms using classification criteria — not one test alone. What triggers lupus flares? UV sunlight, stress, infections, pregnancy, some medicines (procainamide, hydralazine — drug-induced lupus). Hormonal changes — oestrogen may play a role. Not all flares have clear trigger. Can you work with lupus? Many people work full time between flares — flexible arrangements help. Fatigue and joint pain are main workplace challenges — occupational health and rheumatology support adjustments. ## Sources - [NHS — Lupus](https://www.nhs.uk/conditions/lupus/) - [NICE — SLE management](https://www.nice.org.uk/guidance/ng93) - [Lupus UK](https://www.lupusuk.org.uk/)