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Lupus and the Winter

For many people living with lupus, the cold months can bring more than frosty mornings – they can trigger fatigue, joint pain, skin irritation, and even flares. But winter doesn’t have to be a season of discomfort. Discover why lupus symptoms can get worse in colder weather, and practical tips to stay warm, active, and as healthy as possible.

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Introduction and Quick Facts!

Winter can be a time of cozy blankets, warm drinks, and festive celebrations, but for many people living with lupus, it can also bring an increase in symptoms. The colder months often mean more fatigue, more joint and muscle pain, and, for some, the risk of lupus flares. While not everyone with lupus experiences worsening symptoms in winter, those who do know how disruptive it can be. Understanding why this happens and learning ways to manage symptoms can make a significant difference in staying comfortable and healthy throughout the season.

Here Are Some Quick Facts!

  • Cold weather, of course, does not cause lupus, but it can worsen symptoms for many.
  • Joint pain and stiffness often increase during the winter because cold temperatures can affect circulation and trigger inflammation.
  • Some people experience more fatigue and depression in winter due to reduced sunlight and seasonal mood changes.
  • Raynaud’s phenomenon is more common among lupus patients, and cold weather can significantly worsen these symptoms.
  • Winter can increase flare risk because infections, stress, and temperature changes all place added strain on the immune system.
  • Your skin can be more reactive in the winter, especially for those with cutaneous lupus, due to dry air and indoor heating.
  • You should never adjust lupus medications on your own, even if symptoms change seasonally … always consult your healthcare provider first!

For more of the science of winter and lupus, and for more tips on how to protect your health, read on!

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The Science: Why Lupus Symptoms Can Get Worse in Cold Weather

A combination of factors in the winter, like temperature and exposure to viral infections, can have a significant effect on a person’s health and in particular to those with autoimmune conditions like lupus.  Though these factors interact differently for each person, there are some medical details behind the symptoms that we all should know.

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Cold-induced Vasoconstriction:   Exposure to cold triggers vasoconstriction, which narrows blood vessels. For lupus patients, and especially those with Raynaud’s phenomenon, this can lead to pain, numbness, color changes in the fingers and toes, and increased inflammation. The moment you see color changes, warm your fingers or toes immediately – but do so safely!  For more on this, check out KFL’s article, “Lupus and Raynaud’s Syndrome.”

Additionally, reduced blood flow can also worsen joint and muscle stiffness.  These are not only uncomfortable, but can make falls more likely.

 

Immune System Shifts in Winter:  Your immune system actually behaves differently when it is darker and cold!

  • Less sunlight can lower vitamin D levels, which may impact immune regulation.
  • Higher viral activity stimulates the immune system and may trigger flares.
  • Shorter daylight hours can influence circadian rhythms, potentially altering inflammation.
  • Some studies suggest that immune cells may act more aggressively in the cold, which can activate autoimmune conditions like lupus.

 

Stress Hormones and Changes in Routine:  Holiday demands, work pressures, and family obligations often spike in winter. Stress hormones can influence inflammation, and chronic stress may increase flare frequency.

 

Dry Air and Skin Irritation:   Indoor heaters and cold outdoor air remove moisture from the skin. For people with cutaneous lupus, this dryness can worsen rashes, itching, or lesions.  Indoor humidifiers might be a good option in some climates.

 

Seasonal Affective Disorder (SAD):   Reduced light exposure can affect serotonin and melatonin levels, leading to increased fatigue, depression, or sleep disturbances—all of which can contribute to lupus flare-ups.  For more on SAD and lupus, check out our article, “Lupus and Seasonal Affective Disorder (SAD).”

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Tips to Help with Winter Symptoms

  1. Keep warm and protect your extremities.
    • Dress in layers that you can easily add or remove.
    • Wear gloves, warm socks, hats, and scarves—especially if you have Raynaud’s.
    • Use hand warmers or heated gloves when outside.
  1. Maintain healthy vitamin D levels.
    • Ask your doctor about testing your vitamin D levels.
    • Consider supplements if recommended.
    • Get brief periods of daylight exposure when possible.
    • For more details, read this KFL article, “Vitamin D Deficiency and Lupus.”
  1. Stay hydrated and moisturized.
    • Use gentle, fragrance-free moisturizers regularly.
    • Run a humidifier indoors to reduce dryness.
    • Drink water throughout the day – even if you feel less thirsty in winter. Want to learn more about lupus and hydration?  Check out KFL’s cleverly titled article, “Lupus and Hydration.”
  1. Support your immune system.
    • Stay current on recommended vaccines, including the flu shot.
    • Follow good handwashing and infection-prevention habits.
    • Eat a balanced diet rich in fruits, vegetables, whole grains, and lean protein.
  1. Incorporate gentle physical activity into your daily routine.

Low-impact exercise can reduce stiffness and improve mood. Here are some ideas to try:

Remember, always consult your doctor before beginning new exercise routines.

  1. Manage stress!!
    • Try relaxation techniques like breathing exercises or meditation.
    • Give yourself permission to say “no” when needed.
    • Pace yourself during busy holiday periods.  This can be very challenging, so KFL has an entire article devoted to
  1. Prioritize and schedule your sleep.
    • Keep a regular sleep-wake schedule.
    • Limit screen time before bed … and while in bed!
    • Keep your bedroom cool, but not cold.
  1. Track your symptoms.

Use a journal or app to note how weather, stress, and activity levels affect your symptoms. This information can help guide conversations with your healthcare team.

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Video: Seasonal Challenges of Living with Lupus

Here are more great tips, tricks, and valuable advice to get through the cold season, from Dr. Sharon Dowell, clinical rheumatologist and Medical Director of Rheumatology at NEA Baptist Memorial Hospital.

 

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In Conclusion

Winter can be a tough season for people living with lupus, but understanding why symptoms may flare and taking steps to protect your health can help you stay more comfortable throughout the colder months. By keeping warm, managing stress, supporting your immune system, and staying connected with your healthcare team, you can reduce the impact of winter on your lupus symptoms. Every person is unique, so it’s important to find the strategies that work best for your body and your lifestyle. With preparation, awareness, and self-care, winter doesn’t have to stand in the way of your well-being.

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References

Arthritis Foundation. (2021, October 6). Weather & arthritis connection. https://www.arthritis.org/health-wellness/healthy-living/managing-pain/understanding-pain/weather-arthritis-connection

Cleveland Clinic. (n.d.). Raynaud’s phenomenon. https://my.clevelandclinic.org/health/diseases/9849-raynauds-phenomenon

National Institute of Arthritis and Musculoskeletal and Skin Diseases. (n.d.). Lupus: Overview and treatment. National Institutes of Health. (URL not specified in your list.)

Mayo Clinic. (n.d.). Seasonal affective disorder (SAD). https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/symptoms-causes/syc-20364651

National Institutes of Health. (n.d.). Vitamin D and immune modulation. (URL not specified in your list.)

Centers for Disease Control and Prevention. (n.d.). Seasonal viruses and immune response. U.S. Department of Health and Human Services. (URL not specified in your list.)

American Academy of Dermatology Association. (n.d.). Winter skin care and autoimmune conditions. (URL not specified in your list.)

Johns Hopkins Medicine. (n.d.). Lupus and environmental triggers. (URL not specified in your list.)

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Author: Greg Dardis, MS      

Professor Dardis was the Chair of the Science Department at Marylhurst University and is currently an Assistant Professor at Portland State University and the American College of Healthcare Sciences.  His focus has been human biology and physiology with an interest in  autoimmunity.  Professor Dardis is also a former President of the Board of Directors of Kaleidoscope Fighting Lupus.

All images unless otherwise noted are property of and were created by Kaleidoscope Fighting Lupus. To use one of these images, please contact us at [email protected] for written permission; image credit and link-back must be given to Kaleidoscope Fighting Lupus.

All resources provided by us are for informational purposes only and should be used as a guide or for supplemental information, not to replace the advice of a medical professional. The personal views expressed here do not necessarily encompass the views of the organization, but the information has been vetted as a relevant resource. We encourage you to be your strongest advocate and always contact your healthcare practitioner with any specific questions or concerns.

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