When ITP strikes back: Taking control of flare-ups
Last updated July 21, 2025, by Lisa Basile
Fact-checked by PatrÃcia Silva, PhD
Living with the autoimmune condition immune thrombocytopenia (ITP) — previously known as idiopathic thrombocytopenic purpura — can sometimes mean living with the possibility of an ITP relapse or flare-up. If you’ve been in remission for some time, this may be unsettling.
Understanding what ITP flare-up symptoms look like can empower you to take action and manage your symptoms more effectively. Some things you can do to improve your well-being include crafting a flare-up action plan and managing your stress levels.
What is an ITP flare-up?
Experts aren’t entirely sure what triggers ITP, but flare-ups are periods in which your symptoms reappear or worsen. Flare-ups are usually associated with a reduction in your platelet count, which can lead to bleeding and bruising.
In ITP, the immune system attacks the body’s platelets, and the condition can be either primary or secondary. Primary ITP is more mysterious, as the condition has no clear cause.
In secondary ITP, the condition is caused by something else, such as certain medications or other autoimmune diseases. Infections could also trigger an ITP flare-up. People with human immunodeficiency virus (HIV), an H. pylori infection, or hepatitis C seem to have an increased risk of developing ITP, for example. Researchers have also found that COVID-19 could trigger an ITP flare-up in people with a history of known ITP.
Early signs of a flare-up
ITP doesn’t always cause symptoms, so it’s important to see your healthcare provider to assess your ITP bleeding risk. Your doctor can monitor your platelet count, which can help you with managing ITP flares.
Because ITP causes bleeding, you’ll want to be on the lookout for nosebleeds, bleeding gums, new reddish, purple, or brownish-yellow bruises, or tiny, flat, reddish-purple spots. You may also find a hematoma, which is a lumpy spot of clotted blood under the skin.
If you menstruate, your period might suddenly get much heavier, which can clue you into a possible change in your disease activity.
Sudden tiredness might also be a sign that a flare-up is coming. Fatigue is a common symptom of ITP, especially if you’re experiencing a flare-up. In fact, researchers have found that between 22% and 58% of people with ITP experience severe fatigue.
Creating a flare-up action plan
Experiencing a sudden flare in your ITP symptoms can be challenging, but creating an action plan for times of increased disease activity can help you manage ITP flares and reduce anxiety around the experience.
Track your symptoms
Keep track of any symptoms that occur, along with when they first began. Be sure to note any new medications, surgeries, or activities you may have been involved with. Share these notes with your healthcare provider so they can get a better picture of your health.
Make an appointment with your doctor
If you have any new bruises or spots, make an appointment to have your platelet levels checked. Ask your doctor if there are any medications you might need to take or stop taking.
Know when to go to the ER
ITP emergency care may be needed if you experience bleeding that you can’t stop with pressure (a rare occurrence).
Pause high-risk activities
You may want to avoid contact sports or other activities that can cause injury until your doctor gives you the green light again.
Lean on your support system
Getting support from trusted friends or other people with ITP is crucial. You may experience physical, emotional, or social challenges with ITP, so turning to support groups during flare-ups can help you find and connect with others who understand.
Wear medical alert jewelry
If you need medical attention, medical alert jewelry will inform your healthcare providers that you have ITP.
Managing stress
A little stress is an unavoidable part of daily life, but when stress becomes chronic, it can start to affect the immune system. This is where ITP stress management comes into play.
There is no one-size-fits-all approach to stress management, but there are plenty of tools available to people with ITP. The Platelet Disorder Support Association recommends:
- meditation
- self-hypnosis
- breath work
- yoga
- relaxation techniques, such as autogenic training (which relies on verbal self-suggestions to induce body relaxation).
If you like to get creative, journaling or painting are also great ways to refocus the mind.
While you can’t always predict when an ITP flare-up will happen, being prepared can make a big difference. With the right action plan, safe activity choices, and stress management strategies, you can stay in control and support your overall well-being, even during uncertain moments.
Bleeding Disorders News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
