The most common presentation of Sjögren's syndrome involves dry eyes (xerophthalmia) and dry mouth (xerostomia), resulting from the immune system attacking moisture-producing glands, leading to decreased tears and saliva, causing burning, gritty sensations, and difficulty swallowing or speaking. These dryness symptoms are often accompanied by significant fatigue, joint pain, and can progress to affect other systems like skin, lungs, or kidneys.
The two main symptoms of Sjogren's syndrome are:
Patients with this level of disease may benefit from antibiotics or even a myringotomy tube (a tube placed in the eardrum to drain the middle ear). Dryness in the oropharynx due to Sjögren's can also potentially cause referred pain to the ears.
That being said, Sjögren's patients exhibit a variety of skin rashes that are important to recognize and know when to see a board-certified dermatologist. By and far the most common skin conditions associated with Sjögren's are xerosis, or clinically dry skin, and eczematous dermatitis.
In secondary Sjogren's syndrome, which accounts for over 50% of the cases diagnosed, other autoimmune diseases are present, including rheumatoid arthritis (20-30%), systemic lupus erythematosus (15-35%), systemic sclerosis (10-25%), and psoriatic arthritis.
Many of the autoimmune diseases that overlap with Sjögren's can cause the same symptoms. For example, overlapping diseases like lupus and rheumatoid arthritis can also cause fatigue or joint pain — symptoms that are common in Sjögren's. These similarities can make it challenging to diagnose overlapping diseases.
Nipocalimab is the first and only investigational therapy granted U.S. FDA breakthrough therapy designation for the treatment of adults living with moderate-to-severe Sjögren's disease [news release]. Johnson & Johnson. 2024 Nov 11.
This autoimmune disease, which primarily affects the eyes and mouth, can involve other organs and systems that require a variety of treatments. Most people, if they're familiar with Sjögren's at all, think of it as a disease that makes the mouth dry and the eyes gritty.
These rashes can appear as raised bumps, scaly patches, or blisters. Sensitivity to touch. Touching the affected area may elicit tenderness or discomfort. Spreading or changing shape.
Drag moisture into your skin by using products that contain chemicals such as urea, glycerin, lactic or similar “metabolic” or alpha-hydroxy acids, such as AmLactin® cream or Carmol® and Cerave (a dermatologist recommended body cream specifically for severely dry skin).
Conclusions We found higher prevalence of hearing loss, vertigo, tinnitus and sudden deafness among patients with Sjögren's syndrome relative to comparison patients.
Symptoms Of AIED
Patients may feel fullness in the ear and experience vertigo. In addition, a ringing, hissing, or roaring sound in the ear may be experienced. Diagnosis of AIED is difficult and is often mistaken for otitis media until the patient develops a loss in the second ear.
Primary Sjögren's syndrome is an immune systemic disease, involving many organs including the central nervous system. Headaches are common in Sjögren's, estimated to occur in 50% to 75% of patients.
Specific Tests for Sjögren's Syndrome
Your doctor may recommend some or all of the following tests: Blood and urine tests, to look for the presence of antibodies common in Sjögren's syndrome. The results of an ANA (antinuclear antibody) test will determine if you have an autoimmune disorder.
The shoulders, hips and knees may also be painful. Some patients with Sjögren's disease may have joint paint as a result of fibromyalgia. In general, the pain of fibromyalgia arises from the muscles, although it may be perceived as coming from the joints.
Saliva helps reduce the acidity of your stomach, so acid reflux can be common in people with Sjögren's syndrome. Normally, people can treat their symptoms the same way as those without Sjögren's syndrome, such as watching what they eat and using nonprescription medications.
Early lupus warning signs often mimic other illnesses, but key indicators include extreme fatigue, fever, joint pain/swelling, skin rashes (especially a butterfly-shaped rash on the face), hair loss, and sensitivity to sunlight, alongside potential issues like headaches, mouth sores, and fingers/toes turning white or blue in the cold (Raynaud's). These symptoms can appear suddenly or slowly and come and go in flares.
Skin changes.
A violet-colored or dusky red rash appears, most often on the face and eyelids and on the knuckles, elbows, knees, chest and back. The rash may be harder to see on Black skin or brown skin. The rash is often the first sign of dermatomyositis. It may hurt and itch.
The main symptoms are dry eyes and mouth, but other parts of the body may be affected as well, with many people reporting fatigue and joint and muscle pain. In addition, the disease can damage the lungs, kidneys, and nervous system. Sjögren's disease predominantly affects women.
Sjögren's can affect the respiratory system in many patients — including your sinuses, trachea (windpipe), and lungs. Symptoms can include: Dry nose and sinuses.
There are a range of skin conditions that Sjögren's patients might have, including: Xerosis: very dry skin that may be red, scaly, or cracked — especially on the legs, arms, or around the waist.
Nipocalimab is the only investigational treatment to be granted Breakthrough Therapy Designation by the U.S. Food and Drug Administration (FDA) for SjD (November 2024). It also received Fast Track Designation by the U.S. FDA earlier this year in April 2025.
Corticosteroids, a class of drugs that includes prednisone, are fast-acting and may be highly successful in halting severe symptoms of Sjögren's and/or a flare.
Start with five minutes of aerobic exercise daily (e.g. walking, biking, running, elliptical, treadmill) and increase the duration by an additional two-to-three minutes each month up to a maximum of 25 minutes daily. If you have a heart or lung condition, consult your doctor first.