Sjögren's Syndrome Guide: Symptoms, Causes, Diagnosis, and Treatment

Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026

Quick Answer

Sjögren's syndrome is a chronic autoimmune condition in which the immune system attacks the glands that make moisture in the eyes and mouth, causing burning, gritty dry eyes and a cotton-dry mouth. It mostly affects people over 40 and far more often those assigned female at birth. Treatment includes prescription eye drops, saliva-boosting medicines and everyday self-care.

What the research says

• Sjögren's mainly affects women in midlife. A meta-analysis of 21 studies estimated about 61 cases per 100,000 people and 6.92 new cases per 100,000 each year. Women were affected about 10 times more often than men, and the average age was 56 (Qin et al., Annals of the Rheumatic Diseases, 2015) [10].

• Hydroxychloroquine did not ease the main symptoms. In a trial of 120 people with primary Sjögren's, 17.9% on hydroxychloroquine versus 17.2% on placebo improved in dryness, pain and fatigue after 24 weeks, showing no added benefit (Gottenberg et al., JAMA, 2014) [11].

• Primary Sjögren's syndrome is linked to a higher risk of non-Hodgkin lymphoma. A meta-analysis of 15 cohort studies (50,308 people) found a pooled standardized incidence ratio of 8.78 (95% CI 5.51 to 13.99), meaning about nine times the expected number of lymphomas. The ratio was 9.60 in women and 6.29 in men (Ansari and Salesi, Clin Rheumatol, 2024) [4].

What This Guide Is Based On

This guide is built entirely from specialist-reviewed clinical guidance, supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the American College of Rheumatology's Sjögren's disease overview, peer-reviewed research in Annals of the Rheumatic Diseases (the EULAR management recommendations, Ramos-Casals et al., 2020) and Clinical and Experimental Medicine (Negrini et al., 2022), and UpToDate's clinical review of diagnosis and classification (Baer). These peer-reviewed and institution-backed references are cited inline throughout, with the full list at the end of this guide [1] [2].

What Is Sjögren's Syndrome?

Sjögren (SHOW-grin) disease is a chronic condition of the immune system. It used to be called Sjögren syndrome — both names still circulate, so you will meet the condition under either label [1].

In autoimmune conditions, the body attacks its own tissues by mistake. Sjögren disease most often affects the glands that make moisture in the eyes and mouth, which causes fewer tears and less saliva [1].

There are two types. Primary Sjögren's develops on its own, while secondary Sjögren's is triggered by another condition, such as another autoimmune disease or certain viral infections [3].

The condition can happen at any age, but most people are older than 40 at the time of diagnosis, and it is much more common in people assigned female at birth. Sjögren disease may happen alongside other immune system conditions, most often rheumatoid arthritis and lupus, and treatment focuses on easing symptoms [1].

It usually develops between ages 45 and 55 [3].

What Are the Symptoms?

There are two main symptoms of Sjögren disease [1].

Dry eyes. The eyes might burn or itch, and they might feel as if they have sand in them [1].

Dry mouth. The mouth might feel as if it is full of cotton, and this may make it hard to swallow or speak [1].

Some people also have one or more additional symptoms, which are worth mentioning to your provider because they help complete the picture [1].

Other symptoms can include mouth sores, thick saliva, nosebleeds, sensitivity to light, muscle weakness and brain fog [3].

What Causes Sjögren's Syndrome?

Experts do not know what causes the immune system to attack the body in Sjögren disease [1]. Certain genes put people at higher risk of the condition, but it seems that an infection with a certain virus or strain of bacteria may bring it on [1].

Conditions that can trigger secondary Sjögren's include rheumatoid arthritis, psoriatic arthritis and lupus, and infections such as hepatitis C, Epstein-Barr virus and COVID-19 [3]. Having a biological family member with the condition also raises the risk [3].

Who Is Most at Risk?

Sjögren disease most often happens in people with one or more known risk factors [1].

What Complications Can It Cause?

The most common complications of Sjögren disease involve the eyes and the mouth [1].

Less common complications might affect other parts of the body [1]. Inflammation can cause pneumonia, bronchitis, or other issues in the lungs, can keep the kidneys from working as they should, and can cause the liver conditions hepatitis and cirrhosis. A small number of people develop lymphoma, a cancer of the lymph nodes. And nerves may be affected, causing numbness, tingling, and burning in the hands and feet — a condition called peripheral neuropathy [1].

How Is Sjögren's Syndrome Diagnosed?

Diagnosis involves a physical exam and certain tests, which can help rule out other conditions and pinpoint Sjögren disease [2].

Care often involves several specialists, including a rheumatologist, an eye doctor and a dentist [3].

One important first step is a medicine review: some medicines can cause dry mouth, including those taken for allergies and depression, so your healthcare professional will review what you take before going further [2].

From there, the provider may move through four types of testing [2]:

How Is Sjögren's Syndrome Treated?

Treatment depends on the parts of the body affected. Many people manage the dry eyes and dry mouth of Sjögren disease by using eye drops such as artificial tears and sipping water often, but some people need prescription medicines or surgical procedures [2].

There is no cure for Sjögren's [3]. Corticosteroids may also be used to treat pain and other symptoms [3].

Depending on your symptoms, your healthcare professional might suggest medicines that [2]:

Surgery. A minor procedure called punctal occlusion seals the tear ducts that drain tears from the eyes; collagen or silicone plugs placed in the ducts help save tears and may ease dry eyes [2].

What Home Remedies and Self-Care Help?

Many Sjögren disease symptoms respond well to self-care measures [2].

For dry eyes. Use artificial tears, an eye lubricant, or both. Eye lubricants are thicker than artificial tears and can blur your vision, so you might use them only before bedtime; you may need preservative-free artificial tears if preservatives irritate your eyes. Raise indoor humidity with a humidifier, keep air from blowing into your face (avoid sitting in front of a fan or air conditioning vent), and wear goggles or protective eyewear outdoors [2].

For dry mouth. Don't smoke, since smoking irritates and dries the mouth. Take sips of water throughout the day, and skip coffee and alcohol, which dry the mouth further; also avoid colas and some sports drinks, because the acid can harm the coating of your teeth. Sugarless gum or citrus-flavored hard candies can help saliva flow — but limit sweets and don't eat them between meals, since the condition raises your cavity risk. Artificial saliva in spray or lozenge form often works better than plain water, because it contains a lubricant that keeps the mouth moist longer. A nasal saline spray can moisturize and clear nasal passages so you breathe through your nose instead of your mouth, which increases dryness [2].

For oral health. Dry mouth increases the risk of dental cavities and tooth loss. Brush and floss after every meal, keep dental appointments at least every six months, and use daily topical fluoride treatments and antimicrobial mouthwashes [2].

For other dryness. Avoid hot baths and showers, pat the skin dry instead of rubbing, and apply an extra-dry-skin moisturizer while the skin is still damp. Use rubber gloves when washing dishes or housecleaning, use vaginal moisturizers and lubricants for vaginal dryness, and use lip balm for dry lips [2].

How Should You Prepare for Your Appointment?

Depending on your symptoms, you might start by seeing your family healthcare professional, dentist, or eye doctor, and in time you might see a rheumatologist — a doctor who specializes in arthritis and other inflammatory conditions [2].

Before the visit, make a list that includes your symptoms and when they began, other medical conditions you have, your and your family's medical histories, all medicines, vitamins, or supplements you take (including dosages), and questions to ask [2]. Suggested questions range from "What is likely causing my symptoms?" and "What tests do I need?" to "Am I at risk of long-term complications from this condition?" [2].

Your healthcare professional is likely to ask whether your symptoms follow a pattern — such as getting worse throughout the day or when you go outdoors — whether you have lasting conditions such as high blood pressure or arthritis, whether you recently started new medicines, and whether any close relatives have rheumatoid arthritis, lupus, or a similar condition [2].

Conclusion: Dryness Is the Signal — and Relief Is Within Reach

Sjögren (SHOW-grin) disease is a chronic autoimmune condition in which the immune system attacks the glands that make tears and saliva, producing the hallmark pair of dry eyes that burn or feel sandy and a dry mouth that feels full of cotton. The condition usually appears after age 40, affects far more women than men, and often travels with rheumatoid arthritis or lupus. Because some allergy and depression medicines mimic the dryness, diagnosis begins with a medicine review before moving to blood tests, the Schirmer tear test, gland imaging, and sometimes a lip biopsy. Treatment is built around the body parts involved — prescription eye drops, saliva-boosting pills, tear-duct plugs, and whole-body medicines like hydroxychloroquine — and the everyday habits matter just as much: sipping water often, keeping the air moist, protecting your teeth after every meal, and caring for dry skin, lips, and other affected areas.

If your eyes burn like sand, your mouth feels full of cotton, and the dryness is persistent — especially with joint pain, swollen glands near your ears, or fatigue — see a healthcare professional.

This guide is for general education only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions about a medical condition.

Frequently Asked Questions

What is Sjögren's syndrome?

Sjögren (SHOW-grin) disease — previously called Sjögren syndrome — is a chronic autoimmune condition in which the immune system attacks the glands that make moisture in the eyes and mouth, causing fewer tears and less saliva [1].

What are the main symptoms of Sjögren's syndrome?

Dry eyes that burn, itch, or feel as if they have sand in them, and a dry mouth that feels full of cotton and makes swallowing or speaking difficult [1].

Is Sjögren's syndrome the same as ordinary dry eyes or dry mouth?

Not necessarily — ordinary dryness can come from allergy or depression medicines and many other causes. If the dryness is persistent and comes with joint pain, swollen glands in front of the ears, skin rashes, or fatigue, a provider should investigate, because it may be autoimmune [1] [2].

Who gets Sjögren's syndrome?

Sjögren's syndrome can happen at any age, but it is mainly diagnosed in people older than 40 and is much more common in people assigned female at birth; it often occurs alongside rheumatoid arthritis or lupus [1].

How is Sjögren's syndrome diagnosed?

After a medicine review, diagnosis may include blood tests (antibodies, blood cells, inflammation, liver and kidneys), the Schirmer tear test with filter paper under the eyelid, imaging such as a sialogram or salivary scintigraphy, and sometimes a lip biopsy [2].

Is there a cure for Sjögren's syndrome?

There is no cure mentioned in the source material; treatment focuses on easing symptoms, matched to the body parts affected [1] [2].

What medicines treat Sjögren's syndrome?

Prescription eye drops (cyclosporine, lifitegrast), saliva-boosting pills (pilocarpine, cevimeline), NSAIDs or antifungals for complications, and whole-body medicines such as hydroxychloroquine or methotrexate [2].

What self-care helps at home?

Sip water often while avoiding coffee, alcohol, and acidic drinks; use artificial tears and lubricants; raise indoor humidity and wear eye protection outdoors; avoid smoking; stimulate saliva with sugarless gum; protect your teeth with fluoride and dental visits every six months; and moisturize dry skin while it is still damp [2].

Related Reading

Learn more in our guide to Rheumatoid Factor (RF) Test: Normal Range and What a Positive Result Means.

References

1. Mayo Clinic Staff. Sjogren disease - Symptoms & causes. Mayo Clinic. June 30, 2026. https://www.mayoclinic.org/diseases-conditions/sjogrens-syndrome/symptoms-causes/syc-20353216

2. Mayo Clinic Staff. Sjogren disease - Diagnosis & treatment. Mayo Clinic. June 30, 2026. https://www.mayoclinic.org/diseases-conditions/sjogrens-syndrome/diagnosis-treatment/drc-20353221

3. Cleveland Clinic. Sjögren’s Syndrome. Cleveland Clinic. December 23, 2025. https://my.clevelandclinic.org/health/diseases/4929-sjogrens-syndrome

4. Ansari N, Salesi M. The association between primary Sjögren’s syndrome and non-Hodgkin’s lymphoma: a systematic review and meta-analysis of cohort studies. Clin Rheumatol. 2024;43(7):2177-2186. PMID 38722505. https://doi.org/10.1007/s10067-024-06993-6

5. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Sjögren’s Disease. NIAMS. June 2024. https://www.niams.nih.gov/health-topics/sjogrens-disease

6. American College of Rheumatology. Sjögren's Disease. American College of Rheumatology. February 2025. https://rheumatology.org/patients/sjogrens-disease

7. Negrini S, et al. Sjögren's syndrome: a systemic autoimmune disease. Clinical and Experimental Medicine. 2021;22(1):9-25. PMID 34100160. https://doi.org/10.1007/s10238-021-00728-6

8. Ramos-Casals M, et al. EULAR recommendations for the management of Sjögren's syndrome with topical and systemic therapies. Annals of the Rheumatic Diseases. 2019;79(1):3-18. PMID 31672775. https://doi.org/10.1136/annrheumdis-2019-216114

9. UpToDate. Diagnosis and classification of Sjögren's disease. UpToDate. Accessed October 30, 2026. https://www.uptodate.com/contents/diagnosis-and-classification-of-sjogrens-disease

10. Qin B, et al. Epidemiology of primary Sjögren's syndrome: a systematic review and meta-analysis. Annals of the Rheumatic Diseases. 2015;74(11):1983-1989. PMID 24938285. https://doi.org/10.1136/annrheumdis-2014-205375

11. Gottenberg JE, et al. Effects of hydroxychloroquine on symptomatic improvement in primary Sjögren syndrome: the JOQUER randomized clinical trial. JAMA. 2014;312(3):249-258. PMID 25027140. https://doi.org/10.1001/jama.2014.7682