Each person with Sjögren’s experiences the disease differently. Some Sjögren’s patients have challenges with their skin, hair, and nails. Most skin issues seen in people with Sjögren’s are common conditions that can happen for many reasons (such as dry skin) but for people living with Sjögren’s, these conditions can be heightened or more severe. It is important to note that skin, hair, and nail symptoms cannot diagnose Sjögren’s on its own, but can be added to support a diagnosis.
Caring for Your Skin, Hair, and Nails When You Have Sjögren’s Disease
Sjögren’s disease causes inflammation that can damage the glands in the body that produce moisture — including the glands that produce sweat and oil. When sweat and oil glands are impacted by Sjögren’s, it causes dryness that can lead to problems with the skin, hair, and nails. While dryness is the most common cause of skin, hair, and nail problems, other Sjögren’s disease factors, such as sun sensitivity and certain medicines, can also play a part.
Sjögren’s patients may experience a range of skin, hair, and nail issues. And these issues can affect how you feel or look and can have a big impact on your daily life, well-being, and self-esteem.
If you have Sjögren’s, you can take steps that may help you protect your skin, hair, and nail health — and manage problems if they happen.
Skin and Sjögren’s Disease
Skin problems related to Sjögren’s affect about half of all Sjögren’s patients. 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
- Atopic dermatitis: skin rash that’s dry, itchy, or inflamed
- Chronic pruritus: itchy skin
- Urticaria (hives): raised, itchy, red bumps
- Notalgia paresthetica: a type of nerve damage that causes itchy skin and most commonly affects the back or shoulder blades
- Vasculitis: blood vessels beneath the skin that become swollen, irritated, or painful — vasculitis often causes purpura (purple rash, spots, or patches on the skin that form when blood vessels beneath the skin leak blood)
- Erythema nodosum: red, tender lumps, usually on the lower legs
- Annular erythema: raised, circular, red or pink patches on the skin that often appear on the legs, but may also appear on the face, trunk, or arms
- Localized cutaneous nodular amyloidosis: yellow or red bumps that form just under the skin, usually on the face, scalp, arms, or legs. These bumps are rare but occur more often in people who have Sjögren’s than in the general population.
- Dermatofibromas: harmless, firm bumps that may present a small dimple when squeezed. These are common in adults, and most are simple benign growths. However, people who have an underlying autoimmune condition may be more susceptible to having many.
- Vitiligo: involves areas of lost skin pigment. It is more common in people who have autoimmune conditions, including Sjögren’s.
Some problems — like dry skin — are very common among Sjögren’s patients. Others happen less often. Many Sjögren’s patients share that certain rashes, such as hives, can be triggered by sun and/or heat exposure.
Skin symptoms can sometimes be a sign of another health problem. If you notice any new skin symptoms — or if an existing problem gets worse — be sure to talk to your primary care doctor, a rheumatologist (a doctor that treats conditions like Sjögren’s), or a dermatologist (a doctor that treats the skin). They can help you find out what might be causing the problem and can give you advice for managing it.
Learn more about skin problems and Sjögren’s:
Skin Care Tips
If you have Sjögren’s, it’s important to take steps to protect your skin and know when a skin issue needs medical attention.
Try these tips to help you manage dry skin:
- Protect your skin when you shower. Use lukewarm water, keep your shower to 10 minutes or less, choose a gentle soap (one that’s fragrance free, labeled as “mild,” or recommended for sensitive skin), and use a washcloth lightly on your skin or only on your groin, armpits, and feet. Hot water, long showers, harsh soaps, and excessive skin scrubbing can dry out or damage the skin when you have Sjögren’s.
- Moisturize your skin regularly. After you shower or bathe, gently pat your skin with a towel. Apply a moisturizer while your skin is still damp. Choose a thicker moisturizer, like a skin ointment or cream, which work better than lotions to trap moisture in your skin.
- Try products that include “humectants.” Humectants can help pull moisture into the skin. Some skin care products include humectants like urea, glycerin, hyaluronic acid, and lactic acid.
- Avoid using fabric softeners on your clothes. The dyes and fragrances in fabric softeners can irritate the skin. You may also want to consider detergents made for sensitive skin that do not have fragrance.
- Use a humidifier. Humidifiers add moisture to the air and can help keep the skin from drying out. They are helpful in any season, but especially in the winter when the air is drier, and if you have a type of heating called forced-air heat. Humidifiers can help with other Sjögren’s symptoms too, like dry eyes and dry nose. Choose a humidifier that is easy to clean, use distilled water, and clean it regularly with vinegar to reduce mineral buildup and bacteria.
- Moisturizing nasal sprays and a small amount of ointment inside the nostrils at bedtime may help keep the nasal passages comfortable.
- Protect your skin from UV (ultraviolet) light. The sun is the main source of UV light. Wear a hat and ultraviolet (UV)-protective clothing, apply broad spectrum sunscreen to skin not covered by clothes, and consider using UV-protective tinting or film in your car and home windows. These steps can also help you prevent rashes that can be caused by sun and heat.
Get more tips for caring for your skin:
Some skin problems may be signs of more serious problems or may be difficult to manage on your own. Talk to a dermatologist or another doctor if you have:
- Purpura or other signs of vasculitis, such as fever or joint pain and swelling. Doctors can diagnose and help you manage vasculitis. For example, they can prescribe medicines called corticosteroids that can help control inflammation and stop purpura from getting worse and speed the healing process.
- Rashes or hives, especially if they’re new. Rashes and hives can often get better on their own. But it’s still important to talk with a doctor when a rash or hives first appear, or if they’re not getting better. Doctors can prescribe a steroid cream or ointment to help speed healing. If a red or purple bump lasts longer than 24 hours, burns instead of itches, or leaves a stain on the skin when it fades, this may be a type of vasculitis and should be evaluated.
- Any skin problems or symptoms that are difficult to manage. Your doctor can give you advice and recommend steps you can take to care for your skin.
Hair and Sjögren’s Disease
Some people with Sjögren’s find their hair to be dry or dull-looking. And some Sjögren’s patients may also experience hair problems like:
- Dry and brittle hair
- Alopecia: hair loss or thinning
- Telogen effluvium: excessive hair shedding
It’s important to know that Sjögren’s might not always be the underlying cause of these hair problems. If you have Sjögren’s and you notice changes to your hair, talk with your doctor. They can check for other possible causes of these problems, such as medicines that you’re taking.
Your doctor can also give you advice about treatment. Telogen effluvium usually goes away on its own after a few months and may not need to be treated. Treatment for alopecia depends on how severe the problem is and how much it bothers you. Treatment may include:
- Over-the-counter hair loss treatments, such as Rogaine (generic name: minoxidil)
- Injections of platelet-rich plasma (PRP) to encourage hair growth; PRP treatment is often given in a series of sessions over several months, followed by maintenance sessions.
- Hair transplants
Hair Care Tips
If you have Sjögren’s, use these tips to prevent hair damage and keep your hair as healthy as possible:
- Be gentle when brushing or combing your hair. Use a soft bristled brush or wide tooth comb and avoid pulling on your hair more than you need to, as this can cause hair to fall out. Brush your hair only as much as needed to style it.
- Use a gentle shampoo and a moisturizing conditioner for dry, brittle hair. You can still shampoo your hair regularly if you have hair loss but choose a gentle cleanser. Look for labels like “sulfate free,” “hypoallergenic,” or “sensitive scalp.” Follow it up with a moisturizing conditioner. You can also try using a leave-in conditioner for extra moisture. If your hair is thin, try shampoos and conditioners that add volume and moisturize with natural ingredients such as oatmeal.
- Limit damage to your hair. Avoid washing your hair in hot water or using heat tools, like hair dryers, curling irons, or hair straighteners. Too much heat can damage and weaken your hair. If you can, avoid other hair treatments, like hair coloring or perming.
- Avoid tight braids, buns, or ponytails. Hairstyles that pull on your hair can make hair loss worse.
- Consider hair supplements. Certain supplements can support healthy hair, but be sure to talk to your doctor before trying them. For example, biotin (a common supplement) can affect lab results, so you should avoid taking it for a few days before any lab testing.
Nails and Sjögren’s Disease
Researchers are still working to find out how exactly Sjögren’s disease and nail problems are related. Experts do know that the dryness caused by the disease can affect nail health for people with Sjögren’s.
People with Sjögren’s disease may experience nail problems like:
- Dry, brittle nails that flake, break, crack, or crumble
- Ridges that run along the length of the nail
- Discolored nails that look yellow or greenish
- Thick, dry cuticles that are ragged and tear easily
- Redness around the nail (called periungual erythema)
- Fungal infections — people with autoimmune disorders like Sjögren’s are at higher risk for infections
If you notice changes to your nails, talk with your doctor about what might be causing these changes and how to manage them.
Nail Care Tips
If you have Sjögren’s disease, follow these tips for taking care of your nails:
- Keep your nails trimmed short. This can prevent your nails from snagging on things like fabric, which can cause them to break or tear.
- Avoid chemicals and products that can dry your nails. Nail polish, nail polish remover, artificial nails, and nail hardeners can dry out your nails and cause them to break. If you do wear nail polish, look for organic or formaldehyde free products, and be sure to moisturize your hands and nails well after removing the polish. Nail oils can also be helpful. And it’s best to give your nails a break before using nail polish again.
- Protect your hands and nails from water. Too much water can dry out your hands and nails. Wear rubber gloves to protect your hands while washing dishes or doing other cleaning tasks. And be sure to apply moisturizer after you wash your hands.
- Consider nail supplements. Biotin is a common supplement that can help with brittle nails. But it can also impact your lab results, so you should stop taking it a few days before any lab tests. Talk to your doctor before you start taking any supplements.