From the Guidelines
Sun exposure can worsen symptoms for patients with Sjögren's syndrome, so limiting sun exposure and using sun protection is recommended. Many Sjögren's patients experience photosensitivity, where ultraviolet (UV) radiation can trigger or exacerbate skin rashes, joint pain, fatigue, and other systemic symptoms 1. This photosensitivity is particularly common in patients who have overlapping autoimmune conditions like lupus. To manage this, patients should apply broad-spectrum sunscreen with SPF 30 or higher every 2 hours when outdoors, wear protective clothing including wide-brimmed hats and UV-blocking sunglasses, and avoid peak sun hours between 10 AM and 4 PM.
Some key points to consider in managing Sjögren's syndrome and sun exposure include:
- The importance of patient education about the nature of the problem, aggravating factors, and goals of treatment 1
- The use of tear supplementation and stabilization, control of inflammation of the lacrimal glands and ocular surface, and possible stimulation of tear production as treatment options 1
- The potential for certain medications, such as hydroxychloroquine (Plaquenil) and certain NSAIDs like piroxicam, to increase photosensitivity, making sun protection even more crucial
- The biological mechanism involving UV radiation potentially triggering inflammatory responses and autoimmune activity by causing cellular damage and altering DNA, which can stimulate the immune system and worsen autoimmune reactions in Sjögren's patients
It's also important to note that patients with Sjögren's syndrome should be comanaged with a rheumatologist owing to the many possible comorbid systemic conditions 1. Diagnosis and treatment of underlying systemic immune disorders may decrease morbidity and may even be lifesaving 1.
Overall, limiting sun exposure and using sun protection is a crucial aspect of managing Sjögren's syndrome, and patients should be educated on the importance of this and other treatment options to manage their symptoms and prevent complications.
From the Research
Sun Exposure and Sjogren's Disease
- There is limited research directly addressing the impact of sun exposure on patients with Sjogren's disease.
- However, it is known that patients with Sjogren's syndrome often experience dry eyes (keratoconjunctivitis sicca) and dry skin (xeroderma), which may be exacerbated by environmental factors such as sun exposure 2, 3.
- Some studies suggest that patients with Sjogren's syndrome may be more susceptible to skin manifestations, including xeroderma and eyelid dermatitis, which could be worsened by sun exposure 2.
- Additionally, dry eyes associated with Sjogren's syndrome may be further irritated by sun exposure, leading to increased discomfort and risk of complications 4, 5.
- While there is no direct evidence on the effects of sun exposure on Sjogren's disease, patients with the condition are generally advised to take precautions to protect their skin and eyes from the sun, such as wearing sunglasses and using sunscreen 6.
Management of Sjogren's Disease
- Treatment of Sjogren's disease typically focuses on managing symptoms, such as dry eyes and dry mouth, and may include topical lubricants, anti-inflammatory therapy, and tear-conserving strategies 4, 5.
- Patients with Sjogren's syndrome are also advised to avoid exacerbating factors, such as wind, dust, and dry air, which may worsen dry eye symptoms 3, 4.
- New advances in ocular drug delivery and novel therapeutics may offer improved treatment options for Sjogren's syndrome dry eye disease in the future 6.