The term “sicca,” derived from the Latin word for “dry,” is used in a medical context to describe a specific pattern of symptoms. When clinicians refer to sicca syndrome, they are describing persistent dryness, most notably affecting the eyes and mouth. This condition is not a disease in itself but rather a collection of symptoms that points toward an underlying issue with the body’s moisture-producing glands. Understanding sicca syndrome begins with recognizing this characteristic dryness as a sign that requires further investigation to determine its origin.
Hallmark Symptoms of Sicca
The defining symptom of sicca syndrome is a persistent lack of moisture, primarily affecting the eyes, a condition known as keratoconjunctivitis sicca. This often manifests as a gritty or sandy sensation, as if a foreign object is in the eye. Sufferers may also experience burning, itching, redness, and sensitivity to light. Vision can be intermittently blurred, and the eyes may appear red due to the lack of a protective tear film.
This ocular dryness is frequently accompanied by a lack of saliva, a condition called xerostomia. The mouth may feel chalky or full of cotton, making actions like speaking or swallowing difficult, especially with dry foods. Individuals often feel an incessant need to sip liquids to find relief. This can also lead to a diminished or altered sense of taste and contribute to oral health problems.
Beyond the eyes and mouth, sicca can manifest in other parts of the body, indicating a more widespread issue. Some individuals experience a persistent, dry cough as the mucous membranes of the airways are affected. It is also common for patients to report dry skin or vaginal dryness. Systemic symptoms such as unexplained fatigue and persistent joint pain can also be part of the clinical picture, signaling that the underlying cause may be affecting the entire body.
Underlying Causes and Associated Conditions
Sicca symptoms are a signal that the body’s moisture-producing glands are not functioning properly, often due to an underlying medical condition or external factor. A primary cause is autoimmune disease, where the body’s immune system mistakenly attacks its own tissues. Sjögren’s syndrome is the autoimmune condition most linked to sicca, characterized by inflammation of the lacrimal (tear) and salivary glands. This condition is categorized as either Primary Sjögren’s, when it develops on its own, or Secondary Sjögren’s, when it occurs with another autoimmune disorder like rheumatoid arthritis or systemic lupus erythematosus.
Medications are another source of sicca symptoms. Drugs can cause dryness as a side effect. These include antihistamines and decongestants used for allergies and colds, certain antidepressants and antipsychotics, and medications prescribed to manage high blood pressure, such as diuretics. The dryness typically resolves if the medication is stopped, but this should only be done under a doctor’s guidance.
Other circumstances can also lead to the development of sicca. Patients who have undergone radiation therapy to the head and neck for cancer treatment may experience long-term damage to their salivary glands, resulting in chronic dry mouth. Certain infections and other medical conditions can also disrupt the normal function of these glands. While sicca is a common complaint, it is not always caused by an autoimmune disease.
The Diagnostic Process
Determining the cause of sicca syndrome involves an investigation by a healthcare provider. The process begins with a detailed discussion of the patient’s symptoms, overall health, and a review of their medical history, including all current medications. A physical examination will assess for visible signs of dryness in the eyes and mouth.
To quantify the level of dryness, specific tests are used. For the eyes, the Schirmer test measures tear production. This involves placing a small strip of filter paper inside the lower eyelid for a few minutes to see how much moisture it absorbs. For the mouth, a doctor might measure salivary flow rates by collecting saliva over a set period to assess gland function.
If an autoimmune condition is suspected, blood tests are ordered to screen for specific autoantibodies. The presence of antibodies such as antinuclear antibodies (ANA), anti-SSA/Ro, and anti-SSB/La are strong indicators of Sjögren’s syndrome. In some cases, to confirm a diagnosis of Sjögren’s, a minor salivary gland biopsy may be performed. This involves removing a tiny piece of tissue from the inside of the lip to be examined for inflammatory cells.
Management and Symptom Relief
Managing sicca syndrome focuses on alleviating the persistent dryness and preventing complications. The first line of defense involves over-the-counter (OTC) products designed to supplement the body’s moisture. For dry eyes, this includes artificial tears in drop, gel, or ointment forms. For dry mouth, saliva substitutes are available as sprays, gels, and lozenges to provide relief.
When OTC options are insufficient, a doctor may recommend prescription treatments. Medications, such as pilocarpine and cevimeline, can stimulate the glands to produce more saliva and tears. For significant eye inflammation, a physician might prescribe anti-inflammatory eye drops, such as cyclosporine or lifitegrast, to address the inflammatory process on the eye’s surface.
Lifestyle adjustments and home care play a part in managing symptoms. Because a dry mouth increases the risk of tooth decay, good dental hygiene is important. Helpful practices include:
- Using a humidifier at home to add moisture to the air.
- Avoiding dry, dusty, or windy environments.
- Maintaining oral hygiene with regular brushing, flossing, and dental check-ups.
- Staying well-hydrated throughout the day.