Hyperhidrosis is a medical condition that causes excessive sweating. Hyperhidrosis means too much sweating (hidrosis). People who have hyperhidrosis sweat from one or two areas in the body. Most often, sweat from their palms, underarms feet, or head. This excessive sweating can interfere with everyday activities. Hands may be so sweaty that becomes difficult to turn a doorknob or use a computer. Sweat underarms often soak through clothes, causing sweat marks. The skin is often wet, skin infections can develop.
Hyperhidrosis Sign & Symptom
Visible sweating: Beads of sweat on the skin or have sweat-soaked clothing.
Sweating interferes with everyday activities: Sweating cause difficulty holding a pen, use a computer, walking, or turning a doorknob.
Skin turns soft, white, and peels in certain areas: Your skin stay wet for long periods.
Skin infections: Frequent skin infections on the parts of your body that sweat heavily. Athlete’s foot and jock itch are more common skin infections.
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Types of Hyperhidrosis
The two types of hyperhidrosis are Primary Focal and Secondary Generalized.
Primary focal hyperhidrosis refers to excessive sweating that is not caused by another medical condition. Excessive sweating is the medical condition itself. This type of sweating occurs in very specific areas of the body. The most common focal areas are the sweaty hands, sweaty feet, sweaty underarms, and sweaty face or head.
Risk Factors & Causes of hyperhidrosis
Some people are more likely to get hyperhidrosis. Researchers demonstrated that most people have one of the following:
- The family member who had sweats excessively.
- Some medical condition that causes sweating. (diabetes, gout, and tumour or injury also can cause excessive sweating)
- Medicine or food supplement that can cause excessive sweating.
Women often sweat excessively when they get hot flashes during menopause. Some women, however, develop excessive sweating after menopause. This sweating may do not have an obvious cause.
Whether you live in a warm one or a cold climate, you can have hyperhidrosis.
Triggers to attacks of sweating may include:
- Exercise
- Hot weather
- Fever
- Spicy food
- Anxiety
Secondary Causes of localized hyperhidrosis include:
- Stroke
- Surgical sympathectomy
- Spinal nerve damage
- Peripheral nerve damage
- Neuropathy
- Chronic anxiety disorder
- Brain tumour
- Obesity
- Overactive thyroid
- Diabetes
- Menopause
- Cardiovascular disorders
- Parkinson disease
- Respiratory failure
- Endocrine tumours, eg phaeochromocytoma
- Drugs: alcohol, caffeine, cholinesterase inhibitors, corticosteroids, selective serotonin reuptake inhibitors, tricyclic antidepressants, nicotinamide, and opioids
Diagnosis of Hyperhidrosis
To diagnose hyperhidrosis, a dermatologist gives a physical exam of the patient. This may include looking closely at the areas of the body that sweat excessively. Your physicians also ask very specific questions. This helps your doctor understand why the patient has excessive sweating.
Sometimes medical testing may necessary. Some patients may require a test called the sweat test. This can involve coating some of their skin with a powder that turns purple when the skin gets wet.
Before treatment, it is important to find out why a patient has excessive sweating.
What is the treatment of hyperhidrosis?
General measures:
- Wear loose-fitting, sweat-proof garments, stain-resistant
- Change clothing and footwear when damp
- Use absorbent insoles in shoes and replace them frequently
- Apply talcum powder after bathing
- Use a non-soap cleanser
- Try powder containing the anticholinergic drug, diphemanil 2%
- Discontinue any drug that may be causing hyperhidrosis
- Avoid caffeinated food and drink
- Apply topical antiperspirants
Antiperspirants contain 10–25% aluminium salts to reduce sweating; aluminium zirconium salts are more effective than aluminium chloride.
- Topical anticholinergics such as glycopyrrolate reducing sweating
- Deodorants are disguise unpleasant smells
- Available as an aerosol spray, cream, stick, roll-on, wipe or paint
- Applied when the skin is dry, after a cool shower just before sleep
- Wash off in the morning
- Use from once or twice weekly to daily if necessary
- If irritating, apply hydrocortisone cream short-term
Iontophoresis:
- Mains and battery-powered units are available
- For hyperhidrosis of palms, soles, and armpits
- The affected area is immersed in water with a greater effect of glycopyrronium solution
- Gentle electrical current is passed on the skin surface for 10–20 minutes
- Repeated daily for the first two weeks then the alternate day for four weeks
- Requires long-term commitment to treatment
Oral medications:
Oral anticholinergic drugs:
Propantheline 15–30 mg three times daily
May cause dry mouth, blurred vision, constipation, dizziness, and palpitations
Not be taken who have glaucoma or urinary retention
Increased risk of side effects is reported for dementia
Beta-blockers:
Unsuitable for people who have asthma or peripheral vascular disease
Calcium channel blockers, alpha adrenergic agonists (clonidine) and anxiolytics may be useful for some patients.
Botulinum toxin injections:
- Botulinum toxin injections are approved for affecting the armpits hyperhidrosis
- Reduce sweating for three to six months
- Topical botulinum gel is under investigation for hyperhidrosis
- Surgical removal of the axillary sweat glands
Sympathectomy for Hyperhidrosis:
Chemical or surgical endoscopic thoracic sympathectomy (ETS) can reduce sweating of armpit and hand (T3 or T4 ganglion)or face (T2 ganglion), but is reserved for severely affected individuals due to potential risks and complications. Lumbar sympathectomy is not recommended for affecting the feet as it may interfere with sexual function.
