One percent of the human population experience increased sweating constantly, every day. Such a state is called hyperhidrosis.
What is hyperhidrosis?
Hyperhidrosis is secretion of the sweat in amounts larger then the required for the organism to cool down. Most often it is present on the palms of the hands, feet and under the armpit. Not only is the person hampered in performing everyday activities, hyperhidrosis can cause social anxiety and unpleasantness. Even though there are large variations in sweating of individuals, most people sweat during physical activity, stress, anxiety, spending time in overheated spaces. Increased sweating in hyperhidrosis far exceeds natural sweating.
Symptoms of hyperhidrosis
Symptoms of hyperhidrosis are frequent and noticeable sweating, which breaks through the clothes, abundant and disturbing sweating of the feet, under the armpit, on the head and the face and drops of sweat on the hands and feet.
Causes of hyperhidrosis
The cause of hyperhidrosis lies in the regulation of the body temperature, especially in the sweat glands. The body has two types of sweat glands. Eccrine sweat glands, which are almost all over the body and open directly on the surface of the skin and apocrine sweat glands which are on parts of the skin where there are dense hair roots such as the scalp, under the armpit and on the groins. When the temperature of the body rises, autonomous nerve system stimulates these glands to produce fluid and secrete it on the surface of the skin and the fluid has the task of cooling the body while evaporating. This fluid (sweat) consists mostly of water, salt, urea and electrolytes.
Based on their type, hyperhidrosis are divided into:
Focal hyperhidrosis which localized mostly on the palms, soles or armpits with an unknown cause, they are usually genetically conditioned and appear usually before the age of 20. They stop during sleep.
General hyperhidrosis which cover large body surfaces. If they appear suddenly, they are probably from some medication or another disease or state, such as menopause, low blood sugar level, hyperthyreosis, leukemia, lymphomas, heart problems, infection etc.
Complications from increased sweating are following:
- fungal infections
- bacterial infections
- rashes caused by clogs in the skin pores near the sweat glands, most common in children
- discomfort in social life
Treatment of hyperhidrosis
Antiperspirants with aluminum chloride are used for mild hyperhidrosis. It is best to apply them in the evening. They can cause skin irritation so it is necessary to wash them out in the morning.
Anticholinergic medication is applied only for general sweating. They block the binding of acetylcholine and give results in 2 weeks. Dryness of mouth, constipation, urine retention and sickness can occur.
Iontoforesis – batteries with low current change the ion polarity while the exposed body part is submerged in the water. It is safe and can be done at home.
Botulinum toxin or Botox blocks the nerves that activate the sweat glands. The effect lasts from 6 months up to a year. It is applied on the surface of the skin that sweats excessively and can be safely repeated. In the armpit region the procedure is not painful but on the palms of the hands it is often more unpleasant. The method is completely safe. More about botox treatment read here.
Surgery is an option in rare circumstances. The nerves that carry the sympathetic nerve impulse to the sweat glands are cut. An endoscopic thoracic sympathectomy can be performed. It requires a one day hospitalization, and it leaves discrete scars. The success rate is up to 90%. A big problem is in the compensatory increased sweating that occurs in 60% of the patients after the operation and it appears on the back, thighs, sitting area. In 10% of the patients increased sweating may occur while eating – gustatory hyperhidrosis.
One percent of the population suffers from hyperhidrosis, 60% of them can’t remember at what age they have noticed increased sweating, 33% in the puberty and 5% in adulthood.
Spec. Dr. Svetlana Djurisic, dermatologist