What is Hyperhidrosis and What Treatments are Available

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In certain individuals, this process becomes excessive leading to a condition known as hyperhidrosis. This condition is quite common affecting as much as 3% of the world’;s population but most people are unaware of the condition and therefore seldom seek treatment.

So, What Is Hyperhidrosis?

Hyperhidrosis is a medical condition characterized by overreaction of the body’;s mechanism for controlling temperature leading to excessive and unpredictable sweating. This occurs regardless of the prevailing temperature whether hot or cold and physical activity. It means that those with this condition sweat even when it is cold and they are at rest.

This condition usually starts in childhood or adolescence and continues for the rest of lifespan if no treatment intervention is taken. It has no sex preference and can affect anyone from any race although there are those more predisposed. The excessive sweating may involve any part of the body but the most commonly affected areas are the soles of the feet, palms of the hand and the axilla (armpits).

What Causes Hyperhidrosis?

There are normal conditions where people are expected to sweat but this abates after the end of such stimulus. These conditions include nervousness, physical exertion, anxiety, embarrassment, anger and fear. The causes of hyperhidrosis lead to excessive sweating even when such stimuli are absent.

These can be divided into primary or idiopathic causes and secondary causes.

a) Primary causes or focal hyperhidrosis

In this situation, there is a defect in the physiology of temperature regulation that is genetically determined. It runs in the families of such people. In other primary forms of the condition the cause cannot be identified.

b) Secondary causes.

There are various conditions that can present with secondarily with excessive sweating. These include:

Some types of cancers such as carcinoid tumors

Certain metabolic disorders such as diabetes mellitus, hyperactive thyroid gland, hypoglycemia (low blood sugar level)

Use of certain medications which have hyperhidrosis as side effects for example tricyclic antidepressants, propranolol, pilocarpine, and physostigmine and serotonin reuptake inhibitors (SSRIs).

Chronic excessive alcohol intake has also been associated with hyperhidrosis

What Are the Effects of Hyperhidrosis?

In extreme cases, hyperhidrosis can cause serious health as well as social problems. As a matter of fact it can be debilitating to the point of interfering with the daily activities of the suffering individual. Some of these effects are discussed below:

Embarrassing moments: Some people with hyperhidrosis have a condition so severe that sweat can be seen literally dripping from the hands. Thus anything they handle gets wet. This can lead to serious embarrassment especially at work and in public places.

Anxiety and low self-confidence: People with this condition are usually withdrawn, constantly anxious and have very low self-confidence.

Interferences with hygiene: When there is wetness in the shoes because hyperhidrosis, it can lead soaking of the socks which may cause them to stink. In addition, substances contained in the sweat may also cause poor hygiene and lead to infection of the foot.

Reduced productivity: Because of the anxiety, stress and embarrassment associated with this condition, affected individuals may not be able to work properly or may become too uncomfortable at work and this reduces production.

Dehydration: The excessive sweat produced is actually body water and this, if not replaced adequately can lead to dehydration and the complications associated with it including cardiovascular problems.

Is Hyperhidrosis Treatable?

This is the million dollar question everyone is asking. The answer is yes! The problem is that most people are not aware of these treatment methods or are too embarrassed to seek medical health. There is use of medications as well as surgical methods:

a) Use of medications:

The most commonly used medication in the treatment of hyperhidrosis is Botox (Botulinum toxin type A). This drug is FDA approved in the treatment of underarm type. The toxin is injected into the underarm and blocks the nerves that stimulate sweating.

Use of anticholinergic drugs such as glycopyrrolate which prevent the stimulation of the sweat glands but have not been approved.

Use of antiperspirants which act by blocking the sweat gland can also help mitigate the symptoms of this disease.

b) Surgery and other procedures

Lontophoresis: In this procedure, low voltage electricity is used to turn off the sweat glands temporarily. It has also been approved for treatment of hyperhidrosis. Both hands and feet are immersed in water and then some gentle electric current passed through the water. It typically takes 10-20 minutes and requires more than one session.

Endoscopic thoracic sympathectomy (ETS): This is indicated for very severe cases of hyperhidrosis. It is minimally invasive surgery and is used in cases where other methods of treatment have failed.


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