Hyperhidrosis
Hyperhidrosis or excessive sweating, particularly of the armpits, hand palms and feet soles, impacts about 3 percent of the population in the United States. Suffers from all sexes and age groups may find that this skin condition not only causes embarrassment when socializing, but also physical discomfort. The following sections discuss the types, causes, control and treatment of Hyperhidrosis.
What is Hyperhidrosis?
Perspiration through the skin is part of the body’s thermo-regulation function (to regulate body temperature), and also acts as an signal of sexual excitement. During this process, the sweat glands secrete fluids containing water, chlorine, urea, and o and p-cresol chemicals.
Excessive sweating called Hyperhidrosis means that these perspiration fluid components are also produced in greater quantity and excreted through the skin. This can result in clothing becoming wet, chaffing of the skin, and pungent smells. Hyperhidrosis should be differentiated from hypohydrosis that is decreased sweating and hidromeiosis where blocked sweat glands reduce sweating.
Types of Hyperhidrosis
Hyperhidrosis can be localized to certain body parts, like the armpits, hands, feet, groin or breasts; or the condition can be generalized and affect the whole body.
Acquired or congenital (from birth) traits may also be used to distinguish between primary and secondary hyperhidrosis:
- Primary Hyperhidrosis – inherited through autosomal dominant genes and starts before or at puberty
- Secondary Hyperhidrosis – results from health disorders affecting pituitary, thyroid, and insulin function; and may also result from gout arthritis, tumors, chemicals, toxins (mercury), and hormonal changes such as during menopause. Therefore, anyone at any stage in the life cycle can contract Secondary Hyperhidrosis.
Causes of Hyperhidrosis
Life stage, traits or how the hyperhydrosis manifests is an indicator of the cause, as are associated health symptoms. Causes of Hyperhidrosis may include hereditary, health disorders, spinal cord injuries, chemicals and poisons, hormonal changes and nervous response. Nervous excitement or anxiety contributing to hyperhidrosis can be triggered by stress, sensory stimuli, lifestyle factors and diet. The cause of hyperhidrosis is identified through the diagnostic process and directs the course of treatment.
Diagnosing Hyperhidrosis
Hyperhidrosis may be physically observable, but may not always be that obvious and rely on patient accounts. When seeking medical help, a physician or dermatologist usually does a physical examination to check for signs of excess sweating. Sometimes an iodine starch test is performed through application to the skin in the region of excess sweating. Once the starch and iodine is applied to the affected site, the site will turn black if hyperhidrosis is present. Depending on patient health condition, further tests may be performed.
Treatments for Hyperhidrosis
Antiperspirants normally obtained in shops will not solve hyperhidrosis, nor treat it. There are a number of “sweat therapies” that can be used or may be prescribed instead and include:
- Natural management – wearing absorbent cotton clothing; using talcum powder or cornstarch; keeping armpits shaved
- Drysol solution; Formaldehyde or Glutaraldehyde
- Oral medications, such as okybutynin
- Botulinum toxin (Botox) injections
- Electro-therapy
- Surgery, such as Sympathectomy and Skin Grafting
- Liposuction; Laser Sweat Ablation (LSA); Iontophoresis
Sweat Therapies for managing Hyperhidrosis
Usually physicians prescribe a dosage of Drysol (also called aluminum chloride hexahydrate) to be applied to the skin, and covered with a plastic film overnight to block the sweat pores. There are other treatment solutions, such as Formaldehyde, but this product can cause allergic reactions in some people. Another is Glutaraldehyde which may cause skin stains.
Oral medications can be prescribed and these include chemicals such as oxybutynin, benztropine and propantheline. Some patients opt for injections instead. Botox, as it is commonly known, or botulinum toxin, can be used to block nerve impulses stimulating the sweat glands. The botox is usually injected under the affected skin site over four to twelve months. Electro-therapy is also an option where low voltage electric current is applied to the affected skin site to reduce sweat functioning. The therapy is usually administered daily by a physician for a number of months according to the treatment plan.
Permanent Sweat Therapies for Hyperhidrosis
Sympathectomy is the permanent surgical cure for hyperhidrosis where the nerve that controls the sweat function to parts of the body, such as the palm, is removed. Neurosurgeons are cautious to use this procedure because it can exacerbate excess sweating in other parts of the body as a consequence. Another surgical procedure is to remove the skin containing the sweat glands and then applying skin grafts. Such procedures may only be preformed in severe cases.
Alternative Sweat Therapies to Surgery
The use of liposuction to remove excess sweat glands causing auxillary hyperhidrosis is viewed as a suitable replacement for surgery because of reduced scaring and skin disruption. Laser Sweat Ablation (LSA) can be used through applying laser light to the affected skin site to destroy the sweat glands. Local anaesthetic is generally provided. Iontophoresis is another method that prevents the sweat glands from producing excess sweat. Trained cosmetic surgeons can also provide these procedures.