SWEATING (HYPERHYDROSIS)

Hyperhidrosis, also known as excessive sweating, is a condition characterized by heavy sweating that can interfere with daily activities and cause social discomfort. It often results in soaked clothing, dripping hands, and overall discomfort. Unlike typical sweating related to exercise or heat, hyperhidrosis occurs regardless of these factors.

What are the symptoms of Hyperhidrosis?

Sweating is a natural response to exercise, stress, anxiety, or high temperatures. However, in hyperhidrosis, sweating happens excessively and independently of these triggers. It commonly affects areas like the hands, feet, underarms, or face, and occurs symmetrically on both sides of the body. People with hyperhidrosis may experience episodes of excessive sweating at least once a week during the daytime.

What are the causes of Hyperhidrosis?

Hyperhidrosis is the body's natural way of cooling down when body temperature rises, triggered by the nervous system signaling sweat glands to produce sweat.

Primary Hyperhidrosis/Essential Hyperhidrosis:

• This is the most common type, where overactive nerves continuously signal the sweat glands, even without external triggers.
• Conditions worsen during nervousness and anxiety, with palms and soles being commonly affected.
• It is often considered hereditary/genetic in origin.

Secondary Hyperhidrosis:

Excessive sweating is due to an underlying medical condition.

Conditions that may cause secondary hyperhidrosis include:

• Diabetes
• Low blood sugar
• Nervous system disorders
• Infections
• Menopausal hot flashes
• Thyroid disorders
• Heart attack
• Certain cancers
• Opioid withdrawal
• Lung diseases
• Parkinson’s disease
• Adrenal gland tumors
• Spinal cord injury
• Stroke
• Acromegaly
• Carcinoid syndrome

How is Hyperhidrosis Diagnosed?

Diagnostic methods for hyperhidrosis include:

Symptoms and medical history: Your doctor will inquire about your symptoms and medical background.

• Sweat tests: Various tests can pinpoint the areas of excessive sweating. These tests include the iodine-starch test, skin conductance test, thermoregulatory sweat test, and paper test.
• Laboratory tests: These are conducted to rule out any underlying medical conditions that might contribute to excessive sweating. Common tests involve assessing thyroid function and sugar levels.

How is hyperhidrosis treated?

In cases where a medical condition is not the underlying cause of excessive sweating, the following treatments may be considered:

• Prescription-strength antiperspirants: These may contain aluminium chloride and can effectively reduce sweating.
• Glycopyrrolate creams: These are often used for hyperhidrosis affecting the face and head.
• Nerve blockers: Medications that block overactive signaling nerves, helping to reduce sweating.
• Antidepressants: Since anxiety and nervousness can exacerbate hyperhidrosis symptoms, antidepressants may be prescribed to manage these aspects of the condition.

Botox injections for hyperhydrosis

Botox injections temporarily block the nerves responsible for excessive sweating. These injections are targeted to specific areas of increased sweating, such as the palms and armpits, after identifying the exact sites. The procedure can be somewhat uncomfortable and needs to be repeated every 6 months for continued effectiveness.

Iontophoresis for hyperhidrosis

Treatment options for hyperhidrosis include:

• Electrophoresis: This painless method involves passing ionized water through the skin using direct electricity. It temporarily blocks sweat glands and requires repeated sessions initially, followed by maintenance sessions at intervals of 1-3 weeks.
• Microwave therapy: This treatment uses microwave energy to destroy sweat glands. It lasts about 30 minutes, requires repetition every 3 months, and may cause discomfort and changes in skin sensation. It's expensive and less accessible.
• Surgery: Surgical options include:
• Sweat gland removal: Recommended for excessive armpit sweating when other treatments are ineffective.
• Sympathectomy/Nerve surgery: Involves cutting, burning, or clamping nerves that trigger excessive sweating. Not suitable for isolated head and neck sweating.

What can be the complications of Hyperhidrosis?

Excessive sweating can result in:

• Increased susceptibility to infections
• Disruption of daily activities
• Social embarrassment