Hyperhidrosis is a condition characterized by excessive sweating that goes beyond what is necessary for regulating body temperature. It can significantly impact daily activities and quality of life. Sweating may occur even when the person is at rest, in a cool environment, or without any apparent trigger like exercise or heat.
Types of Hyperhidrosis
- Primary Hyperhidrosis:
- The most common form, often localized to specific areas such as the palms, soles, underarms, or face.
- It usually begins in childhood or adolescence and is not associated with an underlying medical condition.
- Likely has a genetic component.
- Secondary Hyperhidrosis:
- Generalized sweating caused by an underlying condition or external factor, such as:
- Endocrine disorders (e.g., diabetes, hyperthyroidism).
- Neurological disorders (e.g., Parkinson’s disease).
- Medications (e.g., antidepressants).
- Menopause (hot flashes).
- Infections or cancer.
Symptoms
- Excessive sweating localized to specific areas (e.g., hands, feet, underarms) or generalized across the body.
- Sweating may occur symmetrically on both sides of the body.
- Episodes often happen without triggers and may worsen during stress or anxiety.
Causes
- Primary Hyperhidrosis:
- Likely caused by overactive sweat glands due to overstimulation by the nervous system.
- Exact causes are not well understood but may be hereditary.
- Secondary Hyperhidrosis:
- Associated with underlying medical conditions or drug side effects.
Diagnosis
- Medical History: To rule out underlying causes and determine if it is primary or secondary hyperhidrosis.
- Physical Examination: Checking the areas affected by sweating.
- Tests:
- Starch-iodine test: A solution applied to the skin turns dark where sweating is excessive.
- Paper test: Measures the amount of sweat produced in a specific area.
- Blood tests or imaging may be used to identify underlying causes in secondary hyperhidrosis.
Treatment
- Lifestyle Changes:
- Use antiperspirants with aluminum chloride.
- Wear breathable clothing and socks.
- Avoid triggers like spicy foods and caffeine.
- Topical Treatments:
- Prescription-strength antiperspirants or creams containing glycopyrrolate.
- Medications:
- Anticholinergics: Reduce sweat production (e.g., oxybutynin, glycopyrrolate).
- Beta-blockers or benzodiazepines: For anxiety-induced hyperhidrosis.
- Botox Injections:
- Blocks nerve signals to sweat glands.
- Effective for localized hyperhidrosis (e.g., underarms).
- Surgical Options:
- Endoscopic thoracic sympathectomy (ETS): Interrupts nerves responsible for excessive sweating. Usually reserved for severe cases.
- Sweat gland removal: For persistent underarm sweating.
- Non-Invasive Procedures:
- MiraDry: Uses microwave energy to destroy sweat glands.
- Iontophoresis: Passes a mild electrical current through the skin to reduce sweat gland activity.
Complications
- Skin Issues: Increased risk of fungal or bacterial infections.
- Social Impact: Embarrassment, anxiety, and social withdrawal due to visible sweating.
- Clothing Damage: Sweat stains and odor.
Prognosis
With proper treatment, most individuals with hyperhidrosis experience significant improvement. Preventive measures and consistent management can help maintain quality of life. For severe cases, advanced treatments like Botox or surgery may provide long-term relief.
