Hyperhidrosis is a disease characterized by excessive sweating , even when it is not hot or the person is lying down. It affects various parts of the body. Its causes may have a genetic or pathological origin. It can be caused by a range of problems. The most common causative agent is heredity, but it can also be caused by phenomena such as menopause , heart disease, anxiety and diabetes , among others.
There are two types of hyperhidrosis:
- Primary focal hyperhidrosis : In focal, or primary, hyperhidrosis , sweating occurs mainly in the feet, hands, face, head, and armpits. It usually starts in childhood. About 30 to 50 percent of people with this type of hyperhidrosis have a family history of excessive sweating .
- Secondary generalized hyperhidrosis : In generalized, or secondary, hyperhidrosis , excessive sweating is caused by a medical condition or the side effect of certain medications. It usually starts in adulthood. This type of hyperhidrosis causes a person to sweat all over the body or just a specific area, including during sleep.
Symptoms are usually:
- excessive sweating for at least six months for no apparent reason;
- excessive at least once a week;
- excessive sweating affects daily activities (such as work, relationships, and cultural activities);
- family history of hyperhidrosis .
These symptoms may indicate that the person has primary hyperhidrosis . If excessive sweating occurs in a specific area, it may indicate secondary hyperhidrosis .
Sweating helps keep the body cool. All people sweat, especially on days with very high temperatures, after physical exercise or during a stressful situation that makes the person very nervous, angry, ashamed or afraid.
However, excessive sweating can also occur in other situations. People with hyperhidrosis seem to have overactive sweat glands. Uncontrollable sweating can lead to feelings of significant discomfort, both physical and emotional.
When excessive sweating affects the hands, feet, and armpits, it is called primary or focal hyperhidrosis . Primary hyperhidrosis affects 2% to 3% of the population. Still, less than 40% of patients with this condition seek medical help. In most cases of primary hyperhidrosis , no cause is found, leading doctors to believe that it is a hereditary problem.
If sweating occurs as a result of another medical condition, it is called secondary hyperhidrosis . Sweating can occur all over the body or in just one area. Among the conditions that can cause secondary hyperhidrosis are:
- Acromegaly ;
- Conditions associated with anxiety;
- Cancer ;
- Carcinoid syndrome;
- Certain drugs and substances of abuse;
- Disorders of glucose control;
- Heart disease;
- Lung disease;
- menopause ;
- Parkinson’s disease;
- Spinal cord injury;
- Tuberculosis or other infections.
In the next articles I will cover in detail the treatments for hyperhidrosis , the advantages and disadvantages of each one. Below is a brief list of possible treatments. Main Treatments for Hyperhidrosis :
Use of antiperspirants:
Excessive sweating can be controlled with special antiperspirants, these are stronger than conventional ones.
Medications for Hyperhidrosis are anticholinergic drugs that help to prevent stimulation of the sweat glands, but although effective for some patients, it is rarely prescribed. Side effects include dry mouth, dizziness and problems with urination. Beta-blockers or benzodiazepines can help reduce stress-related sweating .
Treatment with iontophoresis:
This procedure to treat Hyperhidrosis uses electricity to temporarily “turn off” the sweat gland and is most effective for sweating hands and feet. The hands and feet are placed in water and then a light electrical current is turned on. This is gradually increased until the patient feels a tingling sensation. The therapy lasts between 10 and 20 minutes, and requires several sessions. Side effects, although rare, include blistering and cracking of the skin.
Botulinum toxin application:
Purified botulinum toxin to treat hyperhidrosis can be injected into the armpits, hands, or feet to temporarily block the nerves that stimulate sweating.
Endoscopic Thoracic Sympathectomy (STE) may be recommended in more severe cases, which is minimally invasive. This is indicated when other treatments have failed. This procedure turns off the signal that tells the body to sweat excessively, typically performed on patients whose palms sweat excessively.
It can also be used to treat extreme sweating of the face. STE does not work equally well for those who have excessive underarm sweating. The main complication is starting to sweat in other areas of the body where it didn’t happen before.