Hyperhidrosis

Hyperhidrosis – General Information

Hyperhidrosis is a disorder characterized by excessive sweating which is not the result of heat of the need for thermoregulation. It usually starts during the first years of life or later on, during adolescence, but it can also affect someone older than 20 years. It can affect any part of the body, but the most exposed areas are the soles, the palms and the axillae. Although this disease can manifest itself it can also be the result of other severe complications such as febrile illness, drug abuse or other metabolic disorders. It can appear in three different forms: generalized, localized or emotionally induced. However, all of these forms are quite severe and they can cause a lot of complications and severe emotional distress which can later result in occupational disability of the sufferer. The generalized form of Hyperhidrosis can be the result of an autonomic dysregulation, febrile illness, a metabolic disorder or malignancy, whereas the localized form may develop as the result of a local disruption followed by an irregular regeneration of the nerves. In some rare cases, another form of the disease, essential Hyperhidrosis, may appear as the result of a symphatetic over-activity and it usually involves the vascular endothelium. The most exposed area to the appearance of this disease is Japan, where the frequency is 20 times higher than anywhere else. The good part about this disease is the fact that it does not progress in time and it can not be considered a life-threatening problem; it can however affect the quality of the patient’s life.

Hyperhidrosis – Symptoms

The most common symptom of Hyperhidrosis is the excessive sweating which affects certain parts of the body; however, other signs and symptoms can appear, considering what type of the disease a patient experiences. If the exact areas which are affected by this disease can not be observed directly, the patient can take an iodine test; this test consists of spraying a certain part of the body and the areas which are affected by the disorder will become black. In most of the cases, this disorder is considered idiopathic but sometimes is associated with other neoplastic or neurologic diseases, metabolic diseases (diabetes, gout, hypoglycemia or menopause), medicine abuse, febrile illness, chronic alcoholism or tuberculosis. Localized Hyperhidrosis is quite different from the other forms of this disease, as it is induced emotionally and it usually affects only the soles, the palms and the axillae. In what concerns the sweating of the soles and the palms, this is controlled by the cerebral cortex and it does not respond to temperature stimuli, but to emotional ones; on the other hand, the sweating of the axillae is controlled by both thermoregulatory and emotional stimuli. This particular form of the disorder can also be associated with the following problems: encephalitis, diabetic neuropathies, Frey syndrome, herpes parotitis, glomus tumor, organomegaly, monoclonal disorders, burning feet syndrome, skin changes syndrome, pretibial myxedema or eccrine nevus. An important thing which should be known about this disorder is the fact that it does not affect the sufferer during the night or while he is sedated.

Hyperhidrosis – Treatment

As the signs and symptoms which characterize this disease are quite easy to observe, there is no need for some particular tests in order to diagnose the disease. However, some tests may be performed in order to obtain information about other possible complications or complementary diseases. For example, a thyroid function test can be taken in order to determine the presence of hyperthyroidism, a measurement of the glucose level in the blood can reveal hypoglycemia or diabetes, a measurement of the uric acid level can divulge the presence of gout and a protein test can reveal tuberculosis. As the studies show, those who suffer from Hyperhidrosis do not present any functional abnormalities of the eccrine glands; however, the localized form of the disorder may be the result of an abnormality in the number or the distribution of the eccrine glands.

Even though Hyperhidrosis can not be treated completely, there are some treatment options which can be administrated in order to improve the symptoms. The most common way of treating this disease is the administration of drugs, both systemic and topical agents; in addition, the doctor can choose botulinum and iontophoresis toxin injections. The topical agents which are usually administrated in the case of those who suffer from Hyperhidrosis are the following: boric acid, resorcinol, tannic acid solutions, potassium permanganate, methenamine or formaldehyde. Another solution which is used is the drysol; this should be used during the night and in most of the cases it proved quite effective. However, it application of this solution can sometimes lead to the appearance of some irritation; this is the reason why the patients have to use the product during the night and then wash the area where it has been applied.

The systemic agents which are usually administrated to treat this disease include the anticholinergic substances, such as benztropine, propantheline or oxybutynin. However, the usage of these agents can lead to the appearance of several side-effects, such as blurry vision, dry eyes, dry mouth or even constipation. Another way of treating Hyperhidrosis consists of iontophoresis, which consists of the direct passing of electric current across the area which is affected. Apart from the pharmacologic therapy, the doctor can also choose to perform a surgery; in the case of this disorder, when deciding to perform a surgery the doctor can choose from a surgical sympathectomy, a subcutaneous liposuction and a surgical excision of the area which is affected. Sympathectomy is the most common surgery which is performed in the case of those who suffer from Hyperhidrosis; however, it is considered to be a final option for the treatment of the sufferers. The procedure can be described as a surgical elimination of the ganglia which led to the appearance of the disease. It can be done in two different ways: using an open approach or an endoscopic approach; the second method is, however, more safer and the number of complications which may appear is reduced. On the other hand, the surgical excision of the area which is affected means that the sweat glands in that area are removed.