HYPERHIDROSIS – CAUSES AND METHODS OF TREATMENT

Sweating helps a person adapt to the environment’s high temperature and also serves as a regulator of psycho-emotional stress. The amount of sweat increases in hot weather, during stress, at elevated body temperature, and after eating – this is quite normal and does not need to be dealt with.

But, if a person suffers from increased sweating constantly, this is a pathological condition for no apparent reason. In medicine, it is called hyperhidrosis. This disease brings physical discomfort and leads to problems at work and in personal life. 

If you suspect that you have hyperhidrosis, treatment must be prescribed by a dermatologist or neurologist. Often, increased sweating is a symptom of another disease. Therefore, it is imperative to undergo an examination and find out the cause of the violation of sweating.

Hyperhidrosis: what is this disease

Apocrine and eccrine glands are responsible for sweat secretion. The volume of sweat depends on the work of the eccrine glands, which are located throughout the body. Apocrine doesn’t play a big role in the development of hyperhidrosis because their work is linked to letting out a personal secret, which is linked to attracting partners of the opposite sex.

The glands normally produce up to 0.5-1 liters of sweat daily. It depends on gender, age, and individual characteristics. But when this indicator is exceeded several times, we can discuss the disease. With strong sweating, dehydration occurs, which is dangerous for the body’s normal functioning.

The main cause of the pathology is heredity; that is, the excessive work of the sweat glands in primary hyperhidrosis is genetically determined. The first manifestations are already in adolescence.

If increased sweating occurred for the first time in adulthood, then this may be caused by:

• neurological disorders;
• infectious diseases of internal organs;
• endocrine disorders;
• taking certain medicines;
• malignant formation;
• severe intoxication;
• traumatic brain injury;
• alcohol or drug addiction.

There is also psychogenic hyperhidrosis, which is based on a traumatic or exciting situation. Even a little excitement can lead to profuse sweat production in people with this diagnosis. 

Hyperhidrosis: symptoms of the disease

Sweating is a normal part of a person’s body that helps them maintain their body temperature. But when should we talk about illness? These symptoms imply breaches of this process:

1. Even when you are physically and emotionally calm, you can still sweat.
2. Sweat volume is greatly increased, resulting in physical discomfort. Clothes get wet; on the back and face, you can see streams of sweat fluid.
3. Hygiene practices and using deodorants don’t help.
4. A sharp fetid smell – bromidrosis. Normally, sweat liquid practically does not smell if hygiene procedures are followed.
5. The appearance of colored sweat (chromidrosis). This comes from the slagging of the body or severe intoxication.
6. The formation of scuffs and redness in places of increased sweating and skin folds.

In addition, the behavior and character of a person change. He develops sweat expectancy neurosis. This is a panic fear when a person is constantly in anticipation that at the most important moment, he will become wet and disgraced. Such stress leads to an aggravation of the disease. Also, there are headaches, bouts of lack of air (hyperventilation syndrome), and hypertension.

Types of hyperhidrosis

Pathological sweating due to the occurrence can be primary (congenital) and secondary; that is, it acts as a symptom of another disease.

The place of origin is divided into two types:

1. Local.

Occurs in a specific area of ​​the body. Most often on the feet, palms of the hands, in the armpits, and on the face. In most cases, patients have combined hyperhidrosis, a combination of several problem areas, for example, the palmoplantar form. The local appearance is associated with excessive excitability of the nervous system. However, in some situations, it can be inherited.

2. General or generalized.

Sweat is released all over the body. It can be physiological; that is, it occurs during adolescence, pregnancy, or menopause. Or it occurs due to several serious illnesses (secondary form). Also, generalized sweating is characteristic of the syndrome of withdrawal from certain drugs.

Local hyperhidrosis is divided into the following types:

1. Craniofacial – occurs on the face and head. It can sometimes move to the neck.
2. Axillary or axillary. 
3. Inguinal-perineal – sweat accumulates in the skin folds of the inguinal region.
4. Plantar – occurs on the palms of the hands and the soles.

The generalized form is rare and therefore requires a more detailed study. Often the reasons lie in violations of the internal organs and systems. 

All types of pathological sweating can lead to swelling and inflammation of the skin, and the addition of a bacterial infection, so you should consult a doctor.

Diagnosis and treatment

Before choosing the best treatment option, a dermatologist will conduct a series of diagnostic studies. To rule out disorders of internal organs, a patient will be prescribed the following:

1. General clinical analyses.
2. Ultrasound of the pancreas.
3. Tests for sugar and cholesterol.
4. ECG.

It is also obligatory to consult a neurologist, therapist, or gynecologist (for women). To determine the severity of the pathology, specialized tests are carried out:

1. Minor’s test (starch iodine) is carried out to determine the size of the zone of increased sweating. The skin area is dried, an iodine solution is applied, and starch is sprinkled. Areas of increased sweating are colored blue. With a spot size of 5-10 cm, a mild degree of the disease is put, a spot from 10 to 15 cm indicates moderate severity, and if the size exceeds 20 cm, then the person has a severe degree of hyperhidrosis.
2. Chromatographic study – allows you to study the composition of sweat fluid. For the study, sweat is taken from the most active parts of the body. 

These methods allow you to choose the optimal therapy. With a mild degree of the disease, it is enough to adjust the diet and change your lifestyle. If a doctor finds psychogenic hyperhidrosis caused by being too emotionally excited, a neurologist or a psychotherapist will treat it.

Conservative therapy

Drug treatment consists of taking multivitamin complexes, sedatives, and neuroleptics. Sedatives help reduce the excitability of the nervous system, which leads to a decrease in the manifestations of the disease.

Recommended spa treatment, especially sea or brine baths (saturated salt solution). Lotions or baths give a good result from oak decoction. 

Also, the doctor will recommend using medical antiperspirants with a therapeutic composition. They contain zinc, salicylic acid, triclosan. These substances not only close the sweat glands but also disinfect the skin, preventing the growth of bacteria. This helps to get rid of the bad smell. Validity from 5-15 days. At the same time, there is no negative effect on the sweating process; sweat will be excreted through other body parts.

It helps to narrow the sweat glands’ iontophoresis temporarily. This method of physiotherapy is often used for hyperhidrosis of the palms and feet. To obtain a stable result, it is necessary to repeat the course of treatment after 3-5 months.

Types of surgical treatment

With a moderate or severe degree of the disease, the patient may be offered a radical method – removing sweat glands through surgery.

There are the following methods of prompt disposal of sweating:

1. Curettage – through a surgical incision, the glands are removed in a certain area, most often in the armpit. This gives a lifelong result but requires recovery after the procedure.
2. Liposuction is the removal of the subcutaneous fat layer. This leads to destroying the nerve endings responsible for the sweat gland’s work. Pretty traumatic.
3. Sympathectomy – Gives 100% lifetime sweat protection. During the procedure, an incision or medication destroys the nerve fibers. There are endoscopic and intradermal blocking. It is indicated for sweating of the hands and feet.

The most modern and less traumatic method of operative solution to the problem of excessive sweating is laser lipolysis. The doctor cuts a small hole in the skin and uses a laser to burn the nerve centers of the sweat glands.

These methods require careful preliminary examination and preparation. Surgery is the only treatment method that provides 100% results for life.

Injection treatment

It is impossible to get rid of hereditary hyperhidrosis with the help of medicines. In this case, injections of botulinum toxin are widely used. It is a natural substance that is well tolerated by the body. It does not cause rejection and rarely leads to an allergic reaction.

Botox or Dysport injections are harmless; after a certain time, the drugs are excreted by the body on their own. The toxin blocks the nerve fibers that are associated with the sweat glands. Sweating in this area stops for six months to a year. It depends on the characteristics of the body and metabolism. Its disadvantage is the need to repeat injection courses after removing the toxin. Botulinum therapy can be applied to any part of the body. 

Prevention of excessive sweating

To cope with increased sweating, it is recommended to follow the following rules:

1. Give preference to clothes made from natural fabrics. It may be constructed of cotton, silk, or linen.
2. Shoes should be made from breathable, high-quality materials.
3. Use special moisture-absorbing antibacterial insoles.
4. Do not take medicines without your doctor’s advice, especially antipsychotics or antidepressants.
5. The shower should not be hot. The best option is contrast. Changes in temperature help constrict the sweat glands.
6. Use herbal decoctions as lotions or when taking a bath.

Be sure to visit your doctor annually for preventive examinations or if you have chronic diseases. Increased sweating may indicate pathologies in the body and delay treatment, which can lead to serious consequences.