Hyperhidrosis

2023 Author: Wallace Forman | [email protected]. Last modified: 2023-08-25 11:04

Hyperhidrosis

When a healthy person sweats, the body is cooled by the evaporation of the sweat. This is done to keep the body temperature constant. Sweating protects against overheating and is vital. The body reacts with sweating, for example to physical exertion or high temperatures. The amount of sweat varies depending on the conditions. In hyperhidrosis there is a malfunction of sweating all over the body or in certain parts of the body.

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What types of hyperhidrosis are there?

Armpits, hands or palms, feet or soles of the feet, the face and parts of the face (e.g. the forehead) can be affected. Sweat glands are excessively stimulated in hyperhidrosis, and increased sweat is secreted.

There is a general distinction:

• Primary idiopathic hyperhidrosis. This is not based on an external cause or disease.
• Secondary hyperhidrosis. It occurs when there is an underlying disease, e.g. neurological diseases, mental illnesses, hyperthyroidism, infections, cancer diseases, hormonal disorders, menopause and much more

Increased sweating can have many causes and, for example, be related to the use of medication (such as parasympathomimetics, cortisone preparations). Exertion, psychological / emotional strain or stress are also reasons for increased perspiration. It is not always hyperhidrosis. Strongly perceived sweating can also occur, for example, with enlarged or increased sweat glands.

How is the diagnosis made?

In the course of the diagnosis, it is clarified whether it is actually hyperhidrosis. For this, the collection of the medical history is essential. Symptoms (e.g. when and where sweating occurs) provide important information. Possible causes are clarified, for example suspected illness, existing illnesses that are responsible for sweating, and any medication intake. Various tests can be carried out and laboratory values determined.

Various tests can be performed to determine the severity of hyperhidrosis:

• Iodine starch test according to Minor. With this, newly formed sweat is shown in color using iodine solution and starch.
• gravimetric measurement. The amount of sweat is determined using filter paper that is applied to a specific part of the body. A special scale is used to measure the amount that has been absorbed within a certain period of time.

How is hyperhidrosis treated?

The treatment of primary hyperhidrosis is based on the individual situation of the person affected and the region of the body. Certain behavior or lifestyle changes can be recommended. These include, for example, refraining from wearing synthetic fibers or plastic (clothing, shoes). It can also make sense to refrain from consuming coffee, tea, alcohol, hot and spicy food. Stress reduction as well as learning the mechanisms of stress processing and coping are also considered. More information about stress & relaxation.

Other therapeutic measures include:

• Use of antiperspirants. These are used locally for primary hyperhidrosis on the armpits, hands and feet. Deodorants with aluminum salts (aluminum chloride hexahydrate) in different concentrations can be used. Their effect is based on the closure of the outlets of the sweat glands. The astringent effect of creams, lotions and powders with tannic acid is also used.
• Tap water iontophoresis. The therapy option is primarily carried out on the hands and / or feet. These are immersed in a bath with tap water through which weak sliding currents are passed.
• Injection of botulinum toxin. Injecting the nerve poison switches off the transmission of stimuli from special nerve fibers to the sweat glands. Botulinum toxin is used particularly in the armpit region.
• Radiofrequency therapy, microwaves, ultrasound. Sweat glands are damaged as a result of the heat generated during use. These are mainly used in the armpit area.
• Systemic therapy. If hyperhidrosis occurs all over the body (generalized hyperhidrosis), drugs are administered in tablet form (antihidrotics, psychotropic drugs).

Surgical interventions are particularly carried out when other therapeutic approaches do not show the desired success. They include:

• Subcutaneous curettage and subcutaneous suction curettage. In both procedures, the sweat glands in the armpits are surgically removed under anesthesia. The areas are scraped off with special instruments and, if necessary, suctioned off.
• Endoscopic thoracic sympathectomy (ETS) and CT-guided percutaneous sympathicolysis. Instruments and cameras are inserted into the chest cavity through small incisions and under anesthesia. Then certain nerve parts are interrupted (sympathetic severing). This is done using heat or metal clips in the case of ETS, as well as concentrated alcohol in the case of CT-controlled percutaneous sympathicolysis. The procedure is performed on the hands, face and armpits for hyperhidrosis.

The attending doctor will inform you about the advantages and risks of the individual therapeutic measures. As a result of the operations, for example, so-called compensatory sweating can occur, ie the remaining sweating in body regions that have not been treated is compensatory increased. Gustatory sweating can also occur. This occurs after eating and due to the malfunction of a nerve (N. auriculotemporalis) after surgery.

The treatment of secondary hyperhidrosis is also tailored to the individual. It aims at the optimal therapy of the underlying disease.

The additional use of sage can be made.

Whom can I ask?

To clarify complaints such as excessive sweating, you can contact the following contact persons:

• Family doctor
• Dermatologist
• Neurologist

Depending on the underlying disease and therapeutic measures, other specialists (e.g. for surgery, neurosurgery) are involved in the diagnosis and therapy process. The treatment takes place partly in the hospital (surgical interventions).