Hyperhidrosis, colloquially known as excessive sweating, is characterized by excessive sweating that affects the hands, feet, and armpits. It can affect the entire body surface as a concomitant of other diseases. Hyperhidrosis is relatively harmless physically, but has a strong psychological impact on patients.
What is hyperhidrosis?
As yet unexplained, hyperhidrosis is caused by pathologically strong activity of the sweat glands. In primary hyperhidrosis, this refers to the hands, feet and armpits. If the condition affects the entire body, it is diagnosed as secondary hyperhidrosis, which occurs as a result of a primary condition. Normal sweat production is usually the body’s response to heat or infection in a fever. This mechanism is disrupted in hyperhidrosis. Sufferers experience excessive sweat production that affects areas of the body that are not usually heavily affected by sweat. These include the sides of the hands or even the tops of the feet. Hyperhidrosis is treatable with different methods depending on the severity.
Causes
Scientifically proven causes of primary hyperhidrosis are not yet known. The nerves responsible for controlling the sweat glands react incorrectly and to an excessive degree. It is unclear what triggers this faulty reaction. In part, psychological causes such as stress or insecurity are thought to be a factor. A common cause in secondary hyperhidrosis, on the other hand, is hormonal imbalances or medications that increase sweat production. It is a well-known accompanying symptom during menopause. Depending on the severity of the hyperhidrosis, the palms, the back of the hands or even the top of the feet are affected. In many cases, the combination of visible sweat production and odor development leads to social isolation of patients suffering from hyperhidrosis. This increases the psychological stimuli that promote hyperhidrosis.
Symptoms, complaints and signs
In hyperhidrosis, the symptoms and complaints and their extent can be quite different. Whether and which complaints occur depends, among other things, on where on the body the disease occurs and which form of hyperhidrosis it is. Regardless of the form, hyperhidrosis causes excessive sweating. The sweat leaves large stains on clothing or footwear, which usually smells unpleasant. Especially on the palms of the hands, the soles of the feet and the armpits, a lot of sweat is formed even with slight exertion. People with hyperhidrosis often suffer from accompanying symptoms such as skin irritations. Typical symptoms include redness, itching and slight swelling. Occasionally, inflammations or sores also form in the affected areas. Apart from this, the condition does not result in any other clear symptoms or complaints. However, excessive sweating can have a negative effect on the psyche. Many of those affected suffer, for example, from inferiority complexes or depressive moods. In the long term, the psychological problems can lead to withdrawal from social life. When hyperhidrosis is treated, there are usually no symptoms. However, surgical closure of the skin glands may cause scarring.
Diagnosis and course
Hyperhidrosis is initially detected by the physician dealing with it by taking a medical history. The patient’s reports can further define the areas of increased sweat production. A familial predisposition to hyperhidrosis also becomes conspicuous in this way. For a more precise determination, the minor test can be performed in patients who do not have an allergy to iodine. For local determination of hyperhidrosis, the affected areas of the body are smeared with iodine solution and sprinkled with starch powder after drying. Areas with increased sweat production then turn black. In the modified minor test according to Achenbach, starch-containing paper impregnated with iodine crystals is used. The course of hyperhidrosis is stressful in the social sphere. Many affected persons tend to withdraw from other people. They suffer from hyperhidrosis and become depressed. Physical limitations arise during mechanical activities. Hands that are sweaty due to hyperhidrosis can impair the operation of tools or keyboards.
Complications
As a rule, hyperhidrosis does not cause physical discomfort, but it does cause severe psychological discomfort and complications. The affected person suffers from excessive sweating. If the loss of fluids is not compensated, dehydration occurs in most cases. As a rule, the affected person is ashamed leads the symptoms of hyperhidrosis. Sweat patches or very unpleasant odors appear, which can be a nuisance to the environment. Not infrequently, the disease leads to social exclusion. The affected person often avoids events. Especially in the hot summer days, hyperhidrosis can lead to severe psychological discomfort and even depression. The pathological sweating can also have a negative effect on relationships. Children also suffer from the discomfort of childhood hyperhidrosis due to bullying and teasing. If dehydration occurs, it has a very negative effect on the general condition of the patient and can further lead to unconsciousness. Hyperhidrosis can be treated by removing the sweat glands. In this case, there are usually no complications. Furthermore, medications can also be used to prevent the abnormal sweating.
When should you go to the doctor?
People who suffer from persistent intense sweating should consult a doctor. A medical clarification is necessary especially if the hyperhidrosis massively affects the well-being and burdens the private as well as professional life. If even minor exertion or excitement leads to heavy perspiration, a doctor must be consulted on the same day. At the latest when accompanying symptoms such as aching limbs, muscles, back or headache occur, medical advice is required. External signs such as pallor and a generally sickly appearance should also be clarified. If dizziness, rapid heartbeat and sudden attacks of sweating occur, the emergency physician must be called. Other alarm signs that must be investigated immediately are pain in the chest area, shortness of breath and impaired consciousness. People suffering from hypothyroidism, obesity, cardiovascular disorders or psychological complaints are particularly susceptible to hyperhidrosis. Anyone who belongs to these risk groups should talk to their family doctor if they experience any of the symptoms mentioned above. Depending on the suspected cause, a dermatologist or a specialist in internal medicine may also be consulted.
Treatment and therapy
Treatment of hyperhidrosis in a secondary condition consists of treating and curing the primary condition. In the primary disease, effective sweat inhibitors are initially used in milder cases. The sweat inhibitor aluminum chloride, which is also present in commercial deodorants, is particularly concentrated in the medical version. The active ingredient closes the pores and, in some cases, causes a reduction in sweat production. Botulinum toxin therapy is also used to treat hyperhidrosis. This is an effective nerve toxin. The triggering nerve stimuli come to a standstill and the sweat production of hyperhidrosis is reduced to a tolerable level. This therapy must be repeated at regular intervals. Drug therapy is possible, but it is by no means free of side effects. In severe cases of hyperhidrosis, surgical interventions can be considered. These include removal of the sweat glands in the armpits, suction with severing of the nerve endings in the subcutaneous tissue or severing of nerve fibers in the chest area. However, this does not guarantee a complete cure of hyperhidrosis.
Outlook and prognosis
Even without treatment, hyperhidrosis may regress or stop over time. This is often seen in children and adolescents, where excessive sweating stops altogether after puberty. Since this can only be observed in a few cases, a visit to the doctor should always be made. This has the advantage that the suffering pressure is lowered and the sweating is reduced to a minimum more quickly. Most sufferers cope well with the therapy offered. However, this does not mean that success is immediate and permanent. Only those who strictly follow the instructions of the specialist experience noticeable relief. The classification as primary or secondary also plays a role in the prognosis.If it is a symptom of another disease, i.e. secondary hyperhidrosis, it must be treated. The excessive sweating goes down at the same time and permanently. The prognosis after surgical interventions varies. Here it depends on the type and location of the surgery. In many cases it has to be done again after a few years. In this case it is essential to see a specialist. Only he will be able to determine the outlook and prognosis of hyperhidrosis well-founded.
Prevention
Prevention in hyperhidrosis is limited. It consists primarily in avoiding triggering factors such as stress or certain foods. In addition, it is recommended for those affected to choose textiles in clothing that are more suitable for the increased sweat production in hyperhidrosis, such as cotton or functional fibers. It is not uncommon for people affected by hyperhidrosis to suffer a loss of quality of life. So that excessive sweating does not result in social withdrawal, various self-help measures are recommended.
Aftercare
The person affected by hyperhidrosis usually has few options or measures of direct aftercare. In the first place, the disease must be properly examined and treated, so that no further complications and discomfort occur. The earlier the hyperhidrosis is detected, the better the further course of the disease usually is. It should also be noted that the disease can also be well limited by the use of proper care products. The doctor should be consulted if the use of these products does not lead to the desired success. The affected person should make sure to change clothes regularly. Especially on hot days or after strenuous or sporting activities, the clothes should be changed. Furthermore, special insoles for shoes can be used to reduce perspiration. Likewise, the cornea should be reduced in order to reduce the production of sweat. Since hyperhidrosis in some cases can also lead to depression or psychological upsets, psychological counseling can also be provided. Contact with other patients of this disease can also be useful in this regard, as it will lead to an exchange of information.
This is what you can do yourself
If increased sweating occurs under the armpits, the affected person should shave off the armpit hair. This procedure can reduce unpleasant sweat odor. It also makes sense to wear airy clothing made of cotton. Synthetic fibers are better to avoid. In case of sweaty feet it is also advisable to wear leather shoes. On the other hand, soles made of plastic or rubber are not recommended. A significant role in hyperhidrosis is played by the hygiene of the body. Therefore, it is recommended to shower regularly with deodorant soap. Alternating showers and sauna visits are also considered advisable. Deodorants against hyperhidrosis should contain aluminum chloride. If the excessive sweating appears on the feet, the affected person goes barefoot as often as possible. Diet is also important. Thus, it is advisable to avoid hot and spicy foods. The same applies to hot and caffeinated drinks. The person affected should also reduce the consumption of tobacco products. Regular ablutions, foot baths and drinking sage tea can be helpful. Psychological strategies are also considered to be useful self-help measures. These include exchanging ideas with other sufferers in a self-help group and learning breathing techniques and relaxation methods such as autogenic training or yoga. If psychological causes are responsible for the hyperhidrosis, these must be effectively combated. Professional help can also be sought in this regard.
