Almost everyone is familiar with an occasional overactivity of the sweat glands – hardly anyone who wears air-impermeable, non-breathable shoes and socks for a long period of time gets past a sweaty foot. And almost all people get sweaty under stress. But some people have hyperhidrosis – in them, a genetic predisposition is the cause of excessive sweating.
Hyperhidrosis: excessive sweating.
Hyperhidrosis is a genetic predisposition to profuse sweating – especially pronounced on the arms, hands and feet, but in principle, profuse sweating is possible all over the body. Heavy sweating is also in the case of hyperhidrosis usually associated with unpleasant odor. Those affected hardly dare to shake hands with others or take off their shoes, have constantly wet armpits and clothes and feel unclean and unkempt. People who sweat excessively and suffer from hyperhidrosis have enormous suffering – they carry stacks of towels to dry themselves, hardly dare to be around people or in relationships.
Causes of hyperhidrosis
The causes of such hyperfunction of the sweat glands as in hyperhidrosis are often unclear – a hereditary component may play a role in hyperhidrosis. The psyche can contribute to keeping the vicious cycle of hyperhidrosis going: Stress and anxiety causes sweating, and the sweating episodes in turn lead to stress. Hyperhidrosis can be the concomitant of other diseases: In addition to diabetes and tuberculosis, people sweat particularly much in the case of malaria, hyperthyroidism, certain tumors (for example, Hodgkin’s lymphoma) or after taking medication (antidepressants or caffeine). Hot flashes and heavy sweating also become noticeable as an annoying companion of menopause. In the case of newly occurring sweating attacks – especially at night – a doctor should rule out serious causes in any case.
Therapy for mild hyperhidrosis
In the case of a weak degree of hyperhidrosis, simple measures such as.
- Daily showering
- Shave underarm hair
- Clothing made of natural fibers
- Deodorant soaps and deodorants
For light to moderate sweating, antiperspirants inhibit sweat production. They contain, for example, aluminum chloride, hexamethylene tetramine, formalin or glutardehyde.
Treatment of marked hyperhidrosis.
For more pronounced cases, there are other options:
- Drug treatment
- Ionophoresis (low current therapy)
- Treatment with Botox
- Surgical interventions
- Psychotherapeutic treatment
- Alternative medical approaches
Medication against sweating
There are some drugs, for example, with the active ingredient methanthelinium bromide, which reduce sweating throughout the body. However, these have significant side effects and are therefore little used.
Ionophoresis – low current therapy.
A standard therapy for severe hand or foot sweat is tap water iontophoresis. This involves immersing hands and feet in a salt bath to which a weak direct current is applied via electrodes. The current is generated by a specially designed direct current generator. The channels leading to the outside of the sweat glands are temporarily blocked by coagulation of proteins without damaging the glands. A session lasts about 20 minutes and must be repeated regularly several times a week, at least initially. Many patients who sweat only a little or moderately excessively are helped by ionophoresis over a longer period of time, up to 3 months. However, the success cannot be calculated individually. Those who sweat heavily, especially on the body or in the armpits, cannot use this treatment method. Whether and to what extent this treatment is covered by health insurance must be clarified in each individual case.
Treatment with Botox
Botulinum toxin A is a poison (toxin) of the bacterium Clostridium botulinum. This bacterium is actually known as a causative agent of food poisoning. As an active ingredient, Botox has attracted attention in recent years, especially in cosmetic surgery. Therapeutically, however, industrially produced Botox is used to inhibit the transmission of nerve stimuli. In the case of hyperhidrosis (especially underarm perspiration), nerve impulses to sweat gland cells and thus sweating can be inhibited.The active ingredient is injected in very low concentrations directly into the subcutaneous fatty tissue, which can be very painful, especially on the feet, and requires a good anesthetic. The treatment usually has to be repeated (after half a year at the earliest).
Surgery: removal of the sweat glands
Surgical interventions are rare and not without controversy – from the removal of sweat glands in the armpits (by means of suction = suction curettage) to the cutting of “sweat nerves” in the chest or abdomen. This endoscopic transthoracic sympathectomy (ETS) is mainly used for sweating in the face, under the armpits and/or hands; sweating in other parts of the body occurs as a side effect.
Psychotherapy and alternative medicine for sweating
Some patients are helped by an accompanying psychotherapeutic treatment to cope better with their disease. From herbal medicine, sage in particular is known for its antiperspirant effect – but it must be used over a longer period of time. Methods from complementary medicine such as acupuncture and homeopathy have also proven helpful in some cases.
