Hyperhidrosis
Does hyperhidrosis have a solution? All the information about the causes, symptoms, and treatments for this condition.
Symptoms and Causes
Hyperhidrosis is the excessive production of sweat that occurs spontaneously, even persistently, without being triggered by heat, physical exertion, or stressful situations, although these factors can intensify it.
Depending on the area where excessive sweating occurs, hyperhidrosis is classified into:
- Localized or focal hyperhidrosis: Sweating is limited to certain areas of the body and usually does not occur during sleep. The most affected areas are:
- The palms of the hands (palmar hyperhidrosis).
- The face (facial hyperhidrosis).
- The underarms (axillary hyperhidrosis).
- The feet (plantar hyperhidrosis).
- Generalized hyperhidrosis: Excessive sweating appears all over the body.
Hyperhidrosis usually begins in childhood or adolescence and causes significant physical and emotional distress, making daily life and social interactions more difficult for those affected.
Symptoms
The main symptom of hyperhidrosis is intense, uncontrolled sweating in different parts of the body without an apparent cause.
Causes
Excessive sweating is due to the hyperactivity of the sweat glands. Depending on its causes, hyperhidrosis is classified into two types:
- Primary or idiopathic hyperhidrosis: This is the most common form. It has no apparent cause, is localized, and often has a family history. It typically does not occur during sleep.
- Secondary hyperhidrosis: It results from other medical conditions, such as diabetes, tumors, respiratory failure, thyroid disorders, dermatological conditions, certain types of cancer, menopause, Parkinson’s disease, infections, or the use of antidepressants or other medications.
Risk Factors
The likelihood of developing hyperhidrosis increases in the following cases:
- Having medical conditions or taking medications that cause sweating.
- Being exposed to sweating triggers, such as intense physical activity or stressful situations.
- Consuming alcohol or spicy foods.
- Having a family history of hyperhidrosis.
Complications
Although hyperhidrosis is not a serious disease, it can lead to body odor, skin maceration, secondary skin infections, and contact dermatitis. It also has a significant negative impact on a patient’s social and emotional well-being and can reduce their quality of life.
Prevention
There is no way to prevent primary hyperhidrosis, while secondary hyperhidrosis caused by underlying medical conditions may improve with appropriate treatment. Excessive sweating and its effects can also be minimized by avoiding stressful situations or intense physical activity, wearing breathable fabrics, maintaining proper daily hygiene, and avoiding alcohol or spicy foods.
Which Doctor Treats Hyperhidrosis?
Hyperhidrosis is evaluated by dermatology specialists, who will refer the patient to the appropriate surgical teams for treatment.
Diagnosis
After analyzing symptoms and conducting a clinical examination, a dermatologist may perform tests to identify the cause of hyperhidrosis and assess its progression:
- Sweat test to confirm the focus of excessive sweating, evaluate its intensity, or monitor its progression after treatment:
- Minor’s test (iodine-starch test): A solution of iodine and starch powder is applied to the area under evaluation. The combination causes the excessively sweaty area to turn dark blue, helping to define the most affected regions.
- Paper test: A special paper is placed on the affected area to absorb sweat, which is then weighed to measure the amount of sweat produced.
- Blood and urine tests to determine if sweating is caused by hypoglycemia or thyroid disorders.
- Imaging tests to rule out the presence of tumors.
Treatment
Treatment typically starts by addressing the underlying condition causing hyperhidrosis. If no underlying cause is found, therapies focus on controlling sweating:
- Aluminum chloride-based antiperspirants: These block the sweat ducts. They are mainly applied to the underarms and are highly effective, though they may cause skin irritation. Deodorants do not treat hyperhidrosis but help control body odor.
- Anticholinergic medications in the form of creams, pills, or wipes: These reduce sweat production by acting on acetylcholine, the neurotransmitter responsible for triggering sweating. As a side effect, they also inhibit saliva production and other functions involving acetylcholine.
- Iontophoresis: Used to reduce sweating in the hands and feet. This procedure involves applying an electric current through a water solution where the affected areas are submerged. It temporarily blocks the sweat glands.
- Botulinum toxin: Injected into the nerves that activate the sweat glands, reducing sweating for several months. This is particularly effective for excessive underarm sweating.
- Microwave therapy: This eliminates sweat glands using microwave energy.
- Surgical removal of sweat glands: Used for severe axillary hyperhidrosis. The glands are removed through curettage (scraping) or liposuction.
- Endoscopic thoracic sympathectomy: Primarily used for palmar hyperhidrosis. It involves removing a small section of the spinal nerves that control hand sweating. Due to possible complications and side effects, this surgery is only considered in extreme cases.
