Sweating profusely could be a sign to other medical conditions-Hyperhidrosis

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The term hidrosis implies sweating, while hyper on the other hand means too much. Sweating is a bodily function that helps regulate the body temperature. It is also the release of a salt-based fluid from the sweat glands. However, when the sweat is more than what is needed to regulate body temperature, it is referred to as Hyperhidrosis. It is defined as sweating that disrupts normal activities. It describes a situation that even when you are not hot, anxious, or exercising, you make a lot of sweat.

 It is not only embarrassing but also a health condition that mostly begins during adolescence age. It affects mostly these parts of the body: armpits face, feet, palms of the hands and soles of the feet.

Classifications

Excessive sweating is classified into three types: primary, secondary and generalized.

Primary (idiopathic) focal hyperhidrosis

Excessive sweating that occurs in one or more of the following focal places: palms of the hands; soles of the feet; armpits face/scalp. The exact cause is not known and it is not associated with any other conditions. It is just that the sweat glands in these areas are overactive or more sensitive than normal. In some people, it may run in the family so there may be some genetic factor involved in causing it. 

The severity can vary from time to time. It may come and go and can be made worse by triggers such as anxiety, emotion, spicy foods, and heat. Anxiety about the sweating itself may make it worse. However, for most of the time, nothing obvious triggers the sweating. It tends to be a long-term condition, but symptoms improve in some cases over time.

Secondary focal hyperhidrosis

This is an excessive sweating that occurs in a particular focal part of the body. But, unlike primary focal hyperhidrosis, there is a known or likely cause. For example, a spinal disease or injury may cause sweating in one leg. 

Generalised hyperhidrosis

This means that you sweat more than normal all over. This is less common than primary focal hyperhidrosis. However, it is usually caused by an underlying medical condition. 

Signs and symptoms

Wet palms of the hands

Wet soles of the feet

Frequent sweating

Noticeable sweating that soaks through clothing

Irritating and even painful skin problems, such as fungal or bacterial infections

Constantly worried about having stained clothing

Reluctant to make any physical contact

Socially withdrawn

Causes

Anger

Fear

Emotional stress 

Spinal cord injury

Alcohol abuse

Anxiety

Diabetes

Gout

Heart disease

Hyperthyroidism 

Obesity

Parkinson’s disease

Pregnancy

Respiratory failure

Shingles

Hodgkin’s disease

HIV

Malaria

TB (tuberculosis)

Possible complications 

Hyperhidrosis is generally distressing and embarrassing. The complications include:

Developing cold,

Sweaty handshake 

Destruction of work documents, computer keyboards through bad palm sweat

Frequent wet patch that develops on clothes under the arms

Frequent change of clothes during the day

The affected skin can become sore, irritated and prone to infection. There is a risk of developing eczema on affected skin.

Treatment options 

Use a bland soap substitute such as a moisturiser

Avoid triggers which can make things worse such as heat or spicy food

For armpit sweating: use normal antiperspirants regularly

Avoid clothes that easily show up sweat marks; wear white and black coloured clothes which are less noticeable when wet than other colours

Wear loose clothing under the armpits 

Avoid clothes made with man-made fibres such as nylon

Change your socks at least twice a day

Use an absorbent foot powder twice daily

Wear a different pair of shoes on alternate days

Avoid sport shoes or boots 

Use aluminium chloride

However, if the above general measures and antiperspirant treatments do not work, your doctor may suggest that they refer you to see a skin specialist (dermatologist). The specialist may suggest one of the following treatments:

Iontophoresis: treatment that uses electrical stimulation. It is used mainly to treat sweating of the palms and/or soles. It can also be used to treat armpit sweating. It works well in most cases. 

Botulinum toxin injections: an option that usually works well for armpit sweating. Treatment consists of many small injections just under the skin in the affected areas. The botulinum toxin stops the nerves in the skin that control the sweat glands from working. Botulinum toxin is not licensed to treat sweating of the palms and face. This is because there is a risk that the injections may stop some of the nearby small muscles of the hands or face from working.

Surgery: an operation is an option for people who have not been helped much by other treatments, or if other treatments cause unacceptable side-effects or problems.

For armpit sweating – an option is to remove the sweat glands in the armpit with suction curettage, laser sweat ablation (LSA). 

For palm sweating- through endoscopic thoracoscopic sympathectomy. It is done by keyhole surgery, using a special telescope to locate the nerve, and then to cut the nerve. 

 



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