Excessive Sweating - Hyperhidrosis

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THE term hyperhidrosis is used when a person sweats at inappropriate times and suffers because of it.

How much the condition interferes with one’s life depends in part on the social environment.

A construction worker, for instance, is probably not bothered by excessively sweaty armpits. For a receptionist at a plush hotel, however, sweaty hands resulting from hyperhidrosis can be a serious problem. The hands may become so wet, in fact, that beads of sweat roll off them. 

There are two kinds of hyperhidrosis, primary and secondary. In the latter case, the sweating occurs as a result of another medical condition such as an infection, an illness, a hormonal disorder or poisoning. Doctors then treat the underlying condition.

In primary, or focal hyperhidrosis, no cause can be found. Maybe the problem lies in the person’s head, or maybe in the nerves that lead to the sweat glands.

“The regulation of body temperature by the brain is complex. There is a range of just one or two degrees in which the body feels comfortable, “ said Uwe Wollina, head physician at the Dermatology and Allergology Clinic at Dresden-Friedrichstadt Hospital.

If the body’s temperature begins to rise or sink too much, it takes vital counter-measures. In hot conditions, blood flow is increased to he skin, a process visible in a person’s reddened face. Meanwhile, the sweat glands secrete water, which evaporates on the skin and thereby, cools down the body as well. 

Hyperhidrosis affects approximately 1% to 3% of the adult population in industrialized countries. The condition usually begins during puberty or young adulthood.

Excessive sweating occurs mainly in the armpits. The soles of the feet and palms of the hands are frequently affected as well. Sweating can be so bad that the person’s shoes become soggy and he or she is afraid to shake someone’s hand.

While doctors remain in the dark about what causes primary hyperhidrosis, its treatment is not difficult. There are medications that disable the sweat glands.

The drawback is that all glands then produce less secretions, including the tear glands and salivary glands,” Wollina said. Possible side effects are therefore a dry mouth and dry eyes.

For excessive underarm sweating, Berthold Rzany, a dermatologist and clinical epidemiologist at Berlin’s Charite university hospital, recommends a deodorant containing aluminium chloride or aluminium chloride hexahydrate.

These antiperspirants help in mild cases of hyperhidrosis. People whose skin is irritated by these chemicals or who find them ineffective can have botulinum toxin (Botox) injected into their underarms, which temporarily blocks the nerves that stimulate sweating. The toxin is effective for at least six months, after which the painful procedure must be repeated.

For excessive sweating of the hands and feet, iontophoresis can help. The hands and feet are placed into basins filled with tap water. Electrodes then pass a gentle current of electricity through the water to lower the sweat glands’ production. The procedure must be repeatedly daily at first. Iontophoresis can also be done at home; the necessary equipment is available,” Wollina said.

If none of these methods help, doctors can surgically remove the sweat glands.

Another therapy, which has been practiced for about three years now and is not yet routine involves burning away sweat glands in the armpits with a laser.

There is, strictly speaking, no cure for hyperhidrosis. Almost all of the therapies are prolonged. Left untreated, excessive sweating can, however, decrease over time. It can take a while though. For untreated women, hyperhidrosis does not improve until menopause. - dpa