Hyperhidrosis, colloquially known as excessive sweating, is characterized by excessive sweating affecting the hands, feet, and armpits. As a side effect of other diseases, it can affect the entire body surface. Hyperhidrosis is relatively harmless physically, but has powerful psychological effects on patients.

What is hyperhidrosis?

With hyperhidrosis, sweat leaves large stains on clothing or shoes, which usually smell unpleasant. Especially on the palms of the hands, the soles of the feet and the armpits, a lot of sweat forms even with slight exertion. See AbbreviationFinder for abbreviations related to Hyperhidrosis.

It has not yet been clarified that hyperhidrosis leads to abnormally strong activity of the sweat glands. In the case of primary hyperhidrosis, this refers to the hands, feet and armpits.

When the condition affects the entire body, it is diagnosed as secondary hyperhidrosis, which occurs as a result of a primary condition. Normal sweating is usually the body’s response to heat or infection when you have a fever. This mechanism is disrupted in hyperhidrosis.

Sufferers experience excessive sweating, which also affects areas of the body that are not usually heavily affected by sweat. This includes the sides of the hands or the tops of the feet. Depending on the severity, hyperhidrosis can be treated with different methods.

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 extent. It is unclear what triggers this false reaction.

It is sometimes assumed that psychological causes such as stress or insecurity are a factor. A common cause of secondary hyperhidrosis, on the other hand, is hormonal imbalances or drugs that increase sweat production. It is a well-known side effect of menopause.

Depending on the severity of the hyperhidrosis, the palms of the hands, the backs of the hands or the tops 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 intensifies the psychological stimuli that promote hyperhidrosis.

Symptoms, Ailments & Signs

In the case of hyperhidrosis, the symptoms and complaints and their extent can be very different. Whether and which symptoms occur depends, among other things, on where on the body the disease occurs and what form of hyperhidrosis it is. Regardless of the form, hyperhidrosis involves excessive sweating.

The sweat leaves large stains on clothing or shoes, which usually smell unpleasant. Especially on the palms of the hands, the soles of the feet and the armpits, a lot of sweat forms even with slight exertion. People with hyperhidrosis often suffer from accompanying symptoms such as skin irritation. Typical symptoms include reddening, itching and slight swelling. Occasionally, inflammation or sores form in the affected areas.

Apart from that, the disease 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, mental problems can lead to withdrawal from social life. When treating hyperhidrosis, there are usually no symptoms. However, surgical closure of the skin glands can cause scars.

Diagnosis & History

Hyperhidrosis is first recorded by the doctor dealing with it through an anamnesis. The patient’s reports can pinpoint the areas of increased sweat production. A family predisposition to hyperhidrosis is also noticeable.

For a more precise determination, the minor test can be carried out in patients who are not allergic to iodine. To determine the local hyperhidrosis, the affected parts of the body are coated with iodine solution and, after drying, sprinkled with starch powder. Areas with increased sweat production then turn black. In the modified minor test according to Achenbach, starchy paper is used that is impregnated with iodine crystals.

The course of hyperhidrosis is stressful in the social sphere. Many sufferers tend to withdraw from other people. They suffer from hyperhidrosis and become depressed. Physical limitations result from mechanical activities. Sweaty hands caused by hyperhidrosis can affect the use of tools or keyboards.

Complications

As a rule, hyperhidrosis does not lead to physical symptoms and complications, but to severe psychological ones. The patient suffers from excessive sweating. If the fluid loss is not compensated for, dehydration occurs in most cases. Usually the sufferers feel ashamed of the symptoms of hyperhidrosis.

This results in sweat stains or very unpleasant odors that can pollute the environment. It is not uncommon for the disease to lead to social exclusion. The affected person often avoids events and happenings. Especially on hot summer days, hyperhidrosis can lead to severe mental health problems and even depression. The abnormal sweating can also have a negative effect on relationships.

Children also suffer from the symptoms 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. Usually there are no complications. Medications can also be used to prevent abnormal sweating.

When should you go to the doctor?

People who suffer from persistent intense sweating should consult a doctor. Medical clarification is necessary above all if the hyperhidrosis has a massive impact on well-being and is a burden on private and professional life. If excessive sweating occurs even with little exertion and excitement, a doctor must be consulted on the same day. Medical advice is required at the latest when accompanying symptoms such as joint, muscle, back or headaches occur. External signs such as paleness and a generally ailing appearance must also be clarified.

If dizziness, tachycardia and sudden sweating attacks occur, the emergency doctor must be called. Other alarm signs that need immediate attention include chest pain, shortness of breath, and loss of consciousness. People who suffer from an underactive thyroid, are overweight, have cardiovascular disorders or have psychological problems are particularly susceptible to hyperhidrosis. Anyone who belongs to these risk groups should speak to their family doctor if they experience the symptoms mentioned. Depending on the suspected cause, a dermatologist or a specialist in internal medicine can also be consulted.

Treatment & Therapy

The treatment of hyperhidrosis when it is a secondary condition is to treat and cure the main condition. In the case of the primary disease, effective sweat inhibitors are initially used in milder cases.

The antiperspirant aluminum chloride, which is also found in commercially available deodorants, is particularly concentrated in the medicinal version. The active substance closes the pores and in some cases ensures that sweat production is reduced. Therapy with botulinum toxin is also used for hyperhidrosis. It is a potent neurotoxin. 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. This includes the removal of the sweat glands in the armpits, suction with cutting of the nerve endings in the subcutaneous tissue or cutting of nerve fibers in the chest area. However, complete healing of hyperhidrosis cannot be guaranteed.

Outlook & Forecast

Even without treatment, hyperhidrosis can resolve or stop over time. This is often seen in children and adolescents, where excessive sweating sets in completely after puberty. Since this can only be observed in a few cases, you should always go to the doctor. This has the advantage that the level of suffering is reduced and sweating is reduced to a minimum more quickly. Most of those affected cope well with the therapy offered. That does not mean, however, that the success is immediate and permanent. Only those who strictly follow the instructions of the specialist will experience noticeable relief.

The classification according to 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. Excessive sweating decreases at the same time and permanently. The prognosis after surgery varies. It depends on the type and location of the operation. In many cases it has to be repeated after a few years. A visit to a specialist is essential here. Only he will be able to determine the prospect and prognosis of hyperhidrosis in a well-founded manner.

Prevention

Prevention for hyperhidrosis is limited. It consists primarily of avoiding triggering factors such as stress or certain foods. In addition, it is recommended for those affected to choose textiles for 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 from a loss of quality of life. Various self-help measures are recommended so that excessive sweating does not result in social withdrawal.

Aftercare

In the case of hyperhidrosis, those affected usually only have a few options or measures for direct aftercare. The disease must first and foremost be properly examined and treated so that there are no further complications and symptoms. The earlier hyperhidrosis is detected, the better the further course of the disease.

It should also be noted that the disease can also be limited by using the right care products. The doctor should be consulted if the use of these remedies does not lead to the desired success. The patient should make sure to change their clothes regularly.

Clothing should be changed, especially on hot days or after strenuous or sporting activities. Furthermore, special insoles for shoes can also be used to reduce perspiration. The cornea should also be reduced in order to reduce the production of sweat.

Since hyperhidrosis can also lead to depression or psychological upsets in some cases, psychological counseling can also be carried out. Contact with other patients of this disease can also be useful, as this leads to an exchange of information.

You can do that yourself

If there is increased sweating below the armpits, the affected person should shave off the armpit hair. This procedure reduces the unpleasant smell of sweat. It also makes sense to use airy clothing made of cotton. Synthetic fibers are better avoided. If you have sweaty feet, it is also advisable to wear leather shoes. On the other hand, shoe soles made of plastic or rubber are not recommended.

Body hygiene plays a significant role in hyperhidrosis. It is therefore advisable to shower regularly with deodorant soap. Contrast showers and visits to the sauna are also recommended. Deodorants against hyperhidrosis should contain aluminum chloride. If the excessive sweating appears on the feet, the person concerned goes barefoot as often as possible.

Diet is also important. So it is advisable to avoid hot and spicy foods. The same applies to hot and caffeinated drinks. The affected person should also reduce the consumption of tobacco products. Regular washing, foot baths and drinking sage tea can be helpful.

Psychological strategies are also considered sensible self-help measures. This includes 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, they must be combated effectively. Professional help can also be used.

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