Hyperhidrosis is a condition where patients experience excessive sweating. Sweating in an important function of the body to keep it cool; but, it should never interfere in a patient’s daily activities. Hyperhidrosis can affect a patient’s quality of life. It can cause frustration and embarrassment; impacting a patient’s ability to perform routine chores and could be an occupational hazard. There are three kinds of hyperhidrosis: primary focal, secondary generalized, and generalized idiopathic
Primary focal hyperhidrosis is a true medical condition not caused by medication or another medical problem. It occurs in specific areas of the body (focal), generally appearing equally on both sides. The most commonly affected areas are the hands, feet, underarms, face, and head. Primary focal hyperhidrosis normally begins during childhood or adolescence, frequently starting with excessive sweating of the hands or feet occurring at least once a week when the person is awake. For some patients this condition may be hereditary.
Generalized idiopathic hyperhidrosis is also a genuine medical condition but it causes large areas of the body to sweat. This is normally treated with oral medications.
Secondary generalized hyperhidrosis can be caused by medical conditions, such as overactive thyroid, menopause, peripheral neuropathy (diabetes), or a stroke. Medications (antidepressants or antihypertensives), heat, and exercise, can also cause secondary generalized hyperhidrosis. A key difference in secondary generalized hyperhidrosis and primary hyperhidrosis is the fact the sweating covers large areas and can occur while sleeping. This condition must be investigated by a dermatologist for proper diagnosis and treatment.
THE IMPORTANCE OF TREATING PRIMARY HYPERHIDROSIS
This condition can affect a patient’s quality of life, by interfering in work and social activities. It can cause emotional embarrassment and isolate people. It is psychologically unsettling and can be associated with anxiety and depression. Also physically debilitating, it may cause discomfort and skin irritation, which can lead to bacterial and fungal infections.
TREATMENT OPTIONS FOR PRIMARY HYPERHIDROSIS
- Antiperspirants - Available over the counter and by prescription, these options include gels, topical sprays, roll-ons, and lotions to decrease sweating. The most common ingredient is aluminum chloride hexahydrate. To be most affective antiperspirant should be applied at night to dry skin, the hair-bearing areas of the axillae (underarm) should be covered, and in the morning it should be washed off. An extremely effective option is Drysol.
- Botulinum toxin type A - This medication is injected by your dermatologist into the palms, underarms, or soles of the feet to minimize sweating. Other areas may also be treated. It blocks the release of acetylcholine (a neurotransmitter) this is a very effective treatment that can last four to eight months. Patients are generally very pleased with the results of Botulinum Toxin injections.
- Iontophoresis - Used to treat sweaty hands and feet, this treatment requires the patient to immerse the hands or feet in a shallow pan filled with water. A medical device sends a low-voltage current through the water. This treatment is done every other day and generally requires six to ten sessions. Repeat treatments will be necessary for maintaining the results. Patients administer the treatments at home. A prescription is necessary for the machine.
- Oral medication - Taken by mouth, medications such as Oxybutinin or Glycopyrrolate are used to prevent the stimulation of sweat glands. They block "cholinergic" receptors in the glands and other areas of the body. Beta blockers such as propranolol can also be helpful when treating stress-induced sweating. Because all medications have possible side effects, the benefits should always outweigh any potential risks.
- Surgical intervention - Underarm (axillary) sweat glands can be removed by scraping (curettage), liposuction, or surgical excision. There may be scarring or compensatory sweating.
- Sympathectomy - This surgical procedure interrupts the autonomic nervous system impulses to the sweat glands. Compensatory sweating is a possible side effect, where non-treated areas experience excessive sweating. Because of this side effect, which affects nearly 80 percent of patients who are treated, sympathectomy should be considered only for those patients who fully understand the risk and in whom other treatments have been properly tried and have failed.
For more information, evaluation and treatment, consult a dermatologist who is the expert on conditions related to skin, hair and nails and can help deal with this irritating, often debilitating condition.
We put academic qualifications, many years of combined experience, and training in a variety of special interest areas to work for your healthy, radiant skin. Our providers – Drs. Schachter, Hanna, Curtis, Abdulla, Pollack, and Taradash – welcome new patients for treatment at the Dermatology on Bloor practice on Park Road in Toronto. Our team is here to serve your needs