VOL: 101, ISSUE: 20, PAGE NO: 29What is it?
What is it?
- Hyperhidrosis is a condition causing excessive sweating of the hands, feet and axillae.
- It can sometimes occur in the head, face, chest, back and groin.
- It can be severe and can cause considerable social, psychological and occupational problems leading to a marked effect on the patient's life.
- Regardless of where it is located, hyperhidrosis presents an embarrassing problem to all those afflicted with it.
Signs and symptoms
- Excessive sweating occurring at all times on any part of the body but mostly on the hands, feet and axillae.
- Constant excessive sweating can lead to maceration of the toes and mycotic infections.
- Over activity in the sympathetic ganglion chain, which causes over-stimulation of the eccrine sweat glands.
- It is thought to affect about one per cent of the population.
- It can occur from early childhood until early adulthood, though the peak incidence is in the teenage years.
- In about 50 per cent of people who have hyperhidrosis there is a familial history of the disease.
- It is important to rule out general hyperhidrosis.
- Possibility of hyperthyroidism should be excluded with routine blood testing.
- Psychiatric disorders should be considered.
- Possibility of menopause should be excluded.
- Obesity may also be a cause of excessive sweating.
- Antiperspirants containing aluminium chloride in higher concentrations than that found in over-the-counter products is effective for many people with hyperhidrosis. This is available in products such as Driclor or Anhydrol.
- Disposable axillae pads.
- Antimuscarinic drugs such as oxybutynin and propantheline are often used successfully.
- Iontophoresis can be effective for hand and/or feet hyperhidrosis. This is the topical introduction of ionised drugs into the skin using direct current. It involves placing hands and/or feet in the plastic water filled baths of an Iontophoresis machine. In some areas of the country this is also available for hyperhidrosis of the axillae.
- Botulinum toxin can be used but is only licensed for axillary hyperhidrosis and is not often available on the NHS.
- Retrodermal curretage is available from a very few specialists in the country. It is sometimes suitable for axillary hyperhidrosis and undertaken using local anaesthetic.
- Endoscopic thoracic sympathectomy is only recommended when all other treatments fail, as compensatory sweating can affect a considerable proportion of patients following surgery.
The Hyperhidrosis Support Group for Patients and Medical Staff