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Hyperhidrosis

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VOL: 101, ISSUE: 20, PAGE NO: 29

What 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.

Causes
- Over activity in the sympathetic ganglion chain, which causes over-stimulation of the eccrine sweat glands.

Incidence
- 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.

Differential diagnosis
- 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.

Treatment
- 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.

FURTHER INFORMATION
The Hyperhidrosis Support Group for Patients and Medical Staff

www.hyperhidroisuk.org

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