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Hyperhidrosis
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Hyperhidrosis

Pronounced: Hi-per-hi-dro-sis

En Español (Spanish Version)

Definition

Hyperhidrosis is excessive sweating. It can be an embarrassing and serious problem, affecting social, professional, and intimate relationships.

Hyperhidrosis can be localized. This means it affects a specific part of the body, most commonly the palms of the hands, soles of the feet, or armpits. It can also be generalized, which means it affects the entire body.

Sweat Gland

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Causes

Hyperhidrosis is divided into two categories: primary and secondary .

Primary has no known cause. If you have primary hyperhidrosis, a sweating attack may be triggered by:

  • High emotional states (eg, intense sadness, fear, anger, stress)
  • Spicy foods
  • Hot climates
  • Certain medications:
    • Fever-lowering medicines
    • Insulin
    • Meperidine
    • Emetics (vomit-inducing medicines)
    • Alcohol
    • Pilocarpine

Secondary is caused by an underlying condition. These include:

  • Menopause
  • Fever
  • Infection
  • Cancer, such as lymphoma
  • Thyroid disease
  • Acromegaly or anterior pituitary tumor
  • Hypothalamic disorders
  • Adrenal tumor
  • Parkinson's disease
  • Nervous system disorders
  • Diabetes
  • Tuberculosis
  • Drug withdrawal
  • Certain medications:
    • Fever-lowering medicines
    • Insulin
    • Meperidine
    • Emetics (vomit-inducing medicines)
    • Alcohol
    • Pilocarpine

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition. The main risk factors that have been identified for hyperhidrosis are the conditions that cause secondary hyperhidrosis, which are listed above.

Symptoms

Symptoms include:

  • Sweaty palms of the hands and/or soles of the feet
  • Sweaty armpits
  • Change in amount of sweating
  • Change in pattern of sweating
  • Change in the odor associated with sweating
  • Stained clothing

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. There are no specific tests to diagnose hyperhidrosis. A starch-iodine testtypically used on armpits may be used to determine the areas of the most active sweat glands. Tests may be ordered if your doctor is concerned that you may have a specific medical condition.

Treatment

Treatment includes:

Lifestyle Changes

Frequent clothing changes and careful washing can help decrease the uncomfortable feeling and odor associated with sweating.

Topical Treatments

A number of treatments can be applied to decrease sweating in a particular area. These include:

  • Aluminum chloride hexahydrate
  • Aluminum tetrachloride
  • Formalin compresses
  • Glutaraldehyde compresses
  • Iontophoresis (stimulation with electrical current) – the use of a battery-powered electrical device to apply an electrical current to the affected area. This procedure needs to be repeated on a daily or weekly basis, eventually tapering off to every 1-2 weeks. This may be used for some cases of hyperhidrosis if prescription antiperspirants don't work.

Medications

These may include:

  • Scopolamine
  • Phenoxybenzamine
  • Propantheline

Botulinum A Neurotoxin

This is the poison produced by the bacteria that cause botulism. Injections of this poison can decrease sweating in certain areas such as on the palms of the hands and soles of the feet.

Surgery

This involves the destruction of nerves that stimulate sweating (endoscopic thoracic sympathectomy), local removal of sweat glands via surgical scraping (curettage), or liposuction techniques

Prevention

There are no known ways to prevent hyperhidrosis.

RESOURCES:

Hyperhidrosis
http://www.hyperhidrosis.ca

International Hyperhidrosis Society
http://www.sweathelp.org

CANADIAN RESOURCES

Canadian Institute for Health Information
http://www.cihi.ca/cihiweb/dispPage.jsp?cw_page=home_e

Health Canada
http://www.hc-sc.gc.ca/index_e.html

References:

Braunwald E, Fauci AS, Kasper DL, Hauser SL, Longo DL, Jameson JL, eds. Harrison's Principles of Internal Medicine . 15th ed. McGraw-Hill Professional; 2001.

Cecil Textbook of Medicine . 22nd ed. WB Saunders Company; 2004.

Cecil Textbook of Medicine . 21st ed. WB Saunders Company; 2000.

Kasper DL et al. Harrison's Principles of Internal Medicine . 16th ed. McGraw-Hill Professional; 2004.

Primary Care Medicine . 4th ed. Lippincott Williams & Wilkins; 2000.

Treatment of hyperhidrosis. Dermatologic Clinics . 1998 Oct.



Last reviewed November 2007 by Ross Zeltser, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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