Hyperhidrosis Health Article

Definition

A disorder marked by excessive sweating. It usually begins at puberty and affects the palms, soles, and armpits.

Description

Sweating is the body's way of cooling itself and is a normal response to a hot environment or intense exercise. However, excessive sweating unrelated to these conditions can be a problem for some people. Those with constantly moist hands may feel uncomfortable shaking hands or touching, while others with sweaty armpits and feet may have to contend with the unpleasant odor that results from the bacterial breakdown of sweat and cellular debris (bromhidrosis). People with hyperhidrosis often must change their clothes at least once a day, and their shoes can be ruined by the excess moisture. Hyperhidrosis may also contribute to such skin diseases as athlete's foot (tinea pedis) and contact dermatitis.

Causes and symptoms

Conditions or situations that can trigger hyperhidrosis are varied. They include stressful situations, eating spicy foods, consuming alcohol, the presence of underlying disorders (e.g. tuberculosis, malaria, lymphoma, and diabetes), menopause, hormonal imbalances, and the use of certain drugs. Physicians believe that hyperhidrosis can be linked to a breakdown in communication between the brain and the mechanisms that activate sweating. In addition, a genetic link may also exist: about 40% of people with the condition have a family history of it.

Diagnosis

The condition is diagnosed by patient report and a physical examination.

Treatment

Most over-the-counter antiperspirants are not strong enough to effectively prevent hyperhidrosis. To treat the disorder, doctors usually prescribe 20% aluminum chloride hexahydrate solution (Drysol), which the patient applies at night to the affected areas that are then wrapped in a plastic film until morning. Drysol works by blocking the sweat pores. Formaldehyde- and glutaraldehyde-based solutions can also be prescribed; however, formaldehyde may trigger an allergic reaction and glutaraldehyde can stain the skin (for this reason it is primarily applied to the soles). Anticolinergic drugs may also be used. In addition, an electrical device that emits low-voltage current can be held against the skin to reduce sweating. These treatments are usually conducted in a doctor's office on a daily basis for several weeks, followed by weekly visits. Dermatologists also recommend that patients wear clothing made of natural or absorbent fabrics also may help, avoid high-buttoned collars, use talc or cornstarch, and keep underarms shaved.

The only permanent cure for hyperhidrosis of the palms is a surgical procedure. To treat severe excessive sweating, a surgeon can remove a portion of the nerve near the top of the spine that controls palm sweat. However, not very many neurosurgeons in the United States will perform the procedure. Alternatively, it is possible to remove the sweat gland-bearing skin of the armpits, but this is a major procedure that may require skin grafts.

Prognosis

While the condition cannot be cured without radical surgery, it can usually be controlled effectively.

PERIODICALS

Angerman, Judith E. "Putting a Stop to Sweating." Good Housekeeping, 1 July 1995, 162.

ORGANIZATIONS

American Academy of Dermatology. 930 N. Meacham Road, P.O. Box 4014, Schaumburg, IL 60168-4014. (847) 330-0230. <http://www.aad.org>.

Carol A. Turkington

KEY TERMS

Anticolinergic drugs—Drugs that block the action of the neurotransmitter acetylcholine.

Bromhidrosis—Bacterial breakdown of sweat and cellular debris resulting in a foul odor.

Contact dermatitis—Skin inflammation that occurs when the skin is exposed to a substance originating outside of the body.

Tinea pedis—Fungal infection of the feet of the skin characterized by dry, scaly lesions.